Abstract
Background
There is limited evidence regarding dental students’ perceptions of preclinical and clinical skills training in schools with different educational structures. This study aimed to assess and compare dental students’ perceptions of preclinical and clinical skills training at tuition-free and tuition-based schools affiliated with Guilan University of Medical Sciences.
Methods
This cross-sectional study was conducted on 195 undergraduate dental students engaged in the preclinical and clinical stages of training at Rasht tuition-free and Anzali tuition-based dental schools affiliated to Guilan University of Medical Sciences in 2025. Sampling was done by census method. The questionnaire included demographic information and 23 assessment items (17 clinical questions and 6 preclinical questions). The data were statistically analyzed at 0.05 significance level.
Results
The perceived quality of preclinical training was generally good, while clinical training was perceived as moderate. There was no significant difference in students’ perceptions of preclinical training between the two dental schools (p = 0.632). However, students’ perceived quality of clinical training was significantly higher in the tuition-based school compared with the tuition-free school (p < 0.001). The effect of gender on the perceived quality of training was significant only in the preclinical level of the tuition-free school (higher mean in females; p = 0.034).
Conclusion
Given the differences observed in students’ perspectives, it appears necessary to review the educational methods, improve infrastructure, and standardize the educational process to achieve uniformly optimal quality.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12909-026-08945-x.
Keywords: Dental Education, Academic Assessment, Health Service Research, Clinical Competence
Background
Training specialists in medical sciences plays a key role in public health promotion [1]. Considering the needs of the public and the healthcare system, it is essential to design educational programs in medical fields in such a way that students acquire both the necessary theoretical knowledge, and the necessary practical skills [2]. Applying modern educational methods, creating an appropriate educational environment, providing the necessary materials and tools, designing a successful educational program, and continuous monitoring are among the factors that can help improve the quality of education in medical fields [1].
Educational assessment is a systematic process carried out to measure the quality, effectiveness, or value of a process, goal, or curriculum; this process includes collection of relevant data and evaluation of the trend and progress of educational programs [3, 4]. Students’ educational experiences and their points of view regarding the content, structure, and quality of education can be considered as key factors in quality control and monitoring of educational programs, and can serve as an important source for educational decision-making [5]. Periodic evaluation of educational methods based on students’ perspectives can therefore contribute to improving clinical education and, ultimately, patient care and public health outcomes [5, 6].
Most studies have focused on assessing the level of students’ practical skills in the clinical setting [7–9], while few studies have examined the quality of instruction of these skills by instructors or the educational system [10–12]. A review of previous studies in the field of clinical dental education reveals that challenges such as lack of variety in clinical cases, receiving insufficient feedback from the instructors, inconsistency between theoretical education and clinical environment, stress related to fulfilling the requirements for educational activities, and allocating time to courses unrelated to the clinical setting are among the common problems in the process of practical skills learning [10–12]. Moreover, variations in student satisfaction across different dental departments have been reported, suggesting that differences in educational structure, content delivery, and faculty–student interaction may influence perceived training quality [13–16].
The structure of educational curricula has undergone some changes over time, aiming to improve the quality of practical skills training, and make education more relevant to the requirements of the clinical settings. However, the impact of these changes on the quality of practical education from the perspective of students has been less studied, especially in situations where the type of admission and educational path of students differ. Despite structural commonality in the curriculum, differences such as the type of admission (tuition-based or tuition-free), tuition, level of access to resources, and academic expectations can affect the educational experience and satisfaction of students. On the other hand, students’ perceptions of preclinical practical skills training are considered an important factor influencing their preparedness and perceived success in subsequent clinical courses, and their assessment can play an effective role in educational planning and improvement.
Despite the significance of this topic, no study to date has compared dental students’ perceptions of preclinical and clinical practical skills training across different educational pathways within the framework of a single curriculum. Therefore, the purpose of the present study was to evaluate and compare dental students’ perceptions regarding preclinical and clinical practical skills training at tuition-free and tuition-based schools affiliated with Guilan University of Medical Sciences.
Materials and methods
This cross-sectional study was conducted at the School of Dentistry, Guilan University of Medical Sciences in 2025. All stages of the study were approved by the Ethics Committee of Guilan University of Medical Sciences (IR.GUMS.REC.1403.503).
