Literature Review On

Anxiety, Depression &

Burnout In Dental
Students
 Table of Contents

1 About The Article 4 Results

7
Critical Appraisal
Critical Reflection

2 Introduction 5 Discussion
8 Evidence Based
Triangle

3 Materials and
Methods 6 Critical Evaluation
9 References
 ARTICLE
1
• Burnout syndrome among dental students : a short version of the
“burnout Clinical subtype questionnaire” Adapted for the dental
students. (BCSQ-12-SS)
 About The Article
• Name : Burnout syndrome among dental students : a short version of the
“burnout Clinical subtype questionnaire” Adapted for the dental students.
(BCSQ-12-SS)

• Authors : Jesus montero-marin1, Francesca Monticelli2, Marina Casas3,

Amparo Roman2, Inmaculada Tomas3, Margarita Gili4,5 and Javier
Garcia-Campayo.

• Year of publication : 2011

• Journal name : BMC medical education

 Introduction
● Burnout syndrome is always associated with chronic stress in the working system. It is
defined as a situation in which the affected person experiences feelings of “emotional
fatigue”, “depersonalisation”, and “lack of personal achievement”.
● Emotional fatigue : which is the mental exhaustion lead to loss of interest from
respective jobs. As for example because of covid-19 pandemic the students has gone
through a significant life change.
● “Depersonalisation” refers to the development of negative feelings and behaviour
towards other people, and often involves blaming others for one’s own problems.
● “Lack of personal achievement” is the dissatisfaction to desired end, develops negative
thoughts and doubts own abilities. In a study among the university students, those
pursuing medical careers, such as medicine and nursing are more prevalent to burnout
syndromes. But past studies shows that dentists are more likely to develop the
syndrome. The dental students are also at high risk to develop burnout syndrome.
Introduction
● Study shows that 10% of dental students are suffered from serious emotional
fatigue, 28% with depersonalization and 17% with lack of personal
achievement. The dental universities are advised to adopt stress management
skills into their programmes.

● Clinical Subtype Questionnaire or BCSQ-12. ‘Overload’ refers to individuals’

feeling of risking health and personal life in the pursuit of good results, and is
significantly associated with ‘exhaustion’; ‘lack of development’ refers to the
absence of personal growth experiences for individuals together with their desire
take on other jobs where they can better develop their skills, and is significantly
associated with ‘cynicism’; ‘neglect refers to individuals’ disregard as a
response to any difficulty, and is strongly associated with ‘inefficacy’. the aims
of the present study included adapting the BCSQ-12 for use with students,
evaluating its factorial structure, internal consistency, convergent and
discriminant validity, and contrast the socio-demographic and occupational risk
factors associated with the development of each burnout subtype.
 Methods & Materials
 A cross-sectional design was used, with analyses based on self-reported data collected from two
different sites.

Participants provided their informed consent by reading and approving the objectives of the
study, the participants at whom it was targeted.

Collected data on the following socio-demographic characteristics of the participants: age,

gender, whether one was in a stable relationship (“yes” vs. “no”), children (“yes” vs. “no”) etc.
Then participants responded to a short version of the “Burnout Clinical Subtype
Questionnaire”,orBCSQ-12 [18], adapted for use with students.
The BCSQ-12-SS consists of 12 items that were evenly distributed among the dimensions:
“overload” (e.g., “I think I invest more than is healthy in my commitment to my studies”), “lack of
development” (e.g., “I would like to study something else that would be more challenging to my
abilities”), and “neglect” (e.g., “When the results of my studies are not good at all, I stop making
an effort”).
 Results

 The sample of participants consisted of 314 students, who represented a

RR of 83.07%.

