|Year : 2014 | Volume
| Issue : 3 | Page : 189-193
Knowledge, attitude, and practices in research among postgraduate students in dental institutions in Bengaluru City, India
Nitya Sharma, M Pramila, Archana Krishnamurthy, GK Umashankar, Ranganath, Nikhil Ahuja
Department of Public Health Dentistry, MR Ambedkar Dental College, Bengaluru, Karnataka, India
|Date of Web Publication||15-Nov-2014|
MR Ambedkar Dental College, 1/36, Cline Road, Bengaluru 560 005, Karnataka
Source of Support: None, Conflict of Interest: None
Introduction: Research is not a separate specialty which is practiced by a few, but it is a systematic approach of reasoning, documenting, analyzing, and reporting unusual clinical observations that we come across in everyday clinical practice. This study was conducted to assess research-related knowledge, attitude, and practices among postgraduate students in dental institutions in Bangalore city. Materials and Methods: A cross-sectional survey was conducted using a structured and validated questionnaire. A sample size of 210 postgraduate students was determined. Study was conducted among 2 nd and 3 rd year postgraduate students in 4 randomly selected dental institutions. Descriptive statistics, Chi-square test, and Student's t-test were used to analyze the data. Results: The average percentage of correct responses was 56.7% and 52.6% in 3 rd year and 2 nd year postgraduate students, respectively. Overall, positive attitude was seen in both the groups and was significantly more in 3 rd years in relation to improvement of patient outcome with research and importance of research training during the post graduate course. Research in practice was carried out by 56.9% and 36% of 3 rd and 2 nd year postgraduate students, respectively. The most common obstacle stated for research was the lack of adequate financial and technical facilities for research. Conclusion: The study revealed fair knowledge and a positive attitude toward research but postgraduates failed to transform it into actual practice.
Keywords: Attitude, India, knowledge, research
|How to cite this article:|
Sharma N, Pramila M, Krishnamurthy A, Umashankar G K, Ranganath, Ahuja N. Knowledge, attitude, and practices in research among postgraduate students in dental institutions in Bengaluru City, India. J Indian Assoc Public Health Dent 2014;12:189-93
|How to cite this URL:|
Sharma N, Pramila M, Krishnamurthy A, Umashankar G K, Ranganath, Ahuja N. Knowledge, attitude, and practices in research among postgraduate students in dental institutions in Bengaluru City, India. J Indian Assoc Public Health Dent [serial online] 2014 [cited 2018 Dec 16];12:189-93. Available from: http://www.jiaphd.org/text.asp?2014/12/3/189/144793
| Introduction|| |
Research in oral health care is aimed at in assuring that the profession is kept abreast of scientific and technological advancements, which in turn have short- and long-term impact on the quality of patient care and the continuing development of dental practice which is likely to significantly impact the practice of dentistry. 
In health care sciences, understanding biostatistics may have important implications in modulating clinical practice as it possesses a large effect on evidence-based diagnostic and treatment applications. Similarly, in academics, sufficient knowledge of epidemiological principles is required to successfully conduct a study and correctly analyze data derived from clinical investigations. Comprehension of biostatistics and principles of research design is important for literature evaluation and evidence-based practice in dentistry as well as for researchers wishing to have their publications accepted by international journals.  Hence, a basic understanding of principles of research design and biostatistics is included in the postgraduate curricula by the Dental Council of India for all the subjects. 
Dental students in India are trained to excel theoretically, but there seems to be a disconnect between what is learned and what is applied in the clinics. Some of the changes that might bring dental education to the next level in India could include selecting highly motivated students for dentistry, modifying the teaching methodology with some importance given to treatment planning, and introducing research into the curriculum. Research has changed the face of dentistry and visibly transferred the practice of dentistry over the past few years. 
Till now, surveys have been conducted to record the knowledge of health care professionals on biostatistics and epidemiology, as well as to identify influencing factors.  However, similar data among dental professionals are lacking. The purpose of this study was to assess the research-related knowledge, attitude, and practice among the postgraduate students in Bangalore city. In addition, this study also points out the obstacles faced by the postgraduate students during their postgraduate course while carrying out the research.
| Materials and methods|| |
Study subjects and data collection
This was a cross-sectional study done over a period of 3 months from June to August 2013. List of postgraduate dental institutions was obtained from the website of Rajiv Gandhi University Of Health Sciences, which served as a sampling frame.
Sample size calculation
The sample size was calculated based on the number (465) of 2 nd and 3 rd year postgraduate dental students in 16 dental colleges in Bangalore city. Based on the results of prevalence of knowledge (59.5%) from the pilot study, using confidence level of 95% and design effect 1, sample size was estimated to be of 190 participants. Final sample size was taken as 210 participants after considering 10% nonresponse rates.