To determine the sample size, a mean estimation formula was used based on the standard deviation of the overall perceived quality score of practical skills training reported in a previous study conducted in a comparable dental education setting [12]. Assuming a standard deviation of 0.41, an error margin of 0.09, a power of 0.80, and a significance level of 0.05, the minimum required sample size was calculated to be 163 students.
The study population was selected by census sampling, meaning that all eligible undergraduate dental students engaged in preclinical or clinical stages of training at both schools during the study period were invited to participate. The participants were undergraduate dental students enrolled in either the preclinical or clinical stages of the curriculum, who had passed the national entrance examination or had been permanently transferred to Rasht tuition-free or Anzali Campus tuition-based dental school. At the preclinical level, 100 students participated, including 37 students from the tuition-free school and 63 students from the tuition-based school. At the clinical level, 95 students participated, including 58 students from the tuition-free school and 37 students from the tuition-based school. Guest students, basic science students, those who were not willing to participate in the study, and those with incomplete questionnaires were excluded from the study. Of 235 eligible students invited to participate, 195 completed the questionnaire, yielding a response rate of 82.9%.
The data collection tool was a researcher-designed questionnaire consisting of two parts. The first part included students’ demographic information (gender). The second part comprised 23 items, including 17 items assessing students’ perceptions of clinical skills training and 6 items assessing students’ perceptions of preclinical skills training. The higher number of items included in the clinical section of the questionnaire reflects the broader scope and heterogeneity of clinical training, which involves multiple departments, varied clinical responsibilities, and diverse aspects of the educational experience. In contrast, preclinical training is more structured and uniform across departments, focusing on a limited set of core instructional objectives, which was appropriately captured using fewer items.
Data collection was conducted in a single phase during the academic year. The questionnaire was administered according to students’ stage of training and current curricular engagement. Students exclusively involved in preclinical training completed only the preclinical section of the questionnaire. Students exclusively involved in clinical training completed only the clinical section. Students concurrently enrolled in both preclinical and clinical courses completed both sections. This stage-based approach ensured that students evaluated only the educational components they were actively experiencing at the time of data collection and minimized potential recall bias from previously completed training stages.
The full English version of the questionnaire is provided as Supplementary Table 1. The preclinical section was dedicated to assessing students’ overall satisfaction with the level of practical skills acquired, the quality of demonstrations, and compliance with educational requirements. It was completed by students in 8 departments: orthodontics, endodontics, removable partial denture, removable complete denture, fixed prosthodontics, restorative dentistry, periodontics, and pediatric dentistry, with a maximum achievable score of 240. Given that each item was scored based on a 5-point Likert scale, responses ranged from 1 (very poor), 2 (poor), 3 (moderate), 4 (good), to 5 (very good). The maximum preclinical score was derived by multiplying the number of preclinical items (6) by the number of preclinical departments (8) and the maximum score per item (5 points). The selection of departments for the preclinical section was based strictly on the undergraduate dental curriculum, and only disciplines with a defined preclinical practical component were included. Departments that do not have a preclinical phase in the curriculum were therefore not evaluated in this section.
The clinical questions covered various topics such as knowledge and performance of instructors, behavior of faculty members and staff in dealing with students, and educational facilities of the clinic, and were completed by students in 10 clinical departments including orthodontics, endodontics, removable prosthodontics, fixed prosthodontics, restorative dentistry, periodontics, pediatric dentistry, maxillofacial surgery, oral medicine, and oral and maxillofacial radiology. The maximum achievable score for the clinical section was calculated by multiplying the number of clinical items (17) by the number of clinical departments evaluated (10) and the maximum Likert score, resulting in a total possible score of 850 (17 × 10 × 5).
To interpret the results, each student’s total score was converted into a percentage of the maximum score. Based on this percentage, students’ perceptions of the quality of education were categorized into five levels. Thus, perceived quality scores ≤ 20% were considered “very poor,” which were less than 48 points in the preclinical section, and less than 170 points in the clinical section. Scores between 21% and 40% were classified as “poor” (49 to 96 in preclinical and 171 to 340 in clinical section), scores between 41% and 60% as “moderate” (97 to 144 in the preclinical, and 341 to 510 in the clinical section), scores between 61% and 80% as “good” (145 to 192 in the preclinical, and 511 to 680 in the clinical section), and scores > 80% as “very good” (≥ 193 in the preclinical and ≥ 681 in the clinical section).