 All of the items on the BCSQ-12-SS showed significant correlations among

themselves (75.76% of the total of these correlations). Among the
correlations, 42.42% were > 0.30. All sampling adequacy coefficients
exceeded 0.75, with 66.67% being > 0.80.
 Discussion
• This is the first study that proposes an adaptation of the short version of the “Burnout Clinical
Subtype Questionnaire” or BCSQ-12 [18] for possible application to students, by means of the
“Burnout Clinical Subtype Questionnaire Student Survey” or BCSQ-12-SS.
• The main strength of the present study was its high level of participation, reflected by a high RR,
which made it appropriate to perform our selected analytical procedures.
• The participants were young, and the majority of them were female, did not have children, lived in
shared flats, did not receive a scholarship, enjoyed good family support, and had not failed subjects
over the previous exam period.
• The responses to the items on the BCSQ-12-SS covered a large range of the Likert scale and had
good variability and a high correlation with one another.
• The reliability analysis showed very good results in all dimensions and for all items, which
evidenced the precision of the instrument.
• It is observed that the more hours that students spend studying, the more likely it is for them to
score high on “overload” and, hence, experience more severe levels of Exhaustion.
• The variables “failed subjects over the previous four trimesters” and “received a scholarship “ were
found to be associated with “neglect”. “Neglect” is the central property of the “worn-out” subtype
[14-16], which is characterised by feelings of losing control of study outcomes, a perceived lack of
recognition of one’s efforts and the tendency to give up responsibilities.
1)TITLE: Critical Evaluation
1. It clearly indicates the focus of the study and the target population
2. It reflects the aim of the study
3. The study design adopted is mentioned and specified
4. Title consists of 17 words
5. The title is not specific to the time and place

Alternate title: Burnout syndrome among dental students of Santiago and Huesca Universities in
the year 2010-11 based on a short version of Burnout Clinical Subtype Questionnaire (BCSQ-
12-SS)

2)ABSTRACT:
1. Abstract is informative and structured
2. It gives a precise summary of the study
3. Abstract consists of 355 words
4. Abstract is complex in some areas.
 Critical Evaluation
3)KEYWORDS:
1. 5 keywords are mentioned.

4)INTRODUCTION:
1. A detailed background information is given to understand the aims of the study.
2. The approach of the study is explained.
3. The prevalence and target population and its relevance is explained.
4. The aims and objectives of the study is explained.

5)METHOD:
1. Appropriate study measurement undertaken using the BCSQ-12-SS is highlighted.
2. The statistical procedures undertaken are mentioned.
3. The author has mentioned the ethical clearance made.
4. Limitations of the methods used is not highlighted.
 Critical Evaluation
6)RESULTS:
1. The findings of the study are compared and analysed.
2. The result obtained is presented in a logical manner using tables and charts.
3. Results are based on the aims of the study.
4. A clear indication of the variables are given.
5. The reliability and validity if the study is given.

7)DISCUSSION:
1. A precise, deep and meaningful discussion is given based on the finding.
2. The conclusion is mentioned
3. The current findings are not compared with other related studies.
4. The limitations of the study are not mentioned.

8)REFERENCES:
1. 44 references are given.
2. References are made for every citation.
CRITICAL APPRAISAL:
1. Ethical clearance taken.
2. Reliability and validity of the study.
3. Detailed statistical analysis.
4. The response rate achieved was high.

CRITICAL REFLECTION:
1. Comparison with other studies are not mentioned.
2. Limitations of the study methodology is not mentioned.
3. The clinical importance of the study was not mentioned.
EVIDENCE BASED TRIANGLE

CROSS SECTIONAL SURVEYS

Survey or interview of a
sample or population of
interest at one point in time.
SYSTEMIC
REVIEWS
RANDOMISED
CONTROLLED TRIALS

COHORT STUDIES

CASE CONTROL STUDIES

CASE SERIES, CASE REPORTS

EDITORIALS, EXPERT OPINIONS


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ARTICLE 2
Self Evaluation Of
Anxiety In Dental
Students
About The Article

Topic of the article: Self evaluation of anxiety in

dental students

Author of the article : Karolina Gerreth ,Joanna

Chlapowska,Katarzyna Lewicka-Panczak,Renata
Sniatala,Michal Ekkert and Maria Borysewicz-Lewicka

Date of publication: 28 December 2019

 ● The notion of “dental anxiety” is usually related to anxiety felt by dental patients .
Introduction
● Dentists might experience occupational stress from their interaction with staff and patients,
problems in the treatment of patients, fears of litigation from their patients, time pressure, and
paper work as well as concerns about the financial viability of their practice or defective
equipment.
● It is worth mentioning that financial crisis might also affect the medical professionals’ well-being.
Economic instability can result in mental and physical consequences like anxiety, depression, or
psychological well-being.
● Practical classes in pediatric dentistry clinics pose special difficulties as young patients are
special. Moreover, the students need to communicate with their parents or guardians. Students of
dentistry are exposed to such difficulties because young patients are often anxious for dental
treatment.
● Literature data show that students’ anxiety is increased by their patients’ tension caused by the
performed procedure. Dental profession is considered as one of the most stressing medical
specialties .Stress-related and musculo-skeletal diseases are the most common reasons why
dentists retire from their profession prematurely.
● There are many anxiety assessment tests applied in psychological practice, one of them being the
STAI ques- tionnaire, i.e., State-Trait Anxiety Inventory introduced by Spielberger et al.
 Methods & Materials
All-four 3rd year Polish dental students of the Poznan University of Medical Sciences, that
studied in the academic year 2011/2012, entered the survey between March and April 2012.
The group included 63 females (75.00%) and 21 males (25.00%), aged 22–28 years.

