Evaluating dental students’ satisfaction in clinical Periodontics courses at KSAU-HS: a cross-sectional study
Ensuring the quality of higher education is a priority for the Kingdom of Saudi Arabia. The National Commission for Academic Accreditation and Assessment (NCAAA) is tasked with ensuring that the higher education sector adheres to rigorous standards . Through its comprehensive accreditation and assessment processes, the NCAAA assures students, employers, and the public of the quality and relevance of education at accredited institutions. By emphasizing high standards in research and innovation, the NCAAA supports Saudi Arabia’s goal of becoming a knowledge-based society and ensures that Saudi graduates are globally competitive . A previous study examining the impact of the NCAAA’s accreditation process on medical education in a Saudi Arabian medical college found significant positive effects. The study highlighted improvements in student learning outcomes, with faculty and students aligning curriculum goals to meet professional and regulatory standards. These outcomes also addressed community health needs, as evidenced by the strong performance of graduates in the National Saudi Licensing Exam. The study also noted improvements in educational quality post-accreditation, including mandatory course specifications, greater faculty involvement in developing learning outcomes, and a more adaptable curriculum to meet evolving national and international standards. The accreditation process was crucial in prompting regular curriculum reviews and enhancements, leading to a stronger focus on behavioral and social sciences, as well as medical ethics . Curriculum quality management has always been central to education, and many academic institutions have established deans of quality to ensure the performance and quality of their educational programs. Researchers have focused on this area due to its potential to improve both students’ academic performance and overall education quality. Numerous studies have shown that failure to meet expectations results in student dissatisfaction [ – ], making it essential to assess student feedback as a means of ensuring program quality. Despite the various evaluation metrics available, Kirkpatrick’s model has gained widespread popularity. This model comprises four levels: reaction, learning, behavior, and results. The first level, reaction, assesses participants’ feelings about the course. The second level assesses how well concepts, information, and skills have been understood and retained. The third level evaluates behavior changes related to applying the knowledge gained. The fourth level measures whether the program achieved its desired outcomes . Alqarni’s study was one of the first in Saudi Arabia to apply Kirkpatrick’s model to assess the operative dentistry curriculum . At the College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), dental students are introduced to the fundamental principles of Periodontology, including the diagnosis, prevention, and treatment of periodontal conditions such as gingivitis and periodontitis, throughout the four-year dental program. The dental curriculum is divided into two stages: preclinical (D1 and D2) and clinical (D3 and D4). During D1 and D2, students primarily focus on preclinical laboratory training, where they are introduced to nonsurgical periodontal instruments and practice scaling and root planing techniques. Clinical sessions begin in the second semester of D2, during which students perform full-mouth charting, diagnose periodontal conditions, and treat patients under faculty supervision. In the clinical years (D3 and D4), students are introduced to the surgical aspects of Periodontics through lectures but are restricted to managing nonsurgical cases in the clinic, progressing from phase one to maintenance therapy. For surgical procedures, such as crown-lengthening surgeries, students assist periodontists rather than perform these procedures independently. The inclusion of D3 and D4 students in this study allows for a comprehensive evaluation of satisfaction across different stages of clinical training, reflecting their varied experiences in nonsurgical periodontal care. Assessing students’ satisfaction with their experience in these courses is essential not only for identifying areas of concern but also for improving the learning experience for both students and faculty. To the best of our knowledge, no previous studies have explored the satisfaction levels of dental students enrolled in clinical Periodontics courses. The emphasis on quality assurance by the NCAAA aligns with international accreditation bodies, such as the Commission on Dental Accreditation (CODA), which prioritize student satisfaction and competency-based education. By evaluating student satisfaction in clinical Periodontics, this study contributes to ongoing efforts to ensure that dental education at KSAU-HS meets both national and global standards. This study aims to assess dental students’ satisfaction with clinical Periodontics courses at KSAU-HS and to explore potential differences in satisfaction based on gender and academic level. 

