|Year : 2023 | Volume
| Issue : 1 | Page : 60-66
Factors responsible for the performance of final-year dental surgery students in their professional examinations in Nigeria
Kelechi U Imediegwu1, Chidera P Chukwu2, Ifeanyi E Nweze2, Jude C Abor2, Bassey Asuquo2, Valentina I Ebisike2, Ogechukwu T Ugwu2, Ugwu I Hillary2
1 Department of Orthopaedic Surgery, National Orthopaedic Hospital, Enugu, Nigeria
2 College of Medicine and Dental Surgery, University of Nigeria, UNN, Enugu, Nigeria
|Date of Submission||01-Oct-2022|
|Date of Acceptance||28-Nov-2022|
|Date of Web Publication||18-Jan-2023|
Dr. Kelechi U Imediegwu
Department of Orthopaedic Surgery, National Orthopaedic Hospital, Enugu
Source of Support: None, Conflict of Interest: None
Background: Little is known about the factors responsible for the academic performance of clinical dentistry/dental surgery students, particularly those in their finals in Nigerian universities. Objectives: The objectives of the study were to identify the subjective factors that may affect the performance of dental surgery finalists at the undergraduate level in Nigerian dental schools and to proffer realistic suggestions to improve dental surgery education. Materials and Methods: A cross-sectional survey of final-year dental surgery students in Nigeria was conducted using a well-structured validated online questionnaire distributed randomly through online platforms. Descriptive and inferential data analysis was done with Statistical Package for the Social Sciences (SPSS) version 21. Chi-squares and Fischer’s exact values were calculated. Significance was set at P < 0.05. Consent was obtained from all participants. Results: Sixty-nine final-year dental surgery students completed and submitted the questionnaire. The hours spent on clinical hands-on-dental practice, dental surgery lectures/clinics attendance, and impact of particular course lecturers were the top three most agreed factors influencing the performance of dental surgery students in their examinations. A significant relationship (P = 0.027 [<0.05]; X2 = 4.873) exists between gender and the perception in that the greater cumulative number of study hours was alluded to significantly influencing performance in examinations. More females unlike males indicated that the total number of hours studied does not affect performance. A statistically significant association (P = 0.004 [<0.05]; X2 = 13.274) was also found between age grades and the influence of repeating an examination on performance. A majority of the respondents across all age grades indicated that repeating students do not always perform better or even pass the examinations. A majority of the respondents across all age grades indicated that those that have completed a degree before medical school do not always perform better in examinations. This finding also had a statistically significant association (P = 0.048 [<0.05]; X2 = 7.886). Conclusions: There is a need to coordinate efforts in the management of dental institutions to ensure that adequate attention is given to the dental surgery students at every stage of their training. Creation of dental surgery mentorship programmes may also help in the overall quality of the programme.
Keywords: Academic performance, dental surgery, dentistry, professional
|How to cite this article:|
Imediegwu KU, Chukwu CP, Nweze IE, Abor JC, Asuquo B, Ebisike VI, Ugwu OT, Hillary UI. Factors responsible for the performance of final-year dental surgery students in their professional examinations in Nigeria. J West Afr Coll Surg 2023;13:60-6
|How to cite this URL:|
Imediegwu KU, Chukwu CP, Nweze IE, Abor JC, Asuquo B, Ebisike VI, Ugwu OT, Hillary UI. Factors responsible for the performance of final-year dental surgery students in their professional examinations in Nigeria. J West Afr Coll Surg [serial online] 2023 [cited 2023 Feb 6];13:60-6. Available from: https://jwacs-jcoac.com/text.asp?2023/13/1/60/367948
| Introduction|| |
An evaluation of the academic performance of dental students is a task that has become imperative as healthcare demand for qualified dentists skyrockets. This, however, has remained daunting because of the influence of a variety of factors ranging from social, psychological, economical, to environmental, making it difficult to isolate key elements that determine successful performance. The training of dentists at the undergraduate level follows a pathway that sees students acquire theoretical and practical proficiency in areas such as oral biology, conservative dentistry, prosthodontics, periodontology, community dentistry, and oral surgery before they are licensed to practise. This programme is completed within 6 years in Nigeria. Graduates are expected to be high-performing professionals firmly grounded in the scientific basis of their practice and equipped to critically evaluate and work with a diverse patient population. There are currently eight accredited institutions for undergraduate training of dental students in Nigeria.