The study was carried out during clinical classes in pediatric dentistry where the students were
supposed to perform simple prophylactic or therapeutic procedures on pediatric patients.

The subject’s participation in the research was anonymous and voluntary.

 Methods
The STAI question- naire is composed & Materials
of two-parts scales: the X-1 scale to assess anxiety as a state,
and the X-2 scale to assess anxiety as a trait. Each of them consists of 20 items to which the examined
person responds by checking out one of the 4 categorized answers.

To describe their subjective feelings towards a statement, the participant classifies them in ———-
the STAI-1 four-point scale as “not at all” (the value of 1), “somewhat” (2), “moderately so” (3), and
“very much so” (4).
the STAI-2 scale as: “almost never” (the value of 1),
“sometimes” (2), “often” (3), and “almost always” (4) .

The statistical analysis has been carried out with DELL STATISTICA (data analysis software system)
version 13 Dell Inc (2016, software.dell.com). A value of p ≤ 0.05 was considered statistically
significant.

Distribution of continuous variables (STAI-1 and STAI-2) was tested by means of Shapiro– Wilk test.

The difference test between two proportions was used to check the differences between the percentage
of women and men for each level of anxiety, both for anxiety as a state and anxiety as a trait. This test
was also used to compare the percentage of people with different levels of anxiety, separately for
women and separately for men
 Results
The results were analyzed in three categories of anxiety as a
state: low, normal, and high state of anxiety.
The results obtained from the first and second part of the
questionnaire concerning anxiety as a state and as a trait
showed high level of anxiety as a state in 51.19% of the
students and as a trait in 32.14% and low level in
19.05% and 41.67%, respectively.
 Results
The results were analyzed in three categories of anxiety as a
state: low, normal, and high state of anxiety.
The results obtained from the first and second part of the
questionnaire concerning anxiety as a state and as a trait
showed high level of anxiety as a state in 51.19% of the
students and as a trait in 32.14% and low level in
19.05% and 41.67%, respectively.
Results
 Discussion
Dental students are exposed to stressing situations during clinical classes as part of their curriculum
.However, publications concerning this issue are scarce. Moreover, there is no information on the number of
Polish students seeking help from a psychiatrist or a psychologist to cope with such problems.

Practical classes as a part of the third year curriculum are one of the first clinical classes in the dental
studies and involve noninvasive procedures, mostly prophylactic, to be performed by the students.

In the students’ opinion, a direct relationship with a patient causes additional difficulties comparing to
phantom classes simulations, as not only theoretical knowledge needs to be verified practically but also own
emotions have to be tamed.

It is commonly known that a new experience, like performing a procedure for the first time, may cause
significant anxiety and stress both in adepts of medical art and experienced doctors with many years of
practice.

Assessment of anxiety as a trait in dental students shows them being or not being ready for delivering dental
care during clinical classes to a patient in the developmental age.
 Conclusion
The results show that the anxiety level during clinical classes
is relatively high in the studied population of students.
Preparing the students to cope with stress resulting from
treating the patients seems to be of importance. Such
programmes should be implemented before the start of
practical clinical classes. The acquired knowledge will be
useful in further professional career.
 Critical Evaluation
Title: Materials and Methods :
Indicates the topic and focus of the studyStudy population has been mentioned
Title reflects the aim of the study Study setting has been mentioned
Title comprises of 7 words Study design has been mentioned
Study population is mentioned Study duration has not mentioned
Study setting has been mentioned Appropriate statistical tests have been used
Introduction:
It is meaningful and concise
It is in seminar approach
Need for the study is mentioned
Aim of the study is mentioned
 Critical Evaluation
Result
• Results are presented
in logical manner
• All important results
are presented in table
and figure
• Data given in text
and tables match each
other
• Results are based on
aims of the study
Discussion:
• It is meaningful
• It highlights the important
findings of the study
• Authors have not state the
reason about the variation in
anxiety level between the
male and female dental
students
• Conclusion is mentioned
 Critical Appraisal
• Internal variability - Fair
• Ethical clearance is taken
• Informed consent is taken
• No conflicts of interest regarding publication of this paper