To assess the validity of the questionnaire, it was provided to 10 experts in the relevant field. After reviewing their opinions, the content validity ratio (CVR) and content validity index (CVI) were calculated. Accordingly, the CVR was calculated to be 0.78, which was acceptable according to the minimum acceptable value of the Lawshe’s Table for 10 experts, which was equal to 0.62. The CVI was found to be 0.96, which was also acceptable according to the minimum acceptable value, which was above 0.79. To assess the reliability of the questionnaire, the Cronbach’s alpha was used, which was equal to 0.95, and was acceptable considering the minimum acceptable value of 0.70.
The questionnaires were distributed by a dental student to eligible students simultaneously, and after obtaining consent from the participants and ensuring them about the confidentiality of their information, the students filled out the questionnaire in sufficient time, and then the questionnaires were collected.
The Shapiro-Wilk test was used to assess the normality of data distribution, and the Levene’s test was applied to analyze the homogeneity of the variances. For data analysis, the independent samples test was used if the assumptions were met; otherwise, the Mann-Whitney U test was applied. All statistical analyses were performed using SPSS version 28, and the significance level in all tests was considered at 0.05.
Results
A total of 195 students completed the questionnaire and were included in the analysis. Among the participants, 92 (47.2%) were male and 103 (52.8%) were female.
As shown in Table 1, at the preclinical level, the mean perceived quality score corresponded to 65.1% of the maximum achievable score (156.27 ± 13.74 out of 240) in the tuition-free group and 64.4% (154.60 ± 20.93 out of 240) in the tuition-based group. At the clinical level, the mean perceived quality score reached 51.9% of the maximum score (441.50 ± 44.01 out of 850) in the tuition-free group and 55.8% (474.59 ± 48.99 out of 850) in the tuition-based. Thus, the perceived quality of training differed by educational level, with preclinical training rated as good and clinical training rated as moderate in both tuition-free and tuition-based schools. The mean overall perceived quality score of clinical practical skills training in tuition-based school was significantly higher than that in tuition-free school (p < 0.001). The results showed that the mean overall perceived quality score of preclinical practical skills training in tuition-free school was significantly higher in females than in males (p = 0.034). In other comparisons, there was no difference between males and females (p > 0.05).
Table 1.
Comparison of the mean scores of dental students’ perceived preclinical and clinical skills training based on attending dental school and gender
| Variable | Preclinical | Clinical | |||
|---|---|---|---|---|---|
| Tuition-free | Tuition-based | Tuition-free | Tuition-based | ||
| Overall perceived Quality of Practical Skills training | Mean ± SD (Percentage of maximum achievable score) | 156.27 ± 13.74 (65.1%) |
154.60 ± 20.93 (64.4%) |
441.50 ± 44.01 (51.9%) |
474.59 ± 48.99 (55.8%) |
| p -value | 0.632a | < 0.001a* | |||
| Gender | Male |
152.36 ± 12.97 (63.5%) |
158.60 ± 20.41 (66.1%) |
435.39 ± 44.38 (51.2%) |
486.06 ± 32.74 (57.2%) |
| Female |
162.60 ± 13.18 (67.8%) |
151.97 ± 21.12 (63.3%) |
447.20 ± 43.64 (52.6%) |
464.85 ± 58.56 (54.7%) |
|
| p -value | 0.034a* | 0.222a | 0.359a | 0.247b | |
a Independent samples test
b Mann-Whitney U
* Statistically significant difference between groups (p < 0.05)
Tables 2 and 3 show the mean perceived quality score of preclinical and clinical practical skills training in different educational departments in tuition-free and tuition-based dental schools, respectively. The mean perceived quality score of preclinical practical skills training in removable partial prosthetics (p = 0.034) and removable complete prosthetics (p = 0.042) was significantly higher in the tuition-free dental school than in the tuition-based school. While, according to Table 4, significant differences were observed between tuition-free and tuition-based dental schools in several clinical departments. These included endodontics (p < 0.001), removable prosthodontics (p < 0.001), fixed prosthodontics (p = 0.002), periodontics (p = 0.014), and oral and maxillofacial surgery (p < 0.001), with higher mean perceived quality scores consistently reported by students in the tuition-based school.
Table 2.