Dental training is peculiar because of the high degree of hands-on engagement demanded of the trainees, unlike the sister medical faculty where these are not as emphasised. A study noted high stress levels amongst dental students mainly due to the need to take on patient-related responsibilities very on in training, coupled with other personal and societal matters. This contributes to the intense nature of the programme. Some studies have reported a decline in the performance over years.
Learning is assessed by theoretical and clinical examinations at several stages as indicated by the standard guidelines for dental education approved by the medical and dental council of Nigeria. Although the data on the pass rates and graduation quotas of the different dental schools give an institutional idea of the outcome of students during their education, it has become imperative to determine the students’ opinions on this matter. Previous studies assessing the degree of satisfaction with undergraduate dental training in the country reveal a lack of satisfaction with the quality of clinical training in the country. Also, the evaluation of the trainees themselves presents different perspectives of the same problem allowing for an integral formulation of solutions. Globally, efforts are ongoing to improve the approaches to educating dental students. This effort, however, requires the backing of solid evidence. There is, however, a paucity of information on the state of dental education across Nigeria.
We undertook this study to identify factors from the student’s point of view that influence their academic performance. This will help equip stakeholders with information to enable the design of better and sustainable models of medical and dental education. In the long run, this effort will help boost the efficient production of medical and dental graduates to supplement the currently understaffed healthcare system in the country. This study, therefore, aims to identify the subjective factors that may affect the performance of dental surgery finalists at the undergraduate level in Nigeria dental schools and to proffer realistic ideas to improve dental surgery training.
| Materials and Methods|| |
Study area and type
This was a descriptive online cross-sectional study conducted amongst final-year dentistry students in Nigeria across four universities offering dentistry and dental surgery as a course from each of the major regions of the country chosen at random, which includes Obafemi Awolowo University, Ile-Ife, Osun state (representing Western Nigeria); University Of Calabar, Calabar, Cross-rivers state (representing Southern Nigeria); University of Nigeria, Enugu, Enugu state (representing Eastern Nigeria); and University Of Maiduguri, Maiduguri, Borno state (representing Northern Nigeria). We also got data from eight other dental surgery schools during the pilot study.
Study populations are final-year undergraduate dentistry/dental surgery students in Nigeria.
The sampling procedure was of stratified sampling type where each respondent from a particular university was taken as a stratum and representative of that region.
A semi-structured online-based questionnaire was developed by the principal investigator with online Google forms, and accuracy of the content and internal validity of the survey items were finalised by multidisciplinary inputs from the study investigators.
The questionnaires had two sections: Section one assessed sociodemographic characteristics of the respondents such as age, sex, marital status, if they had children, institute of undergraduate study, religion, and ethnic group. Section two assessed factors affecting their performance, which included study hours, friends, mentors, mindset, emotional factors, spirituality, intelligence quotient, discussion groups, and clinical exposure on the part of the respondent.
Measures were taken to limit bias related to survey research such as response, nonresponse bias and systematic errors. Two independent analysts were employed to confirm the accuracy of result findings and analysis.
This study was carried out for a period of 6 months.
Response rate was 71.13% as 69 final-year dentistry students filled and submitted the form from a total of 97 contacts sent out.
Data analysis was carried out using Statistical Package for Social Sciences (SPSS) by IBM version 21. The data were reviewed and cleaned before analysis. Descriptive analyses were conducted to determine the frequencies and proportions of categorical variables in the study sample. Then inferential analysis using Chi-square and the statistical significance set at P < 0.05 were employed to determine statistically significant associations between the categorical variables. Results were presented in tables and figures.