Critical Reflection
• External validity- Fair
• Sample size is determined
• Comparison with other studies is not mentioned
EVIDENCE BASED TRIANGLE

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ARTICLE 3
Dental Students’ Discomfort and Anxiety
During the First and the Second Lockdown Due
to COVID-19 Pandemic at the School of Dental
Medicine, University of Zagreb
About The Article

Topic: Dental Students’ Discomfort and Anxiety During the First and
the Second Lockdown Due to COVID-19 Pandemic at the School of
Dental Medicine, University of Zagreb
Authors: Marta Adam, Taja Urbančič-Rak, Tin Crnić
Date of publication: June 6, 2021
DOI: 10.15644/asc55/2/8
Introduction
● In December 2019, the first cases of novel coronavirus disease (COVID-19), caused by
severe acute respiratory syndrome virus 2 (SARS-COV-2) were reported in Wuhan, china

● The pandemic has impacted not only the health care system, thus causing millions of
deaths and global health care crisis, but also the course of education at universities around
the world, which had to either postpone or cancel their activities and/or to switch to
alternative teaching and learning methods (online classes)

● The presence of coronavirus within the oral cavity and its spread during clinical work in
dental offices has put our profession amongst one of the riskiest professions and has
closed clinical practice and education in dental medicine

● In the study of dental medicine, acquiring clinical skills is needed to carry out dental
procedures, which is of utmost importance and heavily depends on practical exercises.
Introduction
● Having lost a significant amount of practical exercises, students’ clinical competencies
were jeopardized

● Most schools in Croatia continued to carry out all teaching online due to the pandemic, as
well as due to material damage from the earthquake.

● The objectives of this research were to find out the impact of the COVID-19 pandemic
crisis on the students of dental medicine during the first lockdown, and to compare the
results of their current experience of studying in terms of their subjective attitudes
towards: the COVID-19 situation and its impact on their education, their satisfaction with
the current way of the study program being delivered, the amount of preclinical/clinical
practice, their competence in using PPE during the preclinical/clinical exercises, overall
safety in the preclinical/ clinical environment, the possibility of compensating for the lost
preclinical/clinical exercises, the prospects of employment.
 Methods & Materials
The research is based on three individual questionnaires that were carried out in may 2020
for Brescia colloquium and of one additional questionnaire (AQ) which was carried out in
February 2021.

Three individual questionnaires were designed for third-year students (questionnaire TQ),
fourth-year students (questionnaire FQ) and sixth-year students (questionnaire SQ).

The results of the respective questionnaires were statistically analysed and compared to see
the differences of studying experiences during the first and the second lockdown, and
between the preclinical and clinical students and gender.

The additional questionnaire (AQ) was composed of 12 questions and was a follow-up to the
abovementioned group of questionnaires (TQ, FQ and SQ).

Individual opinions were assessed using a 4-point scale (1-agree, 2-neutral, 3-disagree, 4-i
don’t know). The last question was optional and collected only qualitative data
 Methods & Materials
The study instrument was validated before being distributed to the study sample,
for face validity.
The participants were 120 dental students of the school of dental medicine,
university of zagreb from the first to the sixth year of the integrated study
program. The response rate for AQ was 19%, for TQ 47%, FQ 42% and for SQ
40%.
Inclusion criteria : undergraduate dental students
Exclusion criteria postgraduate dental students
For the statistical analysis of the data, the software package SPSS 20 (IBM corp.,
Armonk, new york, USA) was used. Descriptive statistical analysis was used to
determine the basic statistical parameters (frequencies, median, mod, minimum
and maximum values). The significance of the differences among the tested
groups was assessed by the chi- square or the fisher’s exact tests
 Results

• Results from the 2020 questionnaire (questionnaire TQ and FQ) the

questionnaires, which included the 3rd and the 4th year students, were
answered by 79 dental students.
• No differences between genders were found (p>0.05).
• No differences existed between the preclinical and the clinical
students (p>0.05), except for the motivation since clinical students
were significantly more motivated (p<0, 01).
• The results confirmed that all students felt discomfort and anxiety
towards the future of obtaining their academic knowledge, as well as
their practical competencies, which were deprived of during the first
lockdown
 Results

