Awareness among undergraduates about State Dental Council and Medico - legal issues - Stratified cluster random sampling survey
Introduction
The Dentists Act, 1948 established the Dental Council of India to oversee dental education and the industry across the country.1 The Ministry of Health and Family Welfare and regional state dental councils provide funding for it. Dentistry is no exception to the rule that law has an impact on all aspects of human activity. The main statutes pertaining to health, including the Drug and Cosmetics Act, the Dentists Act, etc., serve as a bridge between law and dentistry.2 Since the early professors of the profession were motivated by altruism, the ethical standards of the dentistry profession are steadily declining due to a market-driven system.
Despite the development of forensic odontology, which mandates that every dentist maintain some sort of record for every patient they treat, corporate dentistry today has degenerated into a typical commercial practice whose concerns are tightly dictated by profit and loss concerns.3 There is a very low percentage of dentists that preserve dental records, according to an assessment of dentists' awareness of the topic. The intellectual basis of health laws is still being applied and improved. This evaluation is predicated on the idea that patients and dental professionals lack information about medico-legal issues, which in turn prevents the development and delivery of dental services in an efficient manner.4
Table 1
Denotes multiple choice questionnaire and allocated points
|
Question number
|
Multiple choice questionnaire
|
Points allocated
|
|
1.
|
The Dentist Act was given in the year
a) 1948
b) 1958
c) 1954
d) don't know
|
01
|
|
2.
|
True among the features included in State Dental Council of India
a) Legitimate registration
b) Continued Dental Education (CDE) Programmes
c) Anti-ragging
d) Tobacco cessation centres in dental colleges
e) All of the above
f) Don't know
|
04
|
|
3.
|
CPA/COPRA stands for
a) Consumer professional act
b) Consumer protection act
c) Co-operative professional act
d) Combined professional act
e) Don't know
|
01
|
|
4.
|
Orld medical association provides services like
a) Health related human rights
b) Medical education -helping physicians to improve skills
c) Patient safety and public health polices
d) Democracy among medical associations
e) Don't know
f) All of the above
|
05
|
|
5.
|
Indemnity insurance is helpful in
a) Medical malpractice allegations
b) Breach of confidentiality allegations
c) Loss of third-party documents
d) All of the above
e) Don't know
|
04
|
|
6.
|
Malpractice in Dentistry involves
a) Delayed treatment of disease
b) Misdiagnosis
c) Intentional misconduct by Dental professional
d) All of the above
e) Don't know
|
01
|
|
7.
|
Medical jurisprudence related to
a) Only Forensic Medicine legal issues
b) Both Dental and Medical legal issues
c) Only Dental legal issues
d) Only Medical legal issues
e) Don't know
|
01
|
|
8.
|
When it is not considered as negligence
a) Inability to obtain consent form in an emergency
b) Doctor that didn't maintain a standard care
c) Injury due to lack of care
d) When patient is mentally conscious but mis-proxy consent is taken
e) Don't know
|
01
|
|
9.
|
True about CPA/COPRA
a) State commission-compensation up to Rs.20/-lakhs
b) District forum-compensation above Rs.25/-lakhs but less than Rs.1/-crore
c) National commission-compensation above Rs.1/-crore
d) All the above
e) Don't know f) Other
|
01
|
|
10.
|
State Dental Council of India register for
a) M.D.S & B.D.S
b) Dental hygienists
c) Dental mechanics/technicians
d) All of the above
e) Don't know
|
01
|
|
11.
|
The dentist act was given by
a) Indian Council of Medical Research
b) Indian Dental Association
c) Dental Council of India
d) Don't know
|
01
|
|
12.
|
Consent is invalid when
a) Given under 12years of age
b) Given under 15years of age
c) Given under 18 years of age
d) Don't know e) Other
|
01
|
|
13.
|
Most over-prescribed drug in dentistry
a) Amoxicillin
b) Cephalosporins
c) Tetracyclines
d) Sulphonamides
e) Don't know f) Other
|
01
|
|
14.
|
One of the following is not the principle of ethics
a) Truthfulness
b) Punctuality
c) Confidentiality
d) Beneficence
e) Autonomy
f) Don't know
|
01
|
|
15.
|
Every Dental Surgeon should maintain his/her patient records for a minimum of
a) 3 years
b) 5 years
c) 2 years
d) Don't know
|
01
|
Materials and Methods
Study design
The current observational study was an online-based questionnaire which was available online for one week between 23/11/2022 and 30/11/2022 which is based on Bikash Ranjan et al., 2015.5 The Google platform was used to construct the questionnaire and the valid link was distributed through social media (Table 1). All participants completed the questionnaire anonymously.
Study population
A total of 625 students of random dental colleges from Andhra Pradesh state had responded. The included criterion was students who are pursuing internship and final year are selected to complete the questionnaire. Remaining undergraduates are not included in this survey.
