Perception of dental and medical teaching faculty regarding mobile dental application

INTRODUCTION With ever increasing research and technology the education methods should dynamically adapt to this ever changing social environment. It is due to the prevalence of mobile technologies that smart mobile phones and handheld computers have become an inseparable educational tool for the present and prospective students. Information and communication technology (ICT) has been a critical component of teaching and learning in higher education over the last few decades. One particularly important trend we have recently witnessed with regard to the use of ICT is the increasing reliance on mobile-connected devices not only in daily tasks but also within professional and educational environment.[12] In earlier times, learning from computers was considered as a hassle because of their large size and adaptability among the users. The main source of education for the students was through the teacher and IT was used as a medium to refer some sources or a method of delivering program curriculum. For instance, in medical and dental learning the desktops/computers were a source for delivering presentations or for literature search which we termed as (D-learning). Teachers were slow to embrace the new technology as compared to traditional education methods which lead to delay in its adaptability among the medical professionals.[34] However, access to the information over these handheld devices offered more advantages and information at the point of source through different applications (apps), which were user friendly and more convenient for the students. But still, every resource on the Internet is not trustworthy and reliable and there is a need of evidence-based material to deliver education and to practice the profession in an ethical manner.[5] The purpose of this study was to objectively investigate whether and up to what extent dental and medical faculty use their smartphones as learning tools. In addition, the subjective attitudes of dental faculty toward smartphones as learning tools were to be investigated. The results of the study will be helpful in providing an insight to use and efficiency of various dental apps as well as portable digital assistants in teaching and learning various aspects of dental and medical education. AIM The aim of this study was to assess the attitude and awareness about the use of mobile dental apps among the dental and medical teaching faculty of Ghaziabad district. OBJECTIVES The main objectives of the study were as follows: To study the prevalence of mobile dental apps usage among the dental and medical teaching faculty. To perception of dental and medical faculty regarding the mobile dental app-based learning on clinical practice and theory examination. MATERIALS AND METHODS A cross-sectional questionnaire survey was carried out among the dental and medical teaching faculty of ITS Dental College, Muradnagar, Ghaziabad to assess the prevalence of dental/medical apps usage and their perception. The project obtained the ethical approval from the ethics committee of the ITS Dental College, Muradnagar, Ghaziabad (Protocol no. ITSCDSR/L/22017/082). The purpose and procedure of the study was informed to each study subject. An information sheet was provided to each individual and verbally explained to the individuals in English language. Written informed consent was obtained from the participants and orientation session was conducted by the principal investigator to outline the various types, uses, functions, and apps. All the dental and medical teaching faculty of ITS Dental College, Muradnagar, Ghaziabad was included in the study. Inclusion criteria The inclusion criteria of the study included the following: Full-time teaching faculty were enrolled in the survey. Exclusion criteria The exclusion criteria of the study included the following: Participants who did not respond to the questionnaire form till three weeks. Participants who were not using smartphones/devices. Participants who did not have Internet connection. The questionnaire was tested for both face and content validity by a panel of experts to ensure comprehensive ability of dental and medical faculty to be surveyed. The reliability of the questionnaire was assessed using Cronbach’s analysis (α = 0.78) and it was found to be good.[6] A questionnaire comprising 15 close-ended questions was administered to the participants having three components numbered as parts 1, 2, and 3, respectively. The first part of the questionnaire comprised questions designed to collect the information related to demographic parameter of the study group such as gender, place, types of smart devices and means of Internet access on the smart devices (Wi-Fi, 3G/4G or both), installation of medical/dental apps (free or paid), and frequency and purpose of usage. The second part of the questionnaire comprised 8 questions pertaining to dental and medical teaching faculty perception related to dental apps and their comparison with the traditional source of knowledge sharing, usage of dental and medical devices, and any threats related to it. The third part of the questionnaire comprised 7 questions related to perception on the characteristic of ideal dental app and recommendations. A 5-point Likert scale[7] was used for scoring purpose for each question in part two to part four of the questionnaire. A numerical value was assigned to each category: 1––strongly disagree; 2––disagree; 3––unsure; 4––agree; and 5––strongly agree. To assess their e-literacy (electronic literacy), few multiple-choice questions pertaining to commonly used dental apps and advantages of these in dentistry were also included in the study. The data obtained were transferred for assessment form to a computer for statistical analysis. Master chart was created using Microsoft Excel software (version 2010, Albuquerque, New Mexico, USA) for data analysis. The statistical average (mean), standard deviation, and percentages were used to represent the different measurements. Data were analyzed with descriptive statistics. For the normality of data, Kolmogorov–Smirnov test was performed, questionnaire was checked for validity and reliability using Cronbach’s α analysis, and interclass correlation coefficient was used to assess the relationship between the study population and questionnaire response. The data were analyzed by using Statistical Package for the Social Sciences software version 23 (IBM). Correlations were tested at 95% significance level (P < 0.05). RESULTS This cross-sectional questionnaire survey was conducted among the dental and medical teaching faculty at ITS Dental College, Muradnagar, Ghaziabad to analyze the knowledge, attitude, and perception of dental and medical teaching faculty regarding use of mobile dental apps and perception regarding ideal mobile dental apps. Demographic details and the 15-item pretested questionnaire were administered to the participants using Google forms with a 5-point Likert scale to assess their beliefs and behaviors as follows: 1––strongly disagree; 2––disagree; 3––unsure; 4––agree; and 5––strongly agree. Of the 63 teaching faculty, seven were not included in the survey as they were not using any smartphone and Internet connection. The final sample included for the analysis on the basis of questionnaire response were fifty six. Table 1 shows the reliability of the questionnaire assessed using Cronbach’s analysis (α = 0.78) and the reliability was found to be good. Data were also analyzed for normality and the distribution was abnormal; thus, a non-parametric chi-squared analysis was used to assess the fitness of the model.Table 1: Reliability analysis of the questionnaireTables 2 and 3 show the intraclass correlation