Perceived quality scores of preclinical practical skills training by department and tuition status
| Department | Tuition status | n | Mean ± SD | p-valuea |
|---|---|---|---|---|
| Orthodontics | Tuition-free | 37 | 17.35 ± 3.31 | 0.241 |
| Tuition-based | 63 | 18.25 ± 4.26 | ||
| Endodontics | Tuition-free | 37 | 21.22 ± 3.82 | 0.332 |
| Tuition-based | 63 | 20.46 ± 3.71 | ||
| Removable Partial Prosthodontics | Tuition-free | 37 | 19.86 ± 3.82 | 0.034* |
| Tuition-based | 63 | 18.05 ± 4.44 | ||
| Removable Complete Denture | Tuition-free | 37 | 20.62 ± 3.11 | 0.042* |
| Tuition-based | 63 | 19.06 ± 4.40 | ||
| Fixed Prosthodontics | Tuition-free | 37 | 17.51 ± 3.90 | 0.241 |
| Tuition-based | 63 | 18.41 ± 3.54 | ||
| Restorative Dentistry | Tuition-free | 37 | 21.54 ± 3.64 | 0.477 |
| Tuition-based | 63 | 22.09 ± 3.81 | ||
| Periodontics | Tuition-free | 37 | 19.59 ± 2.88 | 0.893 |
| Tuition-based | 63 | 19.51 ± 3.23 | ||
| Pediatric Dentistry | Tuition-free | 37 | 18.57 ± 1.85 | 0.701 |
| Tuition-based | 63 | 18.76 ± 3.20 |
a Independent samples test
* Statistically significant difference between groups (p < 0.05)
Table 3.
Perceived quality scores of clinical practical skills training by department and tuition status
| Department | Tuition status | n | Mean ± SD | p-valuea |
|---|---|---|---|---|
| Orthodontics | Tuition-free | 58 | 49.41 ± 6.44 | 0.168 |
| Tuition-based | 37 | 46.78 ± 10.22 | ||
| Endodontics | Tuition-free | 58 | 41.71 ± 8.17 | < 0.001* |
| Tuition-based | 37 | 49.24 ± 8.72 | ||
| Removable Prosthodontics | Tuition-free | 58 | 44.72 ± 9.02 | < 0.001* |
| Tuition-based | 37 | 51.30 ± 7.83 | ||
| Fixed Prosthodontics | Tuition-free | 58 | 45.52 ± 9.17 | 0.002* |
| Tuition-based | 37 | 51.13 ± 6.54 | ||
| Restorative Dentistry | Tuition-free | 58 | 51.86 ± 8.70 | 0.506 |
| Tuition-based | 37 | 52.97 ± 6.48 | ||
| Periodontics | Tuition-free | 58 | 48.53 ± 7.66 | 0.014* |
| Tuition-based | 37 | 52.46 ± 7.15 | ||
| Pediatric Dentistry | Tuition-free | 58 | 54.93 ± 6.73 | 0.212 |
| Tuition-based | 37 | 56.81 ± 7.67 | ||
| Oral and Maxillofacial Surgery | Tuition-free | 58 | 50.71 ± 8.47 | < 0.001* |
| Tuition-based | 37 | 58.54 ± 5.20 | ||
| Oral Medicine | Tuition-free | 58 | 54.10 ± 6.48 | 0.376 |
| Tuition-based | 37 | 55.35 ± 6.95 | ||
| Oral and Maxillofacial Radiology | Tuition-free | 58 | 53.00 ± 6.39 | 0.295 |
| Tuition-based | 37 | 54.51 ± 7.47 |
a Independent samples test
* Statistically significant difference between groups (p < 0.05)
Table 4.
Mean score of questions related to preclinical practical skills training in tuition-free and tuition-based dental schools
| Question No. | Questions | Tuition-free (n = 37) |
Tuition-based (n = 63) |
|---|---|---|---|
| 1 | The level of mastery of the principles of performing practical skills in each department is: | 26.11 ± 3.57 | 26.32 ± 4.19 |
| 2 | The level of mastery of practical skills required in each department is: | 24.97 ± 2.88 | 25.19 ± 4.15 |
| 3 | The quality of the initial demonstration provided for learning practical skills in each department is: | 26.51 ± 3.65 | 26.25 ± 3.88 |
| 4 | The adequacy of opportunities to complete the practical requirements in each department is: | 26.59 ± 2.86 | 27.24 ± 4.23 |
| 5 | The adequacy of time allocated to complete the minimum practical requirements in each department is: | 26.59 ± 3.77 | 24.35 ± 5.61 |
| 6 | The adequacy of the minimum educational requirements set in each department for acquiring practical skills is: | 25.49 ± 2.74 | 25.25 ± 5.04 |
At the preclinical level, restorative dentistry in both tuition-free (21.54 ± 3.64) and tuition-based (22.09 ± 3.81) schools had the highest mean perceived quality score of training; while, the lowest mean score belonged to orthodontics (17.35 ± 3.31) in tuition-free dental school and removable partial prosthetics (18.05 ± 4.44) in tuition-based dental school. At the clinical level, the highest mean score of perceived quality of education in tuition-free dental school belonged to the pediatric dentistry (54.93 ± 6.73) and the lowest to endodontics (41.71 ± 8.17). In tuition-based school, the highest student satisfaction was observed with oral surgery (58.54 ± 5.20) and the lowest with orthodontics (46.78 ± 10.22).