• Results from the 2020 questionnaire (questionnaire TQ and FQ) the

questionnaires, which included the 3rd and the 4th year students, were
answered by 79 dental students.
• No differences between genders were found (p>0.05).
• No differences existed between the preclinical and the clinical
students (p>0.05), except for the motivation since clinical students
were significantly more motivated (p<0, 01).
• The results confirmed that all students felt discomfort and anxiety
towards the future of obtaining their academic knowledge, as well as
their practical competencies, which were deprived of during the first
lockdown
A significant amount (65%) of the 3rd-year dental Results
students did not feel competent to do future clinical work,
with the knowledge they obtained through the course of the first lockdown (figure 1). The results showed
that only 40% of the 3rd-year students felt competent using the protective equipment necessary for the
clinical work (figure 2). During the first lockdown, 51% of the students from the 4th-year felt satisfied
with the substitution of clinical exercises with online classes, considering the situation in the world (figure
3).
All students answered twelve questions. Their opinions were almost uniform, confirming discomfort and
anxiety about their future acceptance of the knowledge and practical skills, as they were deprived of
exercises during the closure due to the COVID-19 pandemic (table 2). The 12th question gathered
additional comments and could be translated into qualitative data. Three answers were noted and all of
them were satisfactory, e.g. ‘’Lectures are better online because they are recorded and I can rewatch them
whenever I need, seminars and preclinical exercises definitely not because students are not well prepared
(I would say it’s because of loss of motivation) and some professors are frustrated.’’
There were no differences between female and male students. Both genders confirmed discomfort and anxiety
about the future acceptance of knowledge and practical skills and competences because of closure due to
the COVID-19 pandemic (table 3).
There was a significant difference between the opinions of the 6th-year students about the influence of the
pandemic crisis on their future careers as dentists. In 2020, most students were neutral and disagreed with
the mentioned statement, while in 2021 they mostly agreed that COVID-19 will have an impact on their
future career (p<0,01) (figure 4).
A significant amount (65%) of the 3rd-year dental Results
students did not feel competent to do future clinical work,
with the knowledge they obtained through the course of the first lockdown (figure 1). The results showed
that only 40% of the 3rd-year students felt competent using the protective equipment necessary for the
clinical work (figure 2). During the first lockdown, 51% of the students from the 4th-year felt satisfied
with the substitution of clinical exercises with online classes, considering the situation in the world (figure
3).
All students answered twelve questions. Their opinions were almost uniform, confirming discomfort and
anxiety about their future acceptance of the knowledge and practical skills, as they were deprived of
exercises during the closure due to the COVID-19 pandemic (table 2). The 12th question gathered
additional comments and could be translated into qualitative data. Three answers were noted and all of
them were satisfactory, e.g. ‘’Lectures are better online because they are recorded and I can rewatch them
whenever I need, seminars and preclinical exercises definitely not because students are not well prepared
(I would say it’s because of loss of motivation) and some professors are frustrated.’’
There were no differences between female and male students. Both genders confirmed discomfort and anxiety
about the future acceptance of knowledge and practical skills and competences because of closure due to
the COVID-19 pandemic (table 3).
There was a significant difference between the opinions of the 6th-year students about the influence of the
pandemic crisis on their future careers as dentists. In 2020, most students were neutral and disagreed with
the mentioned statement, while in 2021 they mostly agreed that COVID-19 will have an impact on their
future career (p<0,01) (figure 4).
A significant amount (65%) of the 3rd-year dental Results
students did not feel competent to do future clinical work,
with the knowledge they obtained through the course of the first lockdown (figure 1). The results showed
that only 40% of the 3rd-year students felt competent using the protective equipment necessary for the
clinical work (figure 2). During the first lockdown, 51% of the students from the 4th-year felt satisfied
with the substitution of clinical exercises with online classes, considering the situation in the world (figure
3).
All students answered twelve questions. Their opinions were almost uniform, confirming discomfort and
anxiety about their future acceptance of the knowledge and practical skills, as they were deprived of
exercises during the closure due to the COVID-19 pandemic (table 2). The 12th question gathered
additional comments and could be translated into qualitative data. Three answers were noted and all of
them were satisfactory, e.g. ‘’Lectures are better online because they are recorded and I can rewatch them
whenever I need, seminars and preclinical exercises definitely not because students are not well prepared
(I would say it’s because of loss of motivation) and some professors are frustrated.’’
There were no differences between female and male students. Both genders confirmed discomfort and anxiety
about the future acceptance of knowledge and practical skills and competences because of closure due to
the COVID-19 pandemic (table 3).
There was a significant difference between the opinions of the 6th-year students about the influence of the
pandemic crisis on their future careers as dentists. In 2020, most students were neutral and disagreed with
the mentioned statement, while in 2021 they mostly agreed that COVID-19 will have an impact on their
future career (p<0,01) (figure 4).
Results
Results
 The spread of the COVID-19 pandemic
Discussionhas immediate effect on dental education,
forcing universities to cancel all of their in-person activities and to switch to a
virtual environment, thus forcing dental students to adapt to new forms of learning
and teaching

