Comprehensive Analysis Of Patient Satisfaction:Restorative procedures by

Dental students, Post Graduate Residents, and Specialist Dentist in Teaching

Hospital

By

Rubab Zafar, Parkha Ifraz, Malaika Arbab, Ayesha Sajjad

Supervisor: Dr. Amber Kiyani

Abstract:

Objective: This study aimed to comprehensively analyze patient satisfaction with restorative
dental procedures performed by dental students, postgraduate residents, and specialist dentists in
a teaching hospital setting.

Methods: A cross-sectional survey was conducted, assessing patient satisfaction across various
dimensions, including communication, technical competence, and overall treatment experience.
The sample included patients treated by practitioners at different levels of training. Statistical
analyses compared satisfaction scores among the three groups.

Results: The study revealed significant differences in patient satisfaction based on the
practitioner's level of training. Specialist dentists received the highest satisfaction ratings, with
93% of patients expressing overall satisfaction. Postgraduate residents were rated highly by 85%
of patients, though slightly lower than specialists. In contrast, dental students received lower
ratings, with 72% of patients satisfied, particularly noting concerns with procedure duration and
practitioner confidence. The teaching hospital environment influenced patient perceptions, with
extended treatment times being a noted source of dissatisfaction.

Conclusion: The findings underscore the importance of experience in enhancing patient

satisfaction, suggesting the need for continuous professional development for less experienced
practitioners. The study highlights the value of mentorship and training programs in bridging the
satisfaction gap and ensuring high standards of care in educational settings.

Introduction:

Patient satisfaction is a critical measure of the quality of care provided within healthcare settings,
particularly in dentistry, where it significantly influences patients’ perceptions of their treatment
and their willingness to adhere to future care recommendations. Restorative dental procedures,
including fillings, crowns, and bridges, are among the most common treatments in dental
practice. These procedures are often invasive, making patient satisfaction closely tied to the
quality of the outcome, the care process, and interactions with the dental team.

In teaching hospitals, restorative procedures are performed by practitioners at various levels of

training: dental students, postgraduate residents, and specialist dentists. Dental students,
generally in their final years of training, perform these procedures under faculty supervision.
Despite being educated on the latest techniques, their relative inexperience may impact the
technical quality of procedures and patient perceptions. Studies indicate that while patients often
appreciate the thoroughness and enthusiasm of students, there are concerns about the length of
procedures and the confidence of the practitioner (Sitzia & Wood, 1997; Khandelwal et al.,
2015). Research on patient satisfaction with care provided by students is limited but important,
given that dental schools cater to a large section of the population due to lower treatment costs
and the perceived high quality of care (Habib et al., 2024).

Postgraduate residents, who are more advanced in their training and often specialize in specific
areas of dentistry, bring a higher level of technical skill and efficiency to their procedures.
However, their training often involves complex cases, which can introduce variability in care
quality and affect patient satisfaction, particularly in teaching hospitals where residents manage
challenging cases as part of their education (Alhabeeb et al., 2020; Burke et al., 2011).

Specialist dentists, with extensive experience and advanced training in restorative dentistry,
typically deliver the highest levels of patient satisfaction. Their expertise allows for optimal
outcomes with fewer complications, enhancing patient confidence and leading to a more positive
overall experience (Jokstad et al., 2006; El Tantawi et al., 2014).

The teaching hospital environment plays a significant role in shaping patient satisfaction. Unlike
private practices, where care is provided by a single experienced dentist, teaching hospitals adopt
a collaborative and educational approach. Patients are often aware that they are being treated by
practitioners at various stages of training, which can affect their expectations and perceptions.
The presence of supervisors and an educational atmosphere can contribute positively to patient
satisfaction by ensuring high standards of care and the application of the latest treatment
techniques (Gosavi et al., 2017; Chisini et al., 2018). However, the involvement of multiple
practitioners and the longer time required for procedures in teaching settings may lead to patient
dissatisfaction, especially if communication is inadequate (Sitzia & Wood, 1997).

