Knowledge, Attitude and Practice of Dental Students About COVID-19
Condition: Acute Respiratory Distress Syndrome; Corona Virus Infection; Acute Lung Injury; Fever; Myalgia; Cough; Dyspnea; Septic Shock; Bleeding
MeSH terms: Infections; COVID-19; Coronavirus Infections; Myalgia; Respiratory Distress Syndrome; Respiratory Distress Syndrome, Newborn; Acute Lung Injury; Dyspnea; Lung Injury
Study type: Observational

Summary: 
      Coronavirus disease 2019 (abbreviated "COVID- 19") is a pandemic respiratory disease that is
      caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The
      disease is highly infectious, and its main clinical symptoms include fever, dry cough,
      fatigue, myalgia, and dyspnoea.1 In China, 18.5% of the patients with COVID-19 developed to
      the severe stage, which is characterized by acute respiratory distress syndrome, septic
      shock, difficult-to-tackle metabolic acidosis, and bleeding and coagulation dysfunction.

      After China, COVID-19 spread across the world and many governments implemented unprecedented
      measures like suspension of public transportation, the closing of public spaces, close
      management of communities, and isolation and care for infected people and suspected cases.
      The Malaysian government had enforced Movement Control Order (MCO) from 18th March to 4th May
      2020 and henceforth Conditional Movement Control Order (CMCO) until 9th June 2020. The battle
      against COVID-19 is still continuing in Malaysia and all over the world.

      Due to the CMO and CMCO in the country, public and private universities have activated the
      e-learning mode for classes and as the government ordered, universities are closed and no
      face-to-face activities allowed. This has forced students of all disciplines including
      dentistry to stay at home which are wide-spread across Malaysia and shift to e- learning
      mode. To guarantee the final success for fight against COVID-19, regardless of their
      education status, students' adherence to these control measures are essential, which is
      largely affected by their knowledge, attitudes, and practices (KAP) towards COVID-19 in
      accordance with KAP theory. Once the restrictions are eased students have to come back and
      resume their clinical work in the campus.

      Hence, in this study we assessed the Knowledge, Attitude, and Practice (KAP) towards COVID-19
      and the students preference for online learning.
    

Detailed description: 
      Due to the CMO and CMCO in the country, public and private universities have activated the
      e-learning mode for classes and as the government ordered, universities are closed and no
      face-to-face activities allowed. This has forced students of all disciplines including
      dentistry to stay at home which is wide-spread across Malaysia and shift to e-learning mode.
      To guarantee the final success for the fight against COVID-19, regardless of their education
      status, students' adherence to these control measures is essential, which is largely affected
      by their knowledge, attitudes, and practices (KAP) towards COVID-19 in accordance with KAP
      theory.

      Background:

      In the KAP study conducted among residents in China, it was noticed that KAP scores were
      associated with a lower likelihood of negative attitudes and preventive practices towards
      COVID-2019. Most Chinese residents of a relatively high socioeconomic status, in particular
      women, are knowledgeable about COVID-19, hold optimistic attitudes, and have appropriate
      practices towards COVID-19. Health education programs aimed at improving COVID-19 knowledge
      are helpful for Chinese residents to hold optimistic attitudes and maintain appropriate
      practices. In a cross-sectional study among pregestational and pregnant women was conducted
      in Shaanxi, China, women at the periconceptional period in Shaanxi lacked the total KAP level
      of periconceptional healthcare, especially those who live in rural areas and have less
      education. The authors concluded that government agencies should reinforce more effective
      primary preventive measures and policies for the prevention of adverse pregnancy outcomes.

      In a study aimed to assess the level of awareness, perception, and attitude regarding
      COVID-19 and infection control among Jordanian dentists, the authors concluded that Jordanian
      dentists were aware of COVID-19 symptoms, mode of transmission, and infection controls and
      measures in dental clinics. But dentists had limited comprehension of the extra precautionary
      measures that protect the dental staff and other patients from COVID-19. They also
      recommended that it would be best practice to send National and international guidelines
      established by the regional and national dental associations to all registered dentists
      during a crisis, including the COVID-19 pandemic, to ensure that dentists are well informed
      and aware of best practices and recommended disease management approaches.

      The outbreak of COVID-19 was unprecedented and forced many universities to launch online
      courses to ensure the continuity of teaching-learning activities, with students staying at
      homes or dorms. It is a massive, challenging shift to move all the existing courses online in
      a matter of days. In general, a complete online course requires an elaborate lesson plan
      design, teaching materials such as audio and video contents, as well as technology support
      teams.

      Many academic institutions in Malaysia commit themselves to eLearning because they believe in
      its effectiveness as an alternative approach to the traditional classroom method of
      disseminating information. A study conducted on e-learning shows that higher education
      institutions in Malaysia offer more than 50% of their courses online. The data also shows
      that 13.8% of lecturers provide more than 80% online learning materials and that 44.6% of
      students prefer to read materials uploaded by their lecturers. The findings also show that
      students' preference for online courses is very encouraging. In fact, lecturers also agree
      that the integration of e-learning into their courses has benefited students. In general, it
      clearly shows that the application of e-learning is accepted by lecturers and students of
      HEIs as an effective means of communication.

      A national study was conducted to evaluate the self-perceived preparedness of final-year
      dental undergraduate students in dental public universities in Malaysia. The authors
      concluded that confidence and experience in some clinical skills, cognitive and behavioral
      attributes could be improved to facilitate their transition into independent dental practice
      after graduation. This is best possible in face-to-face teaching. So given this unprecedented
      situation, it will be best to assess the perception of dental students towards online
      teaching.
    

Intervention name(s): Knowledge, Attitude, Practice, Awareness, Preference
Intervention type(s): Behavioral
Intervention description(s): KAP, Awareness level and Preference were assessed using questionnaires
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        All consenting participants of year 3, 4 and undergraduate dental students studying at
        Faculty of Dentistry, Melaka-Manipal Medical College, Melaka, were included in the study
      
Keywords: Humans; COVID-19; Online learning; Perception