Participants were informed of the purpose of the study and who the researchers are. They were also informed that their participation was voluntary, assured of the confidentiality of the information provided, and their consent was duly provided before filling the questionnaire.
| Results|| |
Social demographic characteristics of respondents
There were 69 respondents from different medical schools across the country with the University of Nigeria Nsukka accounting for a majority of the responses (n = 41; 59.4%), whilst the others were from University of Maiduguri (11; 15.9%); University of Calabar (n = 10; 14.5%); and Obafemi Awolowo University (n = 6; 8.7%). Most respondents were aged between 21 and 25 years (n = 46; 66.7%). Female respondents were the majority (55.1%). Also, a majority of the respondents were single (n = 67; 97.1%).
Factors that influence academic performance
A number of factors grouped into curricular and extracurricular factors were assessed for their perceived impact on the academic performance of undergraduate dental students. [Figure 1] represents the perception of the respondents to questions addressing these factors.
|Figure 1: Students’ perception of factors that influence performance in examinations|
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A significant majority of the respondents indicated that the numbers of hours put in daily positively affected academic performance (n = 65; 94.2%). However, most of the respondents also pointed out that more number of hours studied does not always make for better performance in examinations (n = 39; 56.5%). A high intelligence quotient was perceived to consistently influence the outcome of examinations positively (n = 40; 58%). Other factors perceived by the majority of the respondents to positively affect academic performance were participation in lectures and clinical rotations (n = 65; 94.2%); committed course coordinators (n = 66; 95.7%); participation in group discussions (n = 40; 58%); and revision of past questions (n = 52; 75.4%). Mentorship by senior colleagues was also highlighted as a major contributor to successful performance in examinations.
However, joining social media resource groups, repeating a course, having completed a previous degree programme, and diligent study of textbooks were not perceived to significantly affect academic performance. Certain extracurricular factors such as strong family and friends support network; good religious standings; optimistic outlook towards examinations; and adequate sleep before examinations were also agreed as improving performance in examinations, but others such as being in romantic relationships were perceived to negatively affect performance.
Single students were not seen to generally perform better than married ones, whilst residence within the school environment was not believed to be a major advantage in the examinations by the majority of the respondents.
The disparity in the perception of factors that affect academic performance stratified by gender is shown in [Table 1]. It is interesting to note that males were more likely to perceive that more cumulative number of hours studied affected performance in examinations compared with females as shown in [Figure 2]. A statistically significant difference exists between the perceptions of the two sexes as shown in [Table 1]. Similarly, there was also a disagreement in the perception of the role of textbooks in academic performance. Female respondents were more likely to see diligent studying of textbooks as contributory to good academic performance than males, the majority of whom indicated that diligent studying of textbooks does not affect performance in examinations. There was, however, an agreement on all the other factors between both sexes.
|Table 1: Relationship between sex and students’ perception of different factors that influence performance in examinations|
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|Figure 2: More males indicated that the greater cumulative number of hours of study significantly affects performance in examinations compared to females|
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In addition, a stratification of the perception of factors that affect academic performance by the age range of the respondents as shown in [Table 2] indicated a similarity of perception across all age ranges.
|Table 2: Relationship between age ranges and students’ perception of different factors that influence performance in examinations|
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As seen in [Table 1], a significant relationship (P = 0.027 [<0.05]; X2 = 4.873) exists between gender and the perception that the greater cumulative number of study hours influences significant performance in examinations.
More females indicated that the cumulative number of hours studied does not affect performance.
From [Table 2] above, a statistically significant association (P = 0.004 [<0.05]; X2 = 13.274) was found between age grades and the influence of repeating an examination on performance.
A majority of the respondents across all age grades indicated that the repeating students do not always perform better or even pass the examinations.