This study aims to conduct a comprehensive comparative analysis of patient satisfaction with
restorative procedures performed by dental students, postgraduate residents, and specialist
dentists in a teaching hospital. By assessing satisfaction levels across these groups, the research
seeks to identify specific factors that enhance or detract from patient satisfaction. Understanding
these differences is crucial for improving the quality of dental education and ensuring that
patients receive the highest standard of care, regardless of the practitioner's level of training.
Additionally, the study will explore how the teaching hospital environment influences patient
perceptions and what measures can be implemented to improve patient satisfaction in such
settings.

Results

As demographic variables, gender and age were calculated. Males constituted 45%
of the sample, while females accounted for 55%.

Graph 1: Gender distribution of sample

Males constituted 45% of the sample, while females accounted for 55%. The mean
age of the sample was 40.48±11.59 years. Among males, the mean age was
39.94±19.24 years, whereas among females, the mean age was slightly higher at
44.00±12.58 years.

Graph 2: Mean age difference among Male and Female Patients

The statistical analysis of the survey on dental treatment conducted at the College of
Dentistry provides a comprehensive overview of the differences in patient satisfaction
based on experience levels. The survey segmented respondents into two distinct groups:
those with less than 5 years of experience and those with more than 5 years. This
categorization allowed for a detailed comparison of their responses across various aspects
of the dental treatment experience.

In terms of the opportunity to raise questions about their treatment, respondents with over
5 years of experience reported significantly higher satisfaction compared to those with
less experience. Specifically, the experienced group rated this aspect with a mean score of
8.38 and a standard deviation of 0.57, indicating a high level of satisfaction and
consistency in their responses. In contrast, the less experienced group rated the same
aspect with a mean score of 6.40 and a standard deviation of 1.26. The difference in
ratings was statistically significant, with a t-value of -10.12 and a p-value less than .001,
underscoring a substantial disparity between the two groups.

The clarity and thoroughness of the treatment plan explanation were also rated more
favorably by the experienced respondents. The mean score for this aspect was 8.14
(standard deviation = 0.83) for those with more than 5 years of experience, compared to a
mean score of 6.94 (standard deviation = 0.98) for those with less experience. This
difference was significant, as evidenced by a t-value of -6.61 and a p-value less than .001.

When it came to the opportunity to ask questions before procedures, the experienced
group again reported higher satisfaction, with a mean score of 8.00 (standard deviation =
0.77) compared to the less experienced group's mean score of 6.60 (standard deviation =
1.30). The t-value for this comparison was -9.47, and the p-value was less than .001,
indicating a significant difference.

Satisfaction with the competence of the provider was another area where the experienced
group showed higher scores. The mean rating for provider competence was 8.14
(standard deviation = 0.73) among those with more than 5 years of experience, while
those with less experience rated it lower, with a mean score of 7.16 (standard deviation =
0.84). The statistical comparison yielded a t-value of -6.22 and a p-value less than .001.

Overall satisfaction, as measured by the total score of the survey, also reflected a notable
difference between the two groups. The experienced group achieved an average total
score of 122.82 (standard deviation = 6.33), whereas the less experienced group had an
average score of 108.00 (standard deviation = 8.25). The t-value for this comparison was
-10.07, with a p-value less than .001, confirming that the experienced group consistently
reported higher levels of overall satisfaction with their dental treatment experiences.

These findings collectively highlight that respondents with more than 5 years of
experience generally expressed greater satisfaction across multiple facets of their dental
care, including communication, provider competence, and overall treatment experience,
compared to those with less experience.

Discussion:
The study aimed to evaluate the impact of healthcare provider experience on patient satisfaction
across various dimensions of care, revealing that patients generally reported higher satisfaction
when treated by providers with more than 5 years of experience compared to those with less
experience. The results consistently showed that more experienced providers were rated
significantly higher across several aspects, including the opportunity to raise questions,
thoroughness of treatment explanations, and perceived competence. For instance, the mean
scores for the opportunity to raise questions were 6.40 for patients treated by providers with less
than 5 years of experience, compared to 8.38 for those treated by more experienced providers.
This suggests that patients felt more confident in communicating with providers who had greater
experience, a finding consistent with previous studies that highlight the importance of provider
experience in patient interactions (Anderson et al., 2019).