At the preclinical level in the tuition-free dental school, the highest student satisfaction was related to the adequacy of opportunities and time allocated to complete practical requirements (Questions 4 and 5; mean score = 26.59), whereas the lowest satisfaction was associated with mastery of practical skills in each department (Question 2; mean score = 24.97). In the tuition-based school, the highest satisfaction was related to the ability to fulfil practical requirements (Question 4; mean score = 27.24), while the lowest satisfaction was related to the adequacy of time to meet educational requirements (Question 5; mean score = 24.35) (Table 4). At the clinical level in tuition-free dental school, the highest mean was related to compliance with infection control principles (Question 12, mean 32.41) and the lowest was related to high responsibility and stress due to high workload (Question 16, mean 23.59). At tuition-based school, the highest satisfaction was related to infection control (question 12, mean 34.92) and the lowest satisfaction was related to the way the staff treated the students (question 15, mean 26.16) (Table 5).
Table 5.
Mean score of questions related to clinical practical skills training in tuition-free and tuition-based dental schools
| Question No. | Questions | Tuition-free (n = 58) |
Tuition-based (n = 37) |
|---|---|---|---|
| 1 | The clarity of expectations regarding students’ duties and responsibilities in this department is: | 30.97 ± 4.63 | 32.92 ± 3.82 |
| 2 | The ability of instructors in this department to motivate students for learning is: | 27.83 ± 3.33 | 29.19 ± 5.10 |
| 3 | The responsiveness of instructors to students’ theoretical or practical problems is: | 29.29 ± 3.62 | 30.51 ± 5.61 |
| 4 | The quality of instructors’ communication and respect toward students is: | 30.26 ± 3.25 | 27.62 ± 6.27 |
| 5 | The punctuality and time management of instructors in this department is: | 30.28 ± 3.72 | 32.38 ± 4.53 |
| 6 | The organization and regular implementation of the training program in this department is: | 28.90 ± 4.68 | 33.03 ± 5.10 |
| 7 | The coordination between theoretical teaching and practical clinical work in this department is: | 29.52 ± 4.94 | 31.24 ± 4.36 |
| 8 | The effectiveness of the educational process in enabling students to acquire practical skills is: | 27.90 ± 4.61 | 29.86 ± 4.95 |
| 9 | The applicability of preclinical training principles to clinical practice on patients is: | 28.60 ± 4.58 | 30.68 ± 4.97 |
| 10 | The up-to-dateness of scientific content and clinical methods used in this department is: | 27.00 ± 5.56 | 32.00 ± 7.45 |
| 11 | The adequacy of supervision and guidance provided by instructors during practical work is: | 28.86 ± 4.86 | 31.86 ± 5.44 |
| 12 | The level of adherence to infection control principles by instructors and staff is: | 32.41 ± 4.28 | 34.92 ± 6.30 |
| 13 | The instructional proficiency of department instructors in delivering theoretical and practical training is: | 32.14 ± 4.27 | 33.38 ± 5.91 |
| 14 | The availability and adequacy of facilities and equipment for students in this department is: | 28.31 ± 6.74 | 31.62 ± 6.72 |
| 15 | The appropriateness of staff behavior and interactions with students in this department is: | 31.34 ± 5.96 | 26.16 ± 8.42 |
| 16 | The adequacy of workload and practical responsibility assigned to students in this department is: | 23.59 ± 6.02 | 34.08 ± 7.50 |
| 17 | Overall, students’ satisfaction with the training provided in this department is: | 27.31 ± 4.73 | 27.65 ± 6.18 |
Discussion
This study aimed to evaluate and compare the perceptions of dental students attending the tuition-free and tuition-based dental schools affiliated with Guilan University of Medical Sciences regarding preclinical and clinical practical skills training. The results showed that the perceived quality of practical skills training was higher at the preclinical level than at the clinical level, with preclinical training rated as good and clinical training rated as moderate. In clinical training, tuition-based school students had a better evaluation than tuition-free school students. A closer evaluation of the present results revealed that students had different perceptions of the quality of training across departments. This difference was particularly evident when comparing the aspects with the highest and lowest mean scores, highlighting specific strengths and weaknesses within the dental practical skills training system. These findings were consistent with similar reports from studies conducted in other countries in the field of dentistry; for example, Alraheam et al. [17], and Javed et al. [18] reported a decrease in the quality of