This cross-sectional study evaluated undergraduate dental students’ satisfaction with clinical Periodontics courses at KSAU-HS during the 2022–2023 academic year. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Sample size, sample selection and inclusion criteria All 3rd-year (D3) and 4th-year (D4) dental students enrolled in clinical Periodontics courses were eligible to participate. These cohorts were selected because they represent the clinical phase of the dental curriculum at KSAU-HS, during which students gain hands-on experience treating patients under faculty supervision. In contrast, D1 and D2 students, who are in the preclinical phase, focus primarily on foundational knowledge and preclinical laboratory work, making them ineligible for this study. Participation was voluntary, and all participants expressed their willingness to complete the survey. Survey distribution and participation A web-based survey was developed using Google Forms (Mountain View, CA, USA), based on a previously used questionnaire  with minor adjustments (Supplementary Table 1). Although the original study did not mention a formal validation process, content validity was ensured by expert review. The survey was distributed via email to all eligible students, and a follow-up email was sent one week later to encourage participation. Participation was voluntary, and responses were collected anonymously to protect confidentiality. Ethical approval Institutional Review Board approval was obtained from the King Abdullah International Medical Research Center (Approval No. NRC22R/527/10) prior to the study. Informed consent was obtained from all participants. Variables of interest The questionnaire was organized into six main categories: facility/environment, delivery style, instructor knowledge, content relevance, course materials, and learning objectives. The dental students were classified into two groups: D3 (third-year students) and D4 (fourth-year students). Responses were assessed using a Likert scale with options: Agree, Somewhat Agree, or Disagree. Additional variable included sex (male, female). Statistical analysis We summarized the participants’ demographic characteristics, including gender and level of study, using descriptive statistics, with frequencies and percentages detailing the sample distribution. To explore potential differences in perceptions between male and female students, we conducted Chi-square tests where the assumptions of the test were met. In cases where expected frequencies were low, we considered using Fisher’s Exact Test for more accurate results. Additionally, we used independent t-tests to evaluate mean satisfaction scores across gender and between third- and fourth-year students. Statistical analyses were carried out using NCSS Statistics software (version 20.0), and a significance threshold of p < 0.05 was established. 

All 3rd-year (D3) and 4th-year (D4) dental students enrolled in clinical Periodontics courses were eligible to participate. These cohorts were selected because they represent the clinical phase of the dental curriculum at KSAU-HS, during which students gain hands-on experience treating patients under faculty supervision. In contrast, D1 and D2 students, who are in the preclinical phase, focus primarily on foundational knowledge and preclinical laboratory work, making them ineligible for this study. Participation was voluntary, and all participants expressed their willingness to complete the survey. 

A web-based survey was developed using Google Forms (Mountain View, CA, USA), based on a previously used questionnaire  with minor adjustments (Supplementary Table 1). Although the original study did not mention a formal validation process, content validity was ensured by expert review. The survey was distributed via email to all eligible students, and a follow-up email was sent one week later to encourage participation. Participation was voluntary, and responses were collected anonymously to protect confidentiality. 

Institutional Review Board approval was obtained from the King Abdullah International Medical Research Center (Approval No. NRC22R/527/10) prior to the study. Informed consent was obtained from all participants. 

The questionnaire was organized into six main categories: facility/environment, delivery style, instructor knowledge, content relevance, course materials, and learning objectives. The dental students were classified into two groups: D3 (third-year students) and D4 (fourth-year students). Responses were assessed using a Likert scale with options: Agree, Somewhat Agree, or Disagree. Additional variable included sex (male, female). 

We summarized the participants’ demographic characteristics, including gender and level of study, using descriptive statistics, with frequencies and percentages detailing the sample distribution. To explore potential differences in perceptions between male and female students, we conducted Chi-square tests where the assumptions of the test were met. In cases where expected frequencies were low, we considered using Fisher’s Exact Test for more accurate results. Additionally, we used independent t-tests to evaluate mean satisfaction scores across gender and between third- and fourth-year students. Statistical analyses were carried out using NCSS Statistics software (version 20.0), and a significance threshold of p < 0.05 was established. 