A majority of the respondents across all age grades indicated that those that have completed a degree before medical school do not always perform better in examinations. This correlative finding had a statistically significant association (P = 0.048 [<0.05]; X2 = 7.886).
| Discussion|| |
The assessment of the quality of undergraduate dental education is a task that has been ongoing to correctly delineate existing issues with the system and to proffer sustainable solutions.
Amongst the factors revealed to positively influence academic performance, committed course coordinators and lecturers received the most affirmations. This is in line with the findings of Popoola et al. in a work carried out amongst dental students in South-west Nigeria and a similar work amongst dental students in North America., Dental education differs slightly from medical education because of the extensively practical nature of dental training,; hence, diligent tutor attention will translate faster and more efficient skill acquisition amongst the students, which also will lead to a better outcome in examinations. In the same vein, another dental survey on challenges of clinical dental education across Nigerian universities found that a majority of the respondents recommended improved clinical teaching and supervision by consultants for better outcomes in training.
Similarly, participation in lectures and clinical rotations were also identified with better performance in examinations for similar reasons. Popoola et al. also noted that schools that are fully staffed and with adequate facilities also offer the best clinical learning opportunities to their students.
The total number of hours applied to dental studies was also noted to have an impact on academic performance. This finding corresponds to that of a cross-sectional survey done in Jordan, which showed that students who belonged to the excellent and very good grade point category studied for more cumulative number of hours than others. Also the male respondents were more likely to associate more cumulative number of hours studied with better academic performance than the females. In contrast, whilst a cumulative number of hours applied to dental studies were seen to improve performance, we discovered that this followed a sort of plasticity rule as spending excessive hours solely on the study did not always translate to better performance, therefore highlighting the need for a balance.
The role of mentorship in academic performance of students is a factor that is currently being explored globally. We found that mentorship was seen to be an important factor for better outcomes in examinations. This is in keeping with a number of studies on academic performance. Mushtaq and Khan in their study asserted that mentorship was amongst the factors that remarkably impacted performance in school. Mentorship offers the opportunity for the transfer of experience across academic levels and therefore prepares the recipients to improve on the strengths of their mentors whilst avoiding the mistakes they have made. This may explain why it has become invaluable in the educational sector. Other extracurricular factors such as good family and friends support network, involvement in religious activities, and adequate sleep prior to examinations were found to be linked to a better outcome in examinations. Similar findings were noted by Khan et al. in Pakistan, who also maintained that parental involvement and peer academic performance were associated with academic performance. In addition, we also discovered that praying and having an optimistic outlook to examinations were perceived to be related to better outcomes. Considering the intense nature of the undergraduate dental programme, these could be positive coping mechanisms.
On the other hand, we discovered that the place of residence did not have much influence on performance. This differs from the study done in Pakistan, which indicated that apposite institutional environment made for good performance. Our finding was similar, however, with a work carried out amongst dental students in Iran where it was noted that more dental students who lived with their families had better grade point averages compared with the students who lived in dormitories.
We also noted that emotional instability due to romantic relationships and belonging to several media channels were seen to not improve academic performance. Both factors serve to dissipate effort, which should have been properly directed into learning.
Female respondents were more likely to see diligent studying of textbooks as important to good academic performance. This is similar to the findings of a study carried out amongst medical students in Saudi Arabia where Jameel et al. showed that female students spent most of the time reading textbooks compared with males who preferred the lecture handouts provided by the teachers.
| Conclusions and Recommendation|| |
This study determined that the key factors that positively affected the academic performance of dental students include committed course coordinators and lecturers, good participation in lectures and clinical rotations, number of hours studied, and mentorship. We recommend that there is a need to coordinate efforts in the management of dental institutions in order to ensure that adequate attention is given to the students at every stage of their training. An evaluation of the quality of delivery of the teaching staff may need to be done at intervals to ensure that there is continuous improvement in deficient areas. Incentives should also be offered to high-performing faculty to encourage atmospheres of healthy competition. Extracurricular design of mentorship programmes that offer the students the opportunity to meet and engage role models/mentors may be necessary at the institutions. Finally, efforts could be made to ensure that the obstacles to participation in lectures and clinical activities are reduced to the barest minimum. Attendance rules for students existing in the various dental schools should be enforced to encourage more participation.
