Assessment of Confidence Level among Interns of a Dental College in Performing Various Dental Procedures Assessment of Confidence Level among Interns of a Dental College in Performing Various Dental Procedures

1Associate Professor, Department of Prosthodontics, Kathmandu Medical College and Teaching Hospital, Duwakot, Bhaktapur, Nepal. 2Lecturer, Department of Community and Public Health Dentistry, Kathmandu Medical College and Teaching Hospital, Duwakot, Bhaktapur, Nepal. 3Professor, Department of Oral and Maxillofacial Surgery, Kathmandu Medical College and Teaching Hospital, Duwakot, Bhaktapur, Nepal. 4Associate Professor, Department of Conservative Dentistry and Endodontics, Kathmandu Medical College and Teaching Hospital, Duwakot, Bhaktapur, Nepal.


INTRODUCTION
Assessment of Confidence Level among Interns of a Dental College in Performing Various Dental Procedures clinical/practical's and they must be skilled in certain competencies set up by the dental institution. 2 Any health care professional including a dentist experiences stress during interaction with their patients and staffs due to problems encountered during treatment as well as their concerns regarding litigation from their patients. Self-confidence in clinical competencies and patient management skills can help to alleviate these occupational stresses to a large extent. 3,4 Dental internship provides an opportunity for students to have an on-the-job training experience on various aspects of diagnosis and management of patients. 5 This period is designed in such a way that the students will gain valuable exposure to skills in a semiindependent way compared to clinical years where they are supervised by the department faculty. The dental interns are expected to gain skills in wide range of topics ranging from diagnosis, endodontics, prosthodontics, minor surgical procedures, and management of complications. 6 Therefore, this study was conducted to assess the self-confidence level among dental interns of Kathmandu Medical College and Teaching Hospital in performing various dental procedures.

METHODS
A descriptive cross-sectional study was conducted among 65 dental interns of two batches by from October to November 2020 after obtaining ethical approval from Institutional Review Committee of Kathmandu Medical College and Teaching Hospital. This dental hospital provided dental services through undergraduate students and dental interns under supervision, dental officers and dental faculties. Thus, dental interns were selected for study by census method after receiving informed consent from them.
Pretested structured questionnaire obtained from a similar study conducted by Wu et al. 5 was used for data collection. The questionnaire consisted of two sections. The first section included demographic data and the second sections had questions regarding assessment of the confidence level in different dental procedures. The participants used a four point likert scoring system to indicate responsesfor their confidence level of competencies in each procedure as follows: 1="poor", 2= "average", 3= "good" and 4= "excellent"The self-administered online Google questionnaire forms were provided to the dental internsvia electronic mail and Viber software application. The personal information was kept confidential and the data were used only for the purpose of the study.
Data were entered in Microsoft Excel Sheet and analyzed in Statistical Package of Social Sciences version 20. Mean and standard deviation were calculated for quantitative data.
Frequency and percentage were calculated for each response of questionnaire.

RESULTS
Total of 69 dental interns were provided with the questionnaire and 65 of them filled the online forms. Therefore, the response rate was 94.2%. The mean age of the study participants was 25.22±0.95years. Out of 65 study participants, 19 (29.2%) were males and 46 (70.8%) were females.The confidence level of the study participants on different dental procedures are presented in table 1.

DISCUSSION
The duration of dental undergraduate program in Nepal is of four and half years followed by one year of rotatory internship. 7 The dental curriculum requires students to be proficient in theoretical knowledge, clinical competencies as well as have interpersonal skills. 8 The newly passed undergraduates in the form of intern may feel employed as an apprentice with the other competent and experienced dentists for gaining confidence and additional skills which could otherwise be taught in the learning years at dental school. 9 Self-assessment of dental interns would be helpful to draw realistic evaluation of dental curriculum. 10 Therefore, this study was conducted to assess the confidence level among dental interns in performing various dental procedures. The study was conducted in Kathmandu Medical College and Teaching Hospital situated in Duwakot, Bhaktapur. This dental institution is affiliated to Kathmandu University(KU) and follows the University's guided curriculum for teaching their students. The dental hospital has well-qualified full time teaching faculties and is well equipped with all the dental instruments and facilities required in different departments. It has wellin flow of patients sufficient for all dental students, interns, dental officers and specialists.
In this study, majority of the dental interns (53, 83.1%) had good confidence and very few (3, 4.6%)had excellent confidence in taking case history and oral examination.
In contrast, a study done in Indian dental school by Lagali-Jirge and Umarani showed that 55% of dental interns were confident and 35% were very confident in eliciting thorough case history. 11 In the present study, most of the dental interns had good confidence in taking and interpreting radiographs (53, 81.5%), making comprehensive diagnosis (39, 60%) and treatment planning (34, 52.3%), communicating with patients (45,  17 The confidence level in rubber dam placement could depend upon the availability of the equipment in the department, its use and difficulty in application.It is essential to make rubber dam placement compulsory for dental students for successful restorative and endodontic treatment.
Dental interns in this study had good confidence in a prosthodontic procedure like acrylic partial denture design and construction (33, 50.8% This study has some limitations. The findings of the present study cannot be generalized due to small survey sample. The actual practice records were not obtained from the dental interns which could make a difference in their confidence level. Also, the NMJ I VOL 03 I NO. 02 I ISSUE 05 I Jul-Dec, 2020 Assessment of Confidence Level among Interns of a Dental College in Performing Various Dental Procedures study was conducted among dental interns during the period of their clinical postings and they may not have undergone rotation to some departments due to which their confidence level could be overestimated in the departments where they were posted and lacking where they were yet to attend.

CONCLUSIONS
The findings of the study concluded that the dental interns were confident in simple dental procedures like history taking, clinical diagnosis, scaling and polishing, restoration and simple extractions. However, they had least confidence in complex procedures like surgical extraction, veneer preparation, molar endodontics, metal partial denture fabrication and bridge preparation. The dental interns need more exposure to the complex treatments during internship to build their confidence level.