To obtain a representative sample of 210 postgraduates in dental institutions in a total of 16 postgraduate teaching dental colleges in Bangalore city, a simple random sampling approach was used. Four dental colleges were selected randomly for the purpose of the study from which all 2 nd and 3 rd year postgraduate students who have an experience of writing research protocol for their dissertation and scientific presentations which are a compulsory part of the postgraduate curricula by the Dental Council of India were taken for the study till the effective sample size was attained.
Permission was obtained from the concerned authorities and the principal of the respective colleges. Ethical clearance was also obtained from the Institutional Review Board. All the dental postgraduates (n = 210) present on the day of data collection were individually asked to complete a pretested anonymous questionnaire which was collected later on the same day. Data were collected over a period of 3 months from June to August 2013 from 210.
A pilot study was conducted on 30 subjects who were selected randomly from M R Ambedkar Dental College and Hospital, Bangalore, to pretest the data collection methods and for the clarity and meaning of the questions. The pilot study subjects were not included in the main study. Questionnaire used in this study was developed from the previous literature, , which was validated, and modifications were then made accordingly before the final questionnaire was administered. The questionnaire was designed in English. To estimate the reliability of the questionnaire used in this study, the questionnaire was given twice to the respondents. The co-efficient of reliability were calculated using Crohnbac's α = 0.95 indicating good reliability.
Questionnaire had five parts:
- Part one consisted of informed consent and demographic information of the dental postgraduates such as gender and academic year. Name was not recorded to maintain the confidentiality
- Part two consisted of knowledge on research which was obtained by eight questions having one correct and three false choices. The postgraduates marking the correct response were given a score 1 and the ones giving wrong response were given a score of 0
- Part three of the questionnaire recorded the attitude of postgraduates toward research in the form of a set of seven questions and was analyzed on a five-point Likert scale whose alternatives were: "Strongly agree" "agree" "neither agree nor disagree" "disagree" and "strongly disagree". For further analysis, alternatives were further divided into positive, negative, and neutral attitude. Those reported knowing "strongly agree" and "agree" for the questions were classified as having a positive attitude and those answering "disagree" and "strongly disagree" were classified as having negative attitude and those answering "neither agree nor disagree" were classified as having neutral attitude
- Part four assessed the research in practice by postgraduates. This section comprised of five questions about reading journals regularly, participation in workshops on research methodology, experience in writing research protocol, doing publications and presentations done at international, national, regional, and institutional levels. The answers required a dichotomous response of yes and no
- Part five assessed the perceived barriers in practicing research by the postgraduates. They were classified into institutional and personal reasons. The postgraduates were asked to choose the options which apply to them the most.
Descriptive statistics including frequency for correct responses was used to assess knowledge and practices while mean and standard deviation were calculated to analyze the attitude. Statistical differences between 2 nd and 3 rd year knowledge, attitude, and practices were analyzed using Chi-square test and Student's t-test.
| Results|| |
Of 210 students, 94 students were in their 3 rd year and 116 were in their 2 nd year of postgraduate course. Among 3 rd year postgraduate students, 42 (44.7%) were males, and 52 (55.3%) were females while, among 2 nd year postgraduate students, 57 (49.2%) were males and 59 (50.8%) were females.
Assessment of research related knowledge was done using a set of eight questions in the questionnaire. Overall, the average percentage of correct responses was 56.7% and 52.3% for 2 nd year and 3 rd year post graduate students, respectively, showing better knowledge in the 2 nd year post graduate students [Table 1].
|Table 1: Comparison of correct responses for knowledge assessing questions |
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The attitude of the postgraduate students was assessed by a set of seven questions which were answered on a five-point Likert scale. The 3 rd year postgraduates showed an overall more positive attitude (3.35 ± 0.61) as compared to 2 nd year post graduate students (2.93 ± 1.16), and this difference was statistically significant (P < 0.05) [Table 2].
Overall, the research was more practiced by the 3 rd year postgraduates than 2 nd year postgraduates and the difference in research practice was statistically significant for all parameters except experience in writing research protocols [Table 3].
|Table 3: Comparison of proportions of postgraduates practicing research |
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Among the listed institutional reasons, the absence of adequate technical resources (69.1%) and lack of time (53.3%) were the most commonly cited reason by the postgraduates. Among the listed personal reasons, inadequate financial resources for research (68.1%) and more time toward learning of specialty subject (50.5%) were opted mostly by the postgraduates as obstacles that prevent them to undertake research during their postgraduation course [Table 4].
|Table 4: Obstacles preventing postgraduates from undertaking research during their course |
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| Discussion|| |
A basic familiarity with research methods is essential for competent medical and dental practice. The best way to gain this familiarity is to take part in a research projects, either as a medical/dental student.  Hence, it is important for the post graduates to be aware of research methodology and basic knowledge of biostatistics.