 There is not much evidence showing a plausible effect on higher education,

however one study does show that there could be some positive effects of COVID-
19 on the students’ performance

 More interestingly, during the first lockdown, majority of the participants agreed
that they improved their theoretical knowledge more than they would have done if
there had not been the COVID-19 pandemic (table 1). However, during the second
lockdown, the downgrade of the students’ opinion was noted (table 2, table 3). The
downgrade of the experience could be explained by the lack of digital literacy of
some of the faculty staff and/or students’ fatigue of the online forms of teaching
and learning
 Discussion
 One should note that not all students might have access to the internet or laptops to
work from home . Despite the online forms of teaching being acceptable and
appropriate to deliver seminars, lectures or non-clinical programmes, dental
students worldwide have been deprived of the critical hands-on practice, which is
one of the most crucial parts of their education
 During the first lockdown, 40% of the students felt competent using the PPE,
whereas, after the second lockdown, more students have reported they felt
competent using the PPE (figure 2, table 2, table 3). Such findings are logical as
the students were instructed on how to properly use the PPE.
 The university has organized the clinical work at the university but has reduced the
number of students per group; the groups were cut in half. Consequently, the
amount of clinical practice was reduced for an individual student as well. The
majority of students reported they felt safe and well protected in the environment
of the preclinical/ clinical exercises (table 2, table 3). Despite the efforts of school
of dental medicine to deliver clinical practice to their students, students still
believed that, due to the COVID- 19, they were treating fewer patients than before
and have shown the concern that the COVID-19 would have an impact on their
 Discussion
 Since patient care was at a halt, academic institutions were concerned about
graduating dental students. There have been uncertainties about their clinical
competences and their abilities to meet clinical requirements made by the
accreditation bodies, as well as the preparedness to provide dental care in the post-
covid-19 era
 Apart from the missed in-person teaching and the lack of clinical experience, the
COVID-19 pandemic created a level of uncertainty and anxiety about future
happenings, thus causing an exceeded level of stress among students leading to
unfavourable effects on the learning and psychological health of students
 Even before the outbreak of the COVID-19, discomfort and stress were common
amongst students entering the student life due to expectations, pressure to study
and pass exams . During the first lockdown, students felt even more anxious than
they did during the second lockdown, which could be explained by adaptations to
some new forms of teaching, and decreased levels of stress and fear for both their
own and for family’s health since more information on COVID-19 was available
(table 1, table 2, table 3), and vaccination has just begun.
 CONCLUSION
• The present study showed that the students were uncomfortable by the
COVID-19 pandemic crisis during the first lockdown and the second
lockdown (2020 and 2021, respectively).
• The students have adapted well to the new forms of hybrid teaching,
however, they are aware that dental education needs practice and clinical
exposure, which is something that cannot be delivered online
• Despite the striving of the school of dental medicine to compensate for
the missed clinical exercises, students still feel uncertain about their
clinical competence. There was no significant difference between
genders, while clinical students were more motivated during the first
lockdown. During the second lockdown, preclinical students felt safer but
less confident to treat patients.
Critical evaluation

TITLE :
1. Contains 25 words
2. Title properly explains aim of the study
3. Title is indicative of TOPIC and FOCUS of study in intended sample space
4. Title mentions system variables influencing the study, which is to be measured
5. Study population mentioned
6. Study setting mentioned
7. Study design not mentioned
8. Title status : incomplete

Proposed alternate title :

Deranged mental status of dental students during the first and the second lockdown due to COVID-19
pandemic at the school of dental medicine, University of Zagreb based on independent close ended
questionnaire for cross sectional study
ABSTRACT :

1. Comprises of 296 words

2. Abstract is structured and informative

3. Abstract is simple and intuitive

4. It gives the gist of whole text

5. Information given in the abstract match with that of the detailed text
6. It facilitates the reader in selection of pertinent study.
Article follows IMRaD format.