The demographics of the study participants revealed a relatively balanced distribution, with 23 male students (47.92%) and 25 female students (52.08%). In terms of academic level, the majority of participants were in their third year (33 students, 68.75%), while the remaining were in their fourth year (15 students, 31.25%). This diverse representation across gender and academic levels provides comprehensive insight into student perceptions of the Periodontics course (Table ). The survey results indicate a strong agreement among students regarding the course, with highly positive perceptions. Over 90% agreed they understood the learning objectives (91.67%) and gained knowledge and skills consistent with them (89.58%). Similarly, 91.67% found the course clarified their role as students, and a high percentage believed the course materials were easy to follow (81.25%) and essential for success (89.58%). A significant majority felt confident in applying what they learned to future dental practice (91.67%) and believed they had acquired the essential knowledge and skills needed to succeed as dentists (87.5%). Nearly all students reported that their learning was enriched by the instructor’s knowledge (97.92%) and the experiences shared in class (93.75%). Most students found it easy to be engaged and participate actively in the learning process (83.33% and 89.58%, respectively). Additionally, a majority felt they had ample opportunities to ask questions (89.58%) and practice and demonstrate skills (83.33%). Regarding the pace and length of sessions, over 90% were comfortable with both (91.67% and 87.5%, respectively). However, only 79.17% felt the Periodontics laboratory and clinic were free of distractions and conducive to study (Table ). The survey assessed the perceptions of male and female students across various aspects of the Periodontics course. Overall, both groups showed similar trends in their responses, with no significant differences between male and female perceptions across the assessed aspects of the course. This suggests a consistent experience and perception of the course regardless of gender (Table ). Satisfaction with the Periodontics course was analyzed across gender and academic levels. Male participants had a mean satisfaction score of 95.49 (SD = 7.813), while female participants had a mean score of 95.48 (SD = 8.091). A t-test revealed no significant difference between male and female satisfaction scores (t = 0.0042, p = 0.996). Similarly, third-year students (D3) had a mean score of 95.56 (SD = 8.48), while fourth-year students (D4) had a mean score of 95.31 (SD = 6.59). However, there was no significant difference in satisfaction scores between third- and fourth-year students (t = 0.104, p = 0.917). These findings suggest that satisfaction with the Periodontics course did not vary significantly based on gender or academic level (Table ). 