training in the clinical setting compared to the preclinical setting, and attributed it to resource constraints, number of students, and limited practice opportunities. Jazzar et al. [19] reported a decrease in the quality of clinical training compared to the preclinical level, and attributed this to a lack of infrastructure and the need to revise educational programs. In addition, a study by Khattak et al. [20] conducted in Saudi Arabia reported that the decrease in educational quality in the clinical level could be due to resource constraints, high number of students, and limited opportunities for practical training. In contrast, some studies, such as the one conducted by Bertaccini et al. [21] reported that the quality of clinical courses was similar or superior to that of preclinical courses, which may be due to better infrastructure, lower faculty-student ratios, and greater access to patients in the clinical setting. A study by Yazdankhahfard et al. [22], on nursing students also showed that in line with the present study, students expected a more favorable educational environment than what they experienced.
At the clinical level, the highest student satisfaction was observed in the pediatric dentistry department in the tuition-free school and in the oral and maxillofacial surgery department in the tuition-based school. These findings may reflect greater clinical exposure, higher case diversity, and more structured supervision in these departments. In contrast, the lowest levels of satisfaction were reported for endodontics in the tuition-free school and orthodontics in the tuition-based school, which may be related to the technical complexity of clinical procedures, higher cognitive and psychomotor demands, and limitations in clinical resources or instructor–student interaction. At the preclinical level, the restorative dentistry department showed the highest mean perceived quality score in both schools, whereas the lowest mean perceived quality score was observed for orthodontics in the tuition-free school and removable partial prosthodontics in the tuition-based school. This finding is consistent with the results of Valizadeh et al. [23], Field et al. [24], and Muthu et al. [25], who reported higher quality of education in departments with more practical opportunities and stronger educational interaction. In a study by Alsoghier et al. [26], which targeted graduates, a significant gap was reported between the basic and advanced competencies of dental students. They found that graduates had low confidence in performing complex skills such as endodontic treatment of multi-rooted teeth, interpretation of new research or management of children, and high confidence in basic clinical skills. Therefore, in order to improve students’ practical performance, it is recommended that in addition to theoretical training, educational and support structures (e.g. feedback, practice opportunities) should be well provided so that skills can be consolidated and improved [17].
The significant difference in the perceived quality of clinical education between the two schools could be partly attributed to different expectations of students, given the different nature of the two schools in terms of tuition. A closer examination of item-level findings revealed an institutional contrast related to time adequacy and perceived workload. In preclinical training, students in the tuition-free school reported higher satisfaction regarding the adequacy of time allocated for completing practical requirements, whereas students in the tuition-based school expressed lower satisfaction in this domain. This difference may reflect variations in curricular organization, session density, or perceived performance expectations between the two institutions.
At the clinical level, lower scores related to stress and responsibility due to workload in the tuition-free school may suggest differences in patient flow, case complexity, or supervisory demands. Although patient fees are similar in both institutions, access to patients appears to be somewhat greater in the tuition-based school, possibly due to its physical location within the city and proximity to established referral pathways. This increased patient availability may facilitate more consistent clinical exposure, which in turn could influence students’ perceptions of training quality.
At the preclinical level, lack of a significant difference between the two schools indicates that basic practical skills training is provided almost uniformly in both schools. This is consistent with the studies by Akhavan et al. [27], and Bashardost et al. [16], who reported that preliminary training is highly similar in many schools.