The authors acknowledge all the participants in this study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
Ethics approval and consent to participate
Ethical clearance was obtained from the Health Research and Ethics Committee, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria, before the commencement of the study.
Consent for publication
Participation was voluntary, and the purpose of the research was explained to each respondent. Informed consent was obtained before inclusion into the study. However, anonymity of participants was ensured, and no personal information was collected during the survey.
Additional data can be made available on request to the corresponding author.
| References|| |
Das A, Bhattacharya S, Chakraborty A Seven factors affecting medical undergraduate students’ performance in academics: A study using Ron Fry questionnaire in eastern India. J Adv Med Educ Prof 2020;8:158-64.
Lantz MS, Chaves JF What should biomedical sciences education in dental schools achieve? J Dent Educ 1997;61:426-33.
Medical and Dental Council of Nigeria. Accredited dental training institutions. Available from: https//mdcnigeria.org/education/dental-training-institutions/
. [Last assessed on 15 Jul 2022].
Shankarapillai R, Nair MA, George R The effect of yoga in stress reduction for dental students performing their first periodontal surgery: A randomized controlled study. Int J Yoga 2012;5:48-51.
Khanal S, Shrestha S Perceived stress among undergraduate students in a dental college: A descriptive cross-sectional study. J Nepal Med Assoc 2021;59:892-6.
Sudhir PK, Varghese KG, George B Evaluation of academic performance of undergraduate dental students in a government medical university in Kerala, India. Indian J Dent Res 2019;30:175-9.
Umeizudike KA, Isiekwe IG, Fadeju AD, Akinboboye BO, Aladenika ET Nigerian undergraduate dental students’ knowledge, perception, and attitude to COVID-19 and infection control practices. J Dent Educ 2021;85:187-96.
Khatami S, Macentee MI Evolution of clinical reasoning in dental education. J Dent Educ 2011;75:321-8.
Todres M, Tsimtsiou Z, Sidhu K, Stephenson A, Jones R Medical students’ perceptions of the factors influencing their academic performance: An exploratory interview study with high-achieving and re-sitting medical students. Med Teach 2012;34:e325-31.
Popoola BO, Denloye OO Nigerian dental students’ assessment of their clinical learning. Afr J Biomed Res 2015;18:29-35.
Henzi D, Davis E, Jasinevicius R, Hendricson W, Cintron L, Isaacs M Appraisal of the dental school learning environment: The students’ view. J Dent Educ 2005;69:1137-47.
Orenuga OO, DaCosta OO A survey of challenges and career aspirations of clinical dental students in Nigerian universities. Nig Dent J 2009;17. doi: 10.4314/ndj.v17i1.54386
Aleidi SM, Elayah E, Zraiqat D, Abdallah R, Al-Iede M Factors affecting the academic performance of medical, dental and pharmacy students in Jordan. Jordan J Pharm Sci 2020;13. https://journals.ju.edu.jo/JJPS/article/view/103185
Mushtaq I, Khan SN Factors affecting students’ academic performance. Global J Management Business Res 2012;9:17-21.
Khan KW, Ramzan M, Zia Y, Zafar Y, Khan M, Saeed H Factors affecting academic performance of medical students. Life Sci 2020;1:8-11.
Jowkar Z, Fattah Z, Khorshidi Asl Z, Hamidi SA Stress, sleep quality, and academic performance among dental students in Shiraz, Iran. Int J Dent 2022;2022:3781324.
Jameel T, Gazzaz ZJ, Baig M, Tashkandi JM, Alharenth NS, Butt NS, et al
. Medical students’ preferences towards learning resources and their study habits at King AbdulAziz University, Jeddah, Saudi Arabia. BMC Res Notes 2019;12:30.
[Figure 1], [Figure 2]
[Table 1], [Table 2]