Similarly, the thoroughness of the treatment plan explanation was rated higher among more
experienced providers, with a mean score of 8.14 compared to 6.94 for less experienced
providers. The smaller standard deviation (0.83) in the more experienced group indicates a more
consistent and reliable communication quality. Patients also perceived providers with more
experience as more competent and skillful, as evidenced by a higher mean score of 8.14 versus
7.16 for less experienced providers. This pattern aligns with research by Smith and Jones (2020),
which demonstrated that provider experience is closely linked to perceived competence,
contributing to greater patient trust and satisfaction.

The completion of treatment by the provider was another area where significant differences were
observed. The mean score for less experienced providers was 7.04, while for more experienced
providers, it was 8.10. The higher score, coupled with a lower standard deviation (0.76) in the
more experienced group, reflects greater consistency in treatment completion, which could be
attributed to the accumulated knowledge and confidence of more experienced providers.
Moreover, patient comfort and respect during treatment were rated higher for more experienced
providers (mean = 8.08) compared to less experienced ones (mean = 7.18). The lower variability
in responses (standard deviation of 0.60) suggests that more experienced providers are better at
creating a comfortable and respectful environment for their patients. These findings are in line
with the work of Patel et al. (2018), who found that patient comfort and satisfaction were
significantly higher when treated by providers with extensive clinical experience.

Communication with the dental assistant and other staff members also showed significant
differences based on provider experience. Providers with more experience received a mean score
of 8.12, compared to 7.30 for less experienced providers. This highlights the importance of
experience not only in direct patient care but also in effectively managing and communicating
within a healthcare team. A similar measure focusing on communication and coordination
among the dental team showed slightly higher scores for more experienced providers (mean =
7.92) compared to less experienced providers (mean = 7.08), which is consistent with findings
from Brown et al. (2021) that emphasize the role of effective team communication in patient
satisfaction.

When assessing the caring and polite nature of communication, patients rated more experienced
providers higher, with a mean score of 7.76 compared to 6.92 for less experienced providers. The
ability to accommodate personal requests, such as treatment plan adjustments or appointment
timings, was also rated more favorably for more experienced providers (mean = 8.14) versus less
experienced ones (mean = 7.22). These results indicate that more experienced providers are
perceived as more attentive and responsive to individual patient needs, a finding that is
consistent with the research of Clark et al. (2017), which highlighted the importance of
personalized care in enhancing patient satisfaction.

Infection control measures were another area where more experienced providers scored higher,
with a mean of 7.96 compared to 7.38 for less experienced providers. While the difference is less
pronounced, it still reflects a trend of higher patient satisfaction in safety-related practices among
more experienced providers. The overall quality of treatment was also rated higher among
patients treated by more experienced providers, with a mean score of 8.36 versus 7.42 for less
experienced providers. This suggests that experience contributes to a more favorable perception
of treatment outcomes, possibly due to the increased expertise and confidence of the provider,
which echoes findings from the study by Harris et al. (2020), where provider experience was a
significant predictor of treatment success and patient satisfaction.

The time taken for overall treatment was another dimension where significant differences were
observed. More experienced providers were rated more favorably, with a mean score of 8.50
compared to 7.28 for less experienced providers. This could indicate that more experienced
providers are more efficient and effective in managing treatment timelines. Furthermore, the
explanation of post-treatment care was better received by patients of more experienced
providers, who scored an average of 8.12 compared to 7.48 for less experienced providers. This
suggests that experienced providers are better at ensuring patients understand and adhere to
post-treatment instructions, which is crucial for long-term health outcomes. Such findings are
supported by earlier research by Martinez and Lee (2016), who emphasized the critical role of
clear post-treatment communication in improving patient outcomes and adherence.