Components and scoring of questionnaires
Questions for the current survey were adapted and modified from previously validated and predicted questionnaires. A total of 25 points questionnaire was prepared and based on the number of points attained by the students, they are categorized based on level of awareness as mentioned in Table 2.
Table 2
Components and scoring of questionnaires
|
S. No:
|
Response
|
Range
|
|
1.
|
Low
|
0-12
|
|
2.
|
Medium
|
13-19
|
|
3.
|
High
|
20-25
|
Stratified cluster random sampling survey was done to study the data and refine it with possible variables.6, 7 These included level of awareness (low, medium and high), year of study (final year, internship) and gender variation (male, female).
Results
This online questionnaire was made with the help of Google forms and shared to via whatsapp groups to various dental colleges in Andhra Pradesh state to only final years and intern’s students. The total number of respondents for this questionnaire was 625. Based on the overall survey points, the level of awareness among these individuals were categorized as follows:
Low (35%)
Medium (40%)
High (25%)
Figure 1
Categorization of level of awareness
Level of awareness based on year of study
The specific number of respondents from specific year of study are as follows:
Final year students – 275
Low - 30%
Medium - 55%
High - 15%
Internship students - 350
Low - 40%
Medium - 35%
High - 25%
Figure 2
Level of awareness based on year of study
Level of awareness based on gender
Out of all the respondents, male respondents are 175 and female respondents are 450; thereby their level of awareness was as mentioned in Table 3.
Table 3
Level of awareness based on gender
|
Gender
|
Low
|
Medium
|
High
|
|
N
|
%
|
N
|
%
|
N
|
|
Male (175)
|
61
|
35%
|
35
|
20%
|
79
|
45%
|
|
Female (450)
|
90
|
20%
|
203
|
45%
|
157
|
35%
|
|
Total (625)
|
151
|
24%
|
238
|
38%
|
236
|
38%
|
Results of individual questionnaire
Comparing the level of awareness among final year students and intern’s, the individual questionnaire scores were mentioned in Table 4.
Table 4
Level of awareness for individual questionnaire
|
S. No:
|
Question
|
Final year’s (275)
|
Intern’s (350)
|
|
1.
|
The Dentist Act was given in the year
|
21
|
26
|
|
2.
|
True among the features included in State Dental Council of India
|
18
|
24
|
|
3.
|
CPA/COPRA stands for
|
16
|
23
|
|
4.
|
Orld medical association provides services like
|
17
|
22
|
|
5.
|
Indemnity insurance is helpful in
|
19
|
24
|
|
6.
|
Malpractice in Dentistry involves
|
17
|
24
|
|
7.
|
Medical jurisprudence related to
|
18
|
22
|
|
8.
|
When it is not considered as negligence
|
21
|
23
|
|
9.
|
True about CPA/COPRA
|
17
|
21
|
|
10.
|
State Dental Council of India register for
|
19
|
23
|
|
11.
|
The dentist act was given by
|
20
|
22
|
|
12.
|
Consent is invalid when
|
18
|
24
|
|
13.
|
Most over-prescribed drug in dentistry
|
20
|
25
|
|
14.
|
One of the following is not the principle of ethics
|
17
|
23
|
|
15.
|
Every Dental Surgeon should maintain his/her patient records for a minimum of
|
17
|
24
|
Discussion
This online survey indicated a medium level of awareness among the undergraduates regarding State Dental Council and Medico-Legal issues.8 The range of variables such as number of respondents, level of awareness, year of study and gender variation influenced the outcomes of this study. Selection of final years and internship students from undergraduates was based on their clinical involvement and knowledge about public health dentistry.
There were certain limitations to this survey: majorly, the difficulty in distributing the questionnaire to other colleges among the state and finding similar previous studies. As an alternative, studies in specific year of study (final years, interns) with basic knowledge on public health dentistry with clinical exposure were selected for comparisons.9, 10 Nevertheless, this work revealed strong points that were represented by a large sample size with no missing data.
Since the knowledge on State Dental Council and Medico-legal issues, its functional & structural features and the way of prevention, which has abundance importance for any dental professional to overcome legal situations in their clinical practice and to self protect themselves from ill-legal defamation and false allegations on them.11, 12, 13 Also, the basic principles of Ethics are to be known to every outgoing doctors be it medical or dental, professional ethics are to be followed every now and then to maintain the harmony and welfare of the doctors.14, 15
Although a high number of responses was received for this online questionnaire, participation from other years of study (1st, 2nd, 3rd) was limited and responses from final years and internship students are only appreciated. Therefore, caution should be exercised before the generalization and interpretation of the results.
Conclusion
The responses of the participants generally indicated their medium level of knowledge to the questions asked in the questionnaire.
According to the answers, internship students are observed to have slightly more knowledge compared to final year undergraduates.
It is observed that females had more than the males which might be due to less population of males compared to females among the students.
Conflict of Interest
None.
Acknowledgements
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
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