The present study was conducted to assess research related knowledge, attitude, and practices among postgraduate students in dental institutions in Bangalore city. The overall objective was to identify areas where emphasis should be placed in postgraduate curricula.
The study was aimed at all the postgraduates irrespective of their specialties as basic knowledge of research methodology is compulsory for all specialties. It is in line with results from a recent survey where the statistical knowledge of dental postgraduate students was not influenced by the curriculum of a specific dental specialty. 
Since there is no previous study done in dental students, comparison could not be made with any previous literature in dentistry, hence, it has been made with similar studies done in the medical literature.
Overall, the average percentage of correct responses was 54% in all the postgraduates. This was similar to findings in previous studies done by Pawar et al.  in India  and more as compared to the study by khan et al. in Pakistan.  Furthermore, the knowledge was found better knowledge in the 2 nd year post graduate students. This can be attributed to the fact that in their 2 nd year, the postgraduates have more time study research methodology than their respective subjects.
Both the groups of postgraduates showed a positive attitude toward research which is similar to findings in medical postgraduates in previous studies. , The attitude toward participation in CDE programs, research methodology workshops, and research during postgraduate course was more positive in the 3 rd year postgraduate than 2 nd year students which was statistically significant (P < 0.05). The 3 rd year postgraduates showed an overall more positive attitude (3.35 ± 0.61) as compared to 2 nd year post graduate students (2.93 ± 1.16), and this difference was statistically significant.
The reason for this can be attributed to increase in experience of the 3 rd year postgraduates which resulted in a more favorable attitude toward research than 2 nd year postgraduates. This is in line with the findings in medical postgraduates where attitude increased with years of training.  and in contrast to another study by Khan et al. 
When compared to 2 nd year postgraduates, 3 rd year postgraduates admitted reading journals more regularly. This can be due to the regular journal club discussions which are an essential component of DCI and RGUHS derived curriculum for Master for Dental Surgery course. This finding is much more than found in medical postgraduates in the study by Pawar et al. 
Furthermore, it was seen that the number of postgraduates with experience of writing a research protocol other than the mandatory dissertation in their curriculum were very less in both 3 rd year and 2 nd year postgraduates. This shows a lack of involvement in research projects by the postgraduates and it is similar to that seen in medical postgraduates in the study by Pawar et al. 
The above-mentioned finding is also substantiated by the fact that more 3 rd year had done publications in journals. It can be justified by a report assessing the contribution trend of Indian dental research to the scientific publication during 1996-2007 where it was found that the number of average cites per Indian dental research work has climbed lower since 2002. The cited explanation can be that Indian dental researchers tend not to specialize in a few chosen fields, but the choice of the research topic is made by many other factors, including funding and lack of resources, besides personal interest.  About 71.3% of 3 rd year postgraduates and 56.9% of 2 nd year postgraduates had participated in workshops on research methodology. It is in lines with the study done in medical postgraduates by Pawar et al. 
Among the listed institutional reasons, the absence of adequate technical resources was the most commonly cited reason. It is similar to the study done in the medical postgraduates in Pakistan  but it differs with the one done in the medical postgraduates where in the study by Pawar et al.  "lack of time" was the most common cited reason. As we know that dental materials are expensive, hence lack of financial support can be attributed to be the most common personal reason for dental postgraduates for lack of practice of research. In a review by Elangovan et al., Lack of infrastructure, inadequacy of funds, and lack of research mentors are some of the other reasons for minimal research activity among students in dental schools in India. 
To our knowledge, this is the first study done to assess the research-related knowledge, attitude, and practices of postgraduates in dentistry.
There are various limitations to this study. Since this was a cross-sectional study, causative conclusions could not be established. As questionnaire was used to assess knowledge, attitude, and practices, the Social desirability bias (tendency of respondents to answer questions in a manner that will be viewed favorably by others) central tendency bias (respondents try to avoid extreme statements) and acquiescence (tend to agree with the presented statements) are likely.
| Conclusion|| |
The 3 rd and 2 nd year post graduate students in Bangalore city showed fair knowledge in research and 2 nd year postgraduates had better knowledge than 3 rd year postgraduates. The postgraduates showed a positive attitude toward research with the 3 rd years having a more positive attitude. Both the 2 nd and 3 rd year postgraduates failed to apply research into practice due to lack of technical and financial resources being a major obstacle followed by lack of time and more focus on their mainstream specialty.
Based on our observations, following recommendations can be made to improve the state of research in post graduates such as:
Research component should be made an essential requirement in the undergraduate dental curriculum as well to form a strong foundation. Postgraduates must be encouraged to participate in workshops on research methodology to provide a better perspective of research methodology. The dental colleges can also incorporate summer externships, in which students can rotate through premier research laboratories or research institutes during the program and, therefore, providing a better platform for research-based practice.
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[Table 1], [Table 2], [Table 3], [Table 4]