This study examined the satisfaction levels of dental students in clinical Periodontics courses at King Saud bin Abdulaziz University for Health Sciences, focusing on their academic level. The results indicate strong agreement among students and a highly positive perception of the Periodontics course. The College of Dentistry at KSAU-HS is committed to continuous curriculum improvement, requiring students to evaluate courses at the end of each course. This feedback mechanism has proven effective, with 91.67% of participants agreeing that they understood the learning objectives of the Periodontics course, providing clear evidence that the intended educational goals are being met. This finding aligns with another study, which showed that awareness of learning objectives and intended outcomes significantly enhances student satisfaction . Our findings revealed a strong consensus among students regarding the Periodontics courses, indicating positive perceptions. Additionally, there were no significant differences in satisfaction scores between male and female students, suggesting consistent satisfaction across both gender and age groups. These results align with a previous study in Saudi Arabia that evaluated dental students’ professional satisfaction with operative dentistry teaching and curriculum, which also found no gender-related disparities among students across various course levels . However, Parahoo et al. investigated factors influencing student satisfaction in the Gulf region and showed that different factors impacted satisfaction for each gender . High student satisfaction is often linked to excellent facilities. Well-equipped classrooms, advanced laboratories, and comprehensive libraries foster an optimal learning environment. Comfortable study areas and accessible technology enable students to engage effectively with their coursework. In this study, most of the surveyed students reported that the college’s facilities were distraction-free and conducive to study. This finding aligns with previous research indicating a positive correlation between college facilities and various academic and logistical factors, suggesting that students perceive improvements in their academic abilities when universities enhance their facilities. Access to top-notch resources makes students feel supported and motivated, leading to greater satisfaction and academic success . Self-efficacy, which correlates with persistence in education and confidence in the workplace, is crucial for dental students. Most participants in our study felt that the Periodontics course made them competent to work independently as future dentists. Promoting course satisfaction can further enhance students’ professional readiness, as increased self-efficacy leads to greater motivation and satisfaction with the course . Although 79.17% of students reported satisfaction with the laboratory and clinical environment, this level of agreement is lower compared to other aspects of the course. This suggests potential concerns about the physical space that warrant further investigation. In this study, we did not explore how gender or academic level might influence perceptions of the learning environment. Future research could examine these factors to identify specific issues and develop targeted improvements to the physical learning spaces. Our findings suggest that highly motivated students who are satisfied with their courses tend to have better academic performance. According to a previous study by Santos et al., there is a positive correlation between academic performance and satisfaction with the course . Similar research, including studies in Korea and Australia on medical and psychology students, has also demonstrated a positive correlation between academic performance and course satisfaction . However, some studies, such as one conducted on social work students in Germany, found no such association . These mixed findings indicate that the relationship between satisfaction and performance may be context-dependent. Several factors likely influence this relationship. Personal motivation plays a crucial role, as students who are highly motivated may engage more actively with the course material, leading to greater satisfaction. Prior knowledge and experience with Periodontics may also enhance students’ confidence and perceptions of the course. Additionally, the learning environment, including the quality of facilities, instructor support, and the availability of resources, can significantly impact satisfaction levels. Understanding how these factors interplay with academic performance could provide deeper insights into improving both student satisfaction and educational outcomes. Future research could explore these relationships in more detail through qualitative studies or by incorporating performance metrics to identify specific influences. The strong agreement among students and their highly positive perception of the Periodontics course, as indicated in the survey results, have several significant implications. First, this level of student satisfaction suggests that the Periodontics curriculum, instructors, and learning experiences are effectively meeting students’ educational needs and expectations. This encouraging feedback indicates that the program is well-designed and impactful. Additionally, the highly positive perceptions of the Periodontics course signal that students find the subject matter interesting, relevant, and valuable to their dental education and future professional practice, which bodes well for students’ motivation and learning outcomes. Lastly, constructive student feedback on the Periodontics course may inspire faculty to continue innovating their teaching methods and may lead to opportunities for publications, presentations, or awards recognizing instructional excellence. The application of NCAAA recommendations in dental education not only improves the quality of local programs but also has significant global implications. For example, the emphasis on clear learning objectives, effective instruction, and continuous feedback aligns with international best practices in dental education. The Commission on Dental Accreditation (CODA) similarly prioritizes these elements to ensure graduates are competent and practice-ready. Therefore, by adhering to these standards, dental programs in Saudi Arabia contribute to a globally competent workforce, facilitating international mobility for graduates and enhancing the overall quality of dental care. There are several limitations to this study. First, the cross-sectional design assesses students’ perceptions of the clinical Periodontics courses at a single point in time. Therefore, future studies using a prospective design could provide more comprehensive insights. Second, while this study focused on dental students at the College of Dentistry at KSAU-HS, the results cannot be generalized to other schools in different regions of the country. Future research should include students from various dental schools across the country to achieve more generalizable results. Additionally, online surveys often lack the depth of in-person engagement, which is another limitation. For these reasons, it is important to acknowledge the limitations of online surveys and consider combining them with other methods. Moreover, one limitation of the study is that the questionnaire was adapted from a previous study without formal validation. However, expert review was employed to ensure the relevance and appropriateness of the survey items for assessing student satisfaction in Periodontics courses. Furthermore, we did not perform adjusted analyses to control for potential confounders such as gender and academic level due to the sample size constraints. The relatively small sample size may have also limited the statistical power needed to detect significant differences in satisfaction scores across gender and academic levels. While no significant differences were observed, this finding should be interpreted with caution. Future research with larger sample sizes could benefit from multivariate analyses to explore these relationships in greater depth and provide more definitive conclusions. Another limitation of this study is the use of a Likert scale with only three options: ‘Agree,’ ‘Somewhat Agree,’ or ‘Disagree.’ The absence of a neutral option (‘Neither Agree nor Disagree’) may have led to response bias, as students who were unsure or neutral about certain statements may have felt compelled to choose an option that did not fully represent their views. Future research should consider using a more nuanced Likert scale that includes a neutral option to better capture the full range of student perceptions. Finally, while this study focused on evaluating student satisfaction with clinical Periodontics courses, future research could explore how this satisfaction correlates with specific curriculum outcomes, such as clinical performance, competency exam results, and career readiness. 

The study presents a positive assessment of the Periodontics course, highlighting high student satisfaction across genders and academic years. Students appreciated the clarity of learning objectives, helpful materials, and effective instruction. They felt engaged and had ample opportunities to ask questions and practice skills. Satisfaction was consistent regardless of gender or year of study. To further strengthen the course, future research could explore the relationship between student satisfaction and academic performance, as well as the impact of the learning environment on educational outcomes. These improvements and research directions will help ensure the Periodontics curriculum continues to align with best practices in dental education and effectively prepares students for professional practice. 

Supplementary Material 1. 