KEYWORDS :

7. 3 keywords are mentioned

8. 5th article to be accessed
Introduction:
1. It is descriptive
2. It is in article format
3. It is not built on existing literature
4. Need for the study is mentioned
5. Aim and objective of the study is mentioned
6. A detailed background information is given regarding necessitating the need for the study
7. The prevalence and target population and its relevance is explained
8. It includes all the factors influencing the study
MATERIALS AND METHODS :
● Study population is mentioned
● Study setting is mentioned
● Study design is not mentioned
● Study duration is mentioned
● Authors have mentioned about the ethical clearance ( University of Zagreb, protocol number
05-PA-30-XXIII-2021.)
● Method of data collection is mentioned
● Information regarding consent is mentioned
● Appropriate statistical tests have been used
● Authors have mentioned about data collection were statistically analyzed using SPSS 20 (IBM Corp.,
Armonk, New York, USA)
● Limitations of the study are not mentioned
● Exclusion criteria is mentioned
RESULTS :
● Results obtained are presented in logical manner
● All important results are presented in tables, bar charts and pie
diagrams
● Data given in text and tables match each other
● Results are based on aims of the study
● Flowchart for recruitment of participants is not given
● The findings of the study are compared and analysed.
● A clear indication of the variables are given.
● The reliability and validity of the study is given.
● Qualitative data (optional) collected is not analysed
● No bias is reported
DISCUSSION :
● A precise, deep and meaningful discussion is given based on the finding of the data
analysed that is collected via the questionnaires
● Discussion is lengthy and complex in certain sections
● It could not pinpoint the important findings of the study
● Authors have compared the current findings of the study to other related studies in the
region (Hattar et al (2021), university of Jordan)
● Correlation and comparison is drawn between discomfort and anxiety levels in pre
COVID-19 and in COVID-19 situation
● Possible solution to various problems directly or indirectly related to mentioned
psychological derangement is proposed
● Conclusion is mentioned
● Recommendation is mentioned
● The limitations of the study are not mentioned
● No conflict of interest is reported
References :
● There are references for every citation
● 30 references are given
● All 30 references are e-accessible
● All 30 references are in English
● Harvard referencing system is followed
Critical appraisal

Internal validity: Fair

● Ethical clearance taken [university of Zagreb, protocol number 05-PA-30-
XXIII-2021.]
● E-Consent from volunteered subjects are taken
● User personal data is not collected and all the data obtained was kept
confidential
● Detailed statistical analysis is done
● The response rate achieved was average
CRITICAL REFLECTION

External validity: Fair

● Sample size determination successfully done
● Comparison with other study is mentioned
Evidence based triangle
S Cross sectional Survey:
Survey or interview of a sample or
.
RC
population of interest at one point in time.
R
T
Cohort
studies
Case control
studies
Case series, Case Level of study

reports
Editorials, expert opinions
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ARTICLE 4
SELF PERCEIVED IMPACT OF COVID -19
PANDEMIC BY DENTAL STUDENTS in
BUCHAREST
 About The Article
AUTHORS :Laura Iosif 1 , Ana Maria Cristina T¸âncu 1,*, Andreea Cristiana
Didilescu 2 , Marina Imre 1, Bogdan Mihai Gălbinas ,u 3,* and Radu Ilinca 4
1 Department of Complete Denture, Faculty of Dental Medicine, Carol Davila
University of Medicine and Pharmacy, 17–21 Calea Plevnei Street, Sector 1,
010221 Bucharest, Romania; laura.iosif@umfcd.ro (L.I.); marina.imre@umfcd.ro
(M.I.)
2 Department of Embryology, Faculty of Dental Medicine, Carol Davila University of
Medicine and Pharmacy, 17–21 Calea Plevnei Street, Sector 1, 010221 Bucharest,
Romania; andreea.didilescu@umfcd.ro
3 Department of Dental Prosthesis Technology and Dental Materials, Faculty of
Dental Medicine, Carol Davila University of Medicine and Pharmacy, 17–21 Calea
Plevnei Street, Sector 1, 010221 Bucharest, Romania
Introduction

● Aim : the main goal of the paper was to investigate the educational and
professional, and emotional impact of the covid-19 pandemic on the life of
the dental students in the faculty of dental medicine in the Carol Davila
university of medicine and pharmacy in Bucharest , Romania.

● It is meaningful and detailing is provided

● It is built on current pandemic situation prevailing.