between the study subjects and a significant association was found, which is interpretative of strong correlation among the participants (ICC= 0.273, P = 0.042).Table 2: Intraclass correlation coefficient analysisTable 3: Correlation analysisAs can be seen from Table 4, the chi-squared analysis also revealed a significant association for most of the responses, except for the fact that “dental apps are essential tools.” Figure 1 represents the participants who were using smartphones with Internet connection 11% (n = 7).Table 4: Chi-squared analysis and participant’s response to questionnaire (Q1 to Q15)Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Table: No title available.Figure 1: Participants with smartphones and Internet connectionDISCUSSION This cross-sectional survey was carried out to assess the attitude, knowledge, and anticipation regarding the dental apps usage among dental and medical teaching faculty of Ghaziabad district. The 15-item questionnaire comprising three sections was pretested and was applied after the survey report. The social and demographic details were also collected and compiled. The study group comprised total 56 faculties, who were using smartphones installed with mobile dental apps. Wallace et al.[89] concluded that participants pointed out number of advantages associated with the use of handheld devices such as portability, fast access to information on the Internet, efficient use of time, flexible communications, powerful apps, and access to multimedia resources. The authors also highlighted that those who are not using the smartphones have missed out on many things. In a study examining the use of Personal Digital Assistant (PDA’s) by medical students, Pault et al. reported that smartphones facilitated student learning by providing timely access to key facts, allowing learning in context and by repetition, supplementing other ways of learning, and making use of wasted time, whereas in our survey approximately 9% (n = 7) of the subjects were not included in the survey mainly due to nonusage of smartphones and Internet. In our survey, about 70% of the participants agreed that by using mobile dental apps they were able to save time and had a faster access to reliable available literature. These findings were in agreement with those obtained by Wallace et al.[8] and Paul et al.,[10] in which participants commonly used the devices to manage their time, by accessing schedules and calendars “on the go” (students 81%, residents 84%, and faculty 56%). Robinson et al. (2013)[11] reported that in terms of learning new information medical students have more to learn than residents, who have more to learn than faculty, so it is not surprising that the percentage of each group using smartphones was observed in this order for use of online textbooks, medical podcasts, and online lectures. The only issue with the online learning information and tools is its protection from the hackers. Thus, cybersecurity plays a pivotal role in preserving data and network security among its users. Thus, most of the countries with electronic health records use their specific handheld devices and intranet to tackle the issue of data or identity theft of its consumers.[12] There were plenty of positive remarks that were given by the teaching faculty “I am interested in knowing about the new mobile based applications for dentistry.” Some participants referred it as a “mobile dental apps are friendly as it will save paper and time” and some participants also added that “Initially they find it difficult to use, but later were adapted to it.” All faculties should own the smart devices and a significant correlation was found after the assessment of question 4 (P = 0.00). Response from the participants also reflected in the questionnaire as they believed that mobile dental apps are superior to textbooks (P = 0.03), and strongly believed that they can supplement the dental/medical education and practice (P = 0.00). There were certain suggestions given by the participants for improving the current application “Each department of the dental college should have a separate section,” “Ethical consent can’t be obtained from the patients”, “security features for the protection of data” and “automatic SMS reminder for the patient should be there for their appointment.” This was also expressed as the concern and a significant correlation was found in question 8 (P = 0.00). They agreed that medical publisher should produce mobile apps for education purposes (60.8%) and to be approved by dental council of India (44.7%). Recently webinars, and seminars are being conducted by professionals using online portals to deliver lectures and sharing case reports of different patients. These methods are educationally desirable but at the same there is a raising concern about vulnerability of their privacy and this is a current topic of ongoing debate. Cariogram was also introduced with this purpose, which can assess dental caries risk profile using software installed in the computer for assessment of caries risk giving an insight to the caries prediction and has showed success at numerous levels.[1314] Teledentistry has also been used as one of the major technological advances in the field of dental and medical sciences to diagnose and plan treatment planning for the individuals at outreach area.[151617] A notable number of faculties have started access to mobile dental apps regarding the publishing of a research paper or searching evidence-based practice for tutoring students in their clinical practice. In Northern America, various surveys/interviews and data recording are carried out on mobile apps or tablet provided by the institution for data storage and security. Even many online modules on mobile apps are designed specifically for prospective students or continuing learning by esteemed universities around the globe.[1819] For tobacco cessation activities, many countries have adopted mobile dental apps for helping the consumer in quitting the tobacco by providing various updates round the clock. These apps have shown success in numerous cases for discontinuing the habit.[2021] After an extensive search on the available literature, no such type of research was found, which evaluated teaching faculty regarding the use of mobile application for dental data management. This experimental study is first of its kind, in which questionnaire is given and mobile application is used as an intervention. Thus, more research focused on this platform can be used at the later stages for data evaluation, analysis, and interpretation. CONCLUSION The findings from the study reflected academic and technological platform for using handheld devices in clinical medical and dental setting. The ergonomics of recent handheld devices gives more comfort and portability to the users compared to the standard operating system such as personal computers and desktop, which gives the mobile dental/medical apps an edge over them that can be used for prospective clinical settings. Benefits This research included the following benefits: Being able to keep clinical notes of the patients Portable, convenient, and ease of use Being able to keep a track of their confirmed appointments Online access to support materials, particularly video materials, that can be used for teledentistry.[22] The result of this research gave an insight for the access of mobile apps on handheld devices and helped us to determine the pros and cons faced by the users in the clinical setting where the device was a tool for management and the source for learning as well. Thus, these devices are beginning to take the leadership role in the healthcare facility. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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