Unmuting the Dental Student Voice: A Multi-Institutional Study on Raising Concerns

In healthcare professions, raising concerns refers to the act of reporting issues that may affect the safety, wellbeing, or rights of patients, staff, or the public. There are few studies specifically focused on the abilities of dental students to raise concerns. The aim of this study was to evaluate the confidence in raising concerns amongst undergraduate dental students.

An analytical cross-sectional study design was used for this research to recruit undergraduate dental students at eight dental institutions in Pakistan. Data were collected using an online questionnaire with high reliability. Participation was voluntary and all data were processed anonymously. T-tests and Analysis of Variance (ANOVA) were used to assess significant variations by demographic factors.

A total of 503 students provided their responses to the online survey yielding a response rate of 49.50%. Of these, 397 were female (78.93%) and 105 were male (20.87%). Participant ages were grouped as 18-21 years (30.42%), 22-25 years (63.62%) or 26 and older (5.96%). Existence of an institutional policy on raising concerns was reported by 226, and 38.96% regarded the policy as easily accessible to students. Only 27.23% of participants received formal training in raising concerns. The overall mean score for all items was 0.51 ± 1.37 (95% CI -0.39 to 0.63). ANOVA revealed significant variation by gender and year of study (p < 0.01), with female students and house officers reporting greater self-confidence in raising concerns. The participants were most confident in sharing their concerns with their peers and least confident in reporting them to the head of department. The most frequent barriers to reporting concerns were the fear of causing trouble, not being able to prove, and lack of institutional support.

The findings of this study show that participants reported a low-moderate confidence in raising concerns during clinical training and identified several barriers which may discourage them from whistleblowing. The findings of this study underscore the need for a support structure in clinical training environments and provide further training and support to dental students to allow them to raise concerns in a timely manner.