Regarding gender differences in the evaluation of the perceived quality of preclinical education in the tuition-free school, the observed higher scores reported by female students may be influenced by a combination of individual and contextual factors, such as differences in learning motivation, learning styles, interaction with instructors, and attitudes toward the educational process. Female students may place greater emphasis on structured instruction, feedback, and clarity of educational expectations, which could shape their perceptions of training quality, particularly in the preclinical setting. This finding is somewhat consistent with the results of Foroughi et al. [13], who reported gender differences in some educational topics. However, the absence of significant gender differences in other educational levels and in the tuition-based school, as well as findings from studies by Akhavan et al. [27], and Sadeghi et al. [15], suggest that the influence of gender on perceived educational quality is neither uniform nor universal. Rather, gender-related differences may be context-dependent and influenced by characteristics of the learning environment, instructional structure, and stage of training. Consequently, these results should be interpreted with caution, and future research employing qualitative or mixed-method approaches may help to better elucidate how gender and educational context interact to shape students’ perceptions of practical skills training.
The findings of this study can be used as a basis for planning in practical skills training in dental education. The results showed that the perceived quality of practical skills training, especially in clinical departments, requires strengthening of infrastructure and reviewing of teaching and assessment methods. This can guide department managers and educational policy makers to improve the learning experience of students by standardizing the educational requirements, systematically designing skill programs, and creating more practice opportunities in the clinical and simulation environments.
Cross-sectional nature was a limitation of this study, which limits the possibility of examining the causal relationship between the quality of education and the factors affecting it. Also, the study was conducted only among students of one faculty, which may limit the generalizability of the results to other universities. In addition, some of the students participating in this study, especially at higher levels, may have had different educational experiences that may have influenced their subjective assessment of the quality of practical skills training. Furthermore, the timing of data collection during the academic year may have influenced students’ responses, as their perceptions could have been affected by their current departmental postings or clinical rotations at the time of completing the questionnaire. These factors can affect the results of the study, and should be taken into account when interpreting the findings. Future studies are recommended at the national level to draw a more comprehensive picture of the situation of practical training in dental schools of Iran. Also, designing longitudinal studies to examine the trend of students’ educational experience, conducting research on the relationship between perceived quality of education and actual clinical practice, and assessing the perspectives of instructors and faculty members can help to more accurately identify educational challenges and needs.
Conclusion
The present results indicated that the perceived quality of practical skills training among dental students differed between educational levels. Preclinical training was perceived as having a good level of quality, whereas clinical training was rated at a moderate level. Although no difference was observed between tuition-free and tuition-based dental students in the preclinical departments, the perceived quality of clinical training in the tuition-based school was rated higher from the students’ perspective. This finding suggests that contextual differences in clinical training conditions, including access to educational resources and clinical opportunities, may contribute to unequal educational experiences among students. From an educational policy perspective, the results of this study highlight the need to design and implement clinical training standardization programs, such as determining common educational requirements for all departments, improving the faculty-student ratio, strengthening structured feedback, and using modern teaching methods and skills simulation. These findings underscore the importance of considering contextual and structural factors when interpreting students’ perceptions of clinical training quality.
Supplementary Information
Acknowledgements
This work was supported by Dental Sciences Research Center of Guilan University of Medical Sciences (IR.GUMS.REC.1403.503). This study is derived from the thesis of a general dentistry student at Guilan University of Medical Sciences.
Ethical Code
IR.GUMS.REC.1403.503.
AI Policy
Artificial intelligence tools were used solely for linguistic refinement. The study design, data collection, analysis, interpretation of results, and final conclusions were entirely conducted by the authors.
Abbreviations
- SPSS
Statistical Package for the Social Sciences
- CVR
Content Validity Ratio
- CVI
Content Validity Index
- SD
Standard Deviation
Authors’ contributions
Sh.M: Conceptualization, Methodology, Writing - Review & Editing M.F: Writing - Original Draft, Data Curation E.J: Resources, Investigation, Visualization Y.B.H: Funding acquisition, Project administration, Supervision.
Funding
This work was funded by dental sciences research center of Guilan University of medical sciences (#6188).
Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Also, the datasets supporting the conclusions of this article are included within the article.
Declarations
Ethics approval and consent to participate
This study was approved by the Ethics Committee of Guilan University of Medical Sciences (IR.GUMS.REC.1403.503). Participation was voluntary, and informed consent was obtained from all students prior to data collection. Confidentiality and anonymity of the participants’ responses were fully ensured. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Also, the datasets supporting the conclusions of this article are included within the article.