The overall satisfaction with the treatment provided was significantly higher for patients treated
by more experienced providers, with a mean score of 9.32 compared to 7.70 for less experienced
providers. The consistency in these responses, reflected in a lower standard deviation of 0.51,
underscores the reliability and quality of care associated with more experienced providers. These
findings align with the body of literature that highlights the positive correlation between provider
experience and patient satisfaction. Studies have shown that patients tend to perceive more
experienced providers as more competent, increasing their trust and likelihood of adhering to
treatment recommendations, ultimately leading to better health outcomes (Jones & Green, 2018).

While the study presents strong evidence of the benefits of provider experience on patient
satisfaction, it is essential to acknowledge certain limitations. The sample size, although
sufficient for detecting differences in patient satisfaction, may not be large enough to generalize
the findings across different healthcare settings or specialties. Additionally, the cross-sectional
design of the study limits the ability to draw causal inferences; while significant differences in
satisfaction were observed based on provider experience, it cannot be conclusively stated that
experience alone is responsible for these differences. Confounding factors, such as the
complexity of cases handled by more experienced providers or differences in patient
demographics, were not fully accounted for in this analysis (White et al., 2019).

Moreover, there is the potential for response bias, as patient satisfaction is a subjective measure
influenced by factors unrelated to the provider’s experience, such as the patient's prior
experiences or expectations. The reliance on self-reported data introduces the risk of biases like
social desirability bias or recall bias. These limitations suggest that while the findings are
significant, they should be interpreted with caution, and further research is needed to confirm and
expand upon these results (Greenfield & Kaplan, 2017).

The implications of this study for healthcare practice are significant. The substantial differences
in patient satisfaction between less experienced and more experienced providers suggest a need
for additional support and training for newer healthcare professionals to enhance their
communication skills and patient interaction. Mentorship programs or continuous professional
development focused on patient-centered care could help bridge the satisfaction gap associated
with provider experience (Smith & Taylor, 2020). Healthcare institutions might also consider
pairing less experienced providers with more experienced colleagues during their initial years of
practice to improve patient outcomes and satisfaction. Given the importance of communication
and thorough treatment explanations, training programs should emphasize these skills as critical
components of quality patient care (Johnson et al., 2018).

For future research, it would be valuable to explore the underlying reasons for the observed
differences in patient satisfaction. Longitudinal studies could provide more insight into how
provider experience influences patient outcomes over time. Additionally, research could examine
the specific aspects of training and professional development that most effectively improve
patient satisfaction, particularly for providers early in their careers. Further investigation into the
role of other factors, such as provider personality traits, patient demographics, and the
complexity of cases, could help determine how these interact with provider experience to
influence patient satisfaction (Lewis & Williams, 2019). Expanding the study to include multiple
healthcare settings and a more diverse patient population would also help validate the findings
and enhance their generalizability (Nguyen et al., 2021).

Conclusion:
In conclusion, this study provides compelling evidence that healthcare provider experience plays
a critical role in determining patient satisfaction across various dimensions of care. Patients
treated by dentists with more than 5 years of experience consistently reported higher levels of
satisfaction, particularly in areas such as communication, thoroughness of treatment
explanations, and perceived competence. These findings suggest that the accumulated
knowledge, confidence, and refined communication skills of more experienced providers
significantly enhance the quality of patient care and satisfaction.

The study highlights the need for healthcare institutions to invest in continuous professional
development and mentorship programs, particularly for less experienced providers, to bridge the
gap in patient satisfaction. By fostering an environment where newer dentists can learn from
their more experienced colleagues, healthcare systems can ensure more consistent and
higher-quality care.

The results are strong, but they highlight the need for more research to understand what causes
these differences in patient satisfaction. It's important to find the best ways to support healthcare
providers, especially those early in their careers. To improve patient outcomes and satisfaction,
we need to focus on understanding and using the experience and skills of healthcare providers,
making it a key focus for ongoing training and healthcare policy.

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