Breaking the silence: confidence and barriers in raising concerns among undergraduate dental students- "a national study"

Abstract

Background: Raising concerns in clinical settings, also known as whistleblowing, is vital for safeguarding patient safety and improving the quality of care. Despite research on whistleblowing in medical and nursing fields, there is limited evidence on this topic within dental education. This study aims to assess the self-reported confidence of undergraduate dental students in raising concerns and identify any barriers. Methods: This cross-sectional study utilized an online close-ended questionnaire distributed via Google Forms to senior undergraduate dental students from Jordan University of Science and Technology and the University of Jordan, Jordan. Data collection was voluntary, with subsequent analysis performed using RStudio (version 2023.06.2) incorporating R version 4.0.5. T-tests and Analysis of Variance (ANOVA) were used to assess significant variations between results by gender and stage of study. Results: A total of 382 participants were included in the study yielding a response rate of 30.80%. Of these, 257 were female (67.28%) and 125 were male (32.72%). Overall, 169 (44.24%) participants reported that their institutions had a policy document on raising concerns, while only 71 (18.58%) participants reported receiving formal training in raising concerns at their institution. Approximately 45% of participants reported experiencing situations which warranted raising concerns in clinical settings. The overall mean score for all items was 0.13 (95% CI -0.18 to 0.43). The findings revealed that students were marginally confident in raising concerns related to patient safety. However, their confidence was lower when addressing issues related to the conduct of clinical staff or peers. Common barriers reported included fear of causing trouble, lack of support, and fear of being ignored. ANOVA revealed significant variation by gender and year of study, with female students and final-year students reporting greater self-confidence in raising concerns (p < 0.001). Conclusions: Notwithstanding the limitations of the current study, the results show that participants were marginally confident in raising concerns related to patient safety and several barriers to raising concerns were also identified. These findings underscore the need for dental schools to focus on enhancing students' confidence and empowering them to report concerns when warranted. A transparent and supportive culture can contribute to improvements in patient safety and enhancing professionalism of dental students.