Change is never easy: Exploring the transition from undergraduate to dental student in a U.S.-based program

Abstract

The goal of this study was to gain student-centered insights to better understand the challenges of transitioning from undergraduate to dental education. To this end, questionnaires were designed and distributed to incoming dental students, as well as second-, third-, and fourth-year students in the same year for a cross-sectional assessment in 2015/2016. The same questionnaires were also distributed to those same incoming students when they were in their second, third, and fourth years for a longitudinal assessment (2015-2019). There were both open-ended and Likert scale-type questions about expectations (incoming students) and experiences (years 2-4) in dental school compared to undergraduate education. Accordingly, data analysis involved a combination of qualitative and quantitative statistical approaches. Cross-sectional and longitudinal analyses showed that incoming students expected an increased workload in dental school, but also more attention, support, and access to faculty than they received as undergraduates (i.e., they expected a stronger academic support system). All students also reported experiencing more stress and greater difficulty managing their time than expected when compared to their undergraduate experiences. Thus, our study highlights areas of discrepancy between dental students' initial expectations and their lived experience. Importantly, dental schools can take measures to address these discrepancies, foster a better learning environment, and improve students' overall experience to help pave a smooth path for students to become successful and well-prepared oral health care providers.

Fig 1. Cross-sectional study open-ended question responses.

D1 (class of 2019), D2 (class of 2018), D3 (class of 2017), and D4 (class of 2016) students’ responses to expected/experienced differences between (A) undergraduate classes and dental school classes, (B) undergraduate instructors and dental school instructors, and (C) undergraduate non-classroom experiences and non-classroom experiences in dental school surveyed in 2015.

Fig 2. Cross-sectional study Likert scale-type responses.

D1 (class of 2019), D2 (class of 2018), D3 (class of 2017), and D4 (class of 2016) students’ responses to expected/experienced differences between dental school and undergraduate regarding (A) preparedness for dental school, (B) workload, (C) ability to manage time, (D) stress level, and (E) rate of academic support. For preparedness, 0 = Very inadequate, 1 = Somewhat inadequate, 2 = Somewhat adequate, and 3 = Very adequate. For workload, 0 = Much less, 1 = Less, 2 = About the same, 3 = More, and 4 = Much more. For time management, 0 = Much worse, 1 = Worse, 2 = About the same, 3 = Better, and 4 = Much better. For stress level, 0 = Much lower, 1 = Lower, 2 = About the same, 3 = Higher, and 4 = Much higher. For academic support system, 0 = Much worse, 1 = Worse, 2 = About the same, 3 = Better, and 4 = Much better. Data displayed as mean and standard deviation. **P-value < 0.008 and ***p-value < 0.0001 of D2, D3, and D4 in comparison to D1, as determined by Wilcoxon Rank-Sum test.

Fig 3. Longitudinal study open-ended question responses.

Class of 2019 (D1, D2, D3, and D4) students’ responses to expected/experienced differences between (A) undergraduate classes and dental school classes, (B) undergraduate instructors and dental school instructors, and (C) undergraduate non-classroom experiences and non-classroom experiences in dental school throughout all four years of dental school.

Fig 4. Longitudinal study Likert scale-type responses.

D1, D2, D3, and D4 (class of 2019) students’ responses to expected/experienced differences between dental school and undergraduate regarding (A) preparedness for dental school, (B) workload, (C) ability to manage time, (D) stress level, and (E) rate of academic support. For preparedness, 0 = Very inadequate, 1 = Somewhat inadequate, 2 = Somewhat adequate, and 3 = Very adequate. For workload, 0 = Much less, 1 = Less, 2 = About the same, 3 = More, and 4 = Much more. For time management, 0 = Much worse, 1 = Worse, 2 = About the same, 3 = Better, and 4 = Much better. For stress level, 0 = Much lower, 1 = Lower, 2 = About the same, 3 = Higher, and 4 = Much higher. For academic support system, 0 = Much worse, 1 = Worse, 2 = About the same, 3 = Better, and 4 = Much better. Data displayed as mean and standard deviation. *p-value < 0.05, ** p-value < 0.008 and ***p-value < 0.0001 of D2, D3, and D4 in comparison to D1, as determined by the mixed-effects regression modeling.