● Need for study is mentioned

CRITICAL EVALUATION

Abstract:
● Abstract is structured and informative.
● It gives the gist of whole text.
● Information given in the abstract match with that of
detailed text.
● It facilitates the reader in selection of pertinent study
● Abstract consist of 94 words

Keywords:
● 7 key words have been mentioned
 MATERIALS AND METHODS

● Study design has been mentioned

● Study population has been mentioned

● Study sampling procedures and size has been mentioned

● Authors have mentioned about the Data collection , were
statistically analyzed using STATA/IC 16

● Ethical clearance and informed consent taken.

● No incentives were used for study participation.

● Authors have mentioned about survey as an instrument , since no validated tool could be found in the extant
literature.

● Data management and analysis were carried out.

● Appropriate statistical tests has been used.

 RESULTS
● Regarding the psychological impact reported by the students -

● Descriptive analysis are carried out in the form of table and chart.

● Data given in text and table match each other.

● A significant positive correlation was computed between anxiety and level of stress.

● Academic learning was positively correlated with academic teaching.

● But no significant correlations are found between the ranks of study motivation and the years of study
 DISCUSIONS

● It is meaningful and given in an elaborate manner.

● Conclusion is mentioned

● Authors have not compared the current findings of the study to other related studies.

● Supplementary materials has been provided

● Author declare no conflict of interest

 REFERENCES

● 70 References are given

● References are made for every citation.

 CRITICAL APPRAISAL

● Internal validity : fair

● Ethical clearance and consent taken

 CRITICAL REFLECTION

● External validity : fair

● Sample size is determined

● Comparison with other studies is not mentioned

EVIDENCE BASED TRIANGLE

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ARTICLE 5
Psychological impact of the
coronavirus disease
2019(COVID19) pandemic on
dental students
AUTHORS
Zaki Hakami1 Sanjeev B. Khanagar2 Satish Vishwanathaiah3 Abrar Hakami4
Ahmed M. Bokhari5 Ahmad H. Jabali6 Dhafer Alasmari7 Abdullah M. Aldrees8
1 Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University,
Jazan, Saudi Arabia
2 Dental Public Health, Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz
University for Health Sciences, Riyadh,
Saudi Arabia
3 Division of Pediatric Dentistry, Department of Preventive Dental Sciences, College of Dentistry, Jazan University,
Jazan, Saudi Arabia
4 Resident Doctor, Jazan Psychatric Hospital, Military Forces Hospital, Jazan, Saudi Arabia
5 Division of Dental Public Health, Department of Preventive Dental Sciences, College of Dentistry, Jazan
University, Jazan, Saudi Arabia
6 Division of Endodontics, Department of Restorative Dental Sciences, College of Dentistry, Jazan University,
Jazan, Saudi Arabia
7 Department of Periodontology and Oral Medicine, College of Dentistry, Qassim University, Buraidah, Saudi
Arabia
8 Division of Orthodontics, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud
University, Riyadh, Saudi Arabia
Introduction

• Aim : the main goal of the paper was to investigate the

psychological impact of the covid-19 pandemic on the life of the
dental students in the faculty of dental medicine in Saudi
Arabia
• It is meaningful and detailing is provided

• It is built on current pandemic situation prevailing.

• Need for study is mentioned

CRITICAL EVALUATION

Abstract:
• Abstract is structured and informative.
• It gives the gist of whole text.
• Information given in the abstract match with that of detailed text.
• It facilitates the reader in selection of pertinent study
• Abstract consist of 100 words

Keywords:
• 9 key words have been mentioned
Method
● A cross-sectional study was conducted among dental students in Saudi Arabia to investigate the psychological
problems they experienced during the COVID-19 outbreak. The study was reviewed and approved by the
Ethical Committee of the Scientific Research Unit, College of Dentistry, Jazan University, before it commenced
(Reference number: CODJU-2003F).
● The data were collected using a Microsoft forma questionaaire

● The data were analyzed using SPSS version 26(IBMCorporations, Armonk, NY, USA)
Results

• Regarding the psychological impact reported by the

students -

• Descriptive analysis are carried out in the form of table

and chart.

• Data given in text and table match each other.

• Academic learning was positively correlated with

academic teaching.
Discussion

● It is meaningful and given in an elaborate mannner

● Conclusion is mentioned

● Supplementary Materials have been provided

● Authors declare no conflict of interest

References

● 30 references was given

● Reference are given for every citations

Critical appraisal

Internal validity: fair

Ethical clearance and consent taken
Critical reflection

External validity : fair

Sample size is determined
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