1. Introduction

Attitude is a mental and neural readiness and develops by experience ^[1]. Attitude is recognized as the combination of knowledge, feelings and readiness of every person toward a field of study or a profession. Individuals’ attitudes change at different stages of life as a function of changes in the environment. Attitudes toward profession are dependent on factors such as job environment conditions, organization discipline, relations governing the job environment and the effect of cultural factors. Therefore, social factors affect educational and professional satisfaction ^[2]. If the field of study is not favorite, education and working in this field is boring and even impossible ^{[3, 4]}. Positive attitude toward career future creates educational motivation. This leads to professional progress and success in future ^[5]. The nature of students’ attitude toward their field of study is an individual and personal factor that affects students’ academic progress ^[1]. In clinical fields of study, such as dentistry, the whole course is an exciting and challenging period for students. During this period, due to more severe stresses involved than the basic sciences, all the students must have mental health and positive attitudes to be able to adapt to these factors and be successful in their education and profession. Personal characteristics, clinical and educational environment rules of the university and socioeconomic factors are considered as effective factors for education quality and creation of students’ attitudes ^[6]. It is possible that lack of job security in students of medical sciences affect their attitudes toward their field of study and future of the career ^[7].

A study reported that attitudes change the most during the academic education ^[8]. It is necessary to recognize factors affecting dental students’ attitudes because it can help regulate educational rules and plans, provide suitable possibilities, plan in order to achieve clinical proficiencies and train efficient dentists in dental schools. It is useful to know the attitude type both for prediction of students’ performance in theoretical and practical courses during the course and for their professional behaviors ^[9].

Studies conducted on dental students indicate that most of the students have chosen this field of study based on their personal interest ^{[10, 11, 12]}. Irrespective of the reasons that students state for choosing dentistry, most of them expect clear and secure career future. This factor is the most important educational motive in this field of study. In a study conducted by Hedayati et al in Shiraz, it was found that dental students were interested in their field of study, while they did not have a positive attitude toward the future of the career ^[13]. In addition, in a cross-sectional study conducted by Baharvand et al in 4 dental schools in Tehran, it was found that the most important reason for choosing this field was an interest in dentistry and the high social status associated with it. Most of them were interested in private practice ^[12].

In a study conducted by Kapoor et al on factors effective in choosing dentistry as a field of study in India, it was found that the most important reason was serving and helping people ^[14]. In addition, Ghanizadeh et al in Tabriz reported the high social status, independent performance and serving people as the most important motives to choose dentistry as a field of study ^[15].

Due to the importance of dentistry in health promotion and people’s life quality and considering that commitment, motivation and proficiency of dental students are affected in relation to the performance of clinical education system, and also considering the fact that clinical professions are always affected by social, political and economic changes, it is necessary to have knowledge about motivation and attitudes toward health care professions.

The aim of this study was to assess the attitudes of Kerman Dental School students toward their field of study and the future of the career.

2. Methods

In this cross-sectional, analytical-descriptive study, the attitudes of under- and post-graduate students in Kerman Dental School toward their field of study and future of the career were assessed.

Sampling was carried out by enumeration. First, the lists of all the post-graduate students and the first- and second-year under-graduate students (basic sciences course) and fifth- and sixth-year under-graduate students (clinical stage) studying in Kerman Dental School were collected. After detailing comments about the aim of the study to under- and post-graduate students, and mentioning that all the information in the questionnaires would be confidential, with participation in the study being voluntary, the questionnaires were distributed among them. All the stages of the study were conducted by a last-year student who was adequately trained. The study questionnaire included 15 questions in two parts. The first part included 9 questions about the field of study and the second part included 6 questions about the profession. The questionnaire was first designed in Minnesota University in America for health profession students. It was translated into Farsi by Jamali et al ^[16] and confirmed by specialists. Then, it was modified by Hedayati et al ^[13] so that it could be used for dental students. Its validity and reliability were confirmed. The grading scale of the questionnaire was based on five-point Likert scale. To answer the questions, the scores 1 to 5 were considered, respectively, for total disagreement and total agreement. Therefore, score 1 indicated the least tendency and score 5 indicated the highest tendency.

Finally, data were analyzed by SPSS 19 statistical software. The statistical tests of means and standard deviations were used for descriptive data. Mann-Whitney, Kruskal-Wallis, Spearman’s correlation and chi-squared statistical tests were used for analysis of data.

3. Results

A total of 212 under- and post-graduate students participated in this study by filling in the questionnaires. Of all the subjects, 171 (82%) were under-graduate and 38 (18%) were post-graduate students. Three (1.4%) questionnaires were excluded from the study because they were incomplete. Totally, 209 questionnaires were used. Of 171 under-graduate students, 48 (28%) were in basic sciences stage and 123 (72%) were in the clinical stage (Table 1).

Table 1. Distribution of participant according to Educational level and Sex

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Table 2. Distribution of under and post-graduate dental student’s response to questions about attitude toward their field of study

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Furthermore, of 209 subjects, 61 (29.2%) were male and 145 (69.4%) were female, and three of them (1.4%) had unknown gender. The minimum age of the participants was 18 and the maximum was 42. The average age of the participants was 23.32 ± 3.55 years.

In this study, the attitude score range in each area was 0‒100. The attitude scores were divided into three levels of poor (50≤), moderate (51‒74) and good (≥75). Based on the results, the students’ score of attitude toward their field of study was poor in 3%, moderate in 45% and good in 3% of the subjects (Table 2 and Table 3).

Table 3. Distribution of under and post-graduate dental student’s response to questions about attitude toward their future of the career

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Chi-squared test did not reveal any significant differences in attitude scores for the field of study and future of the career between under- and post-graduate students (P<0.001).

Chi-squared test did not demonstrate any significant differences in the frequencies of attitude scores in the field of study and future of the career between basic science course and clinical course students (P=0.29 and P=0.27).

Spearman’s correlation test showed no significant differences between the age and the attitude scores of dental students in relation to their field of study (P=0.27). There was a poor, positive and significant relationship (r=0.25) between age and dental student’s attitude scores in relation to the future of their career (P=0.00).

Mann-Whitney U test was used to compare the attitude scores in relation to the field of study and the future of the career between male and female dental students, revealing no significant differences (P>0.05).

4. Discussion

The nature of attitude toward the field of study and future of the career is an individual factor that affects the educational motive, scientific progress and future career success. In this study, the attitude of more than half of the dental students had poor attitude toward the future of the career. In this study, the attitude of post-graduate students toward their field of study and the future of the career was significantly better. In addition, this attitude was not significantly different between the students in basic sciences course and those in the clinical course. There was no significant difference between male and female dental students’ attitudes towards their field of study and future of the career. However, the dental students over 23 years of age exhibited significantly higher attitude scores. The results of this study are consistent with the results of a study conducted in Shiraz which revealed that most dental students (86.4%) were satisfied with their field of study, while about one-third were worried about their career ^[13]. Furthermore, in a study by Kapoor et al in India, the same results were obtained. In that study most of the dental students had positive attitude towards their field of study, but 51.9% were concerned about the future of the career ^[14]. However, some studies have shown that most students chose dentistry on their personal interest, but throughout life, various factors are effective in shaping and changing the attitudes of humans, with psychologists expressing different views on the subject ^[2]. Students had an exciting and challenging period during their education, which can change and create new attitudes in them. A dental student may select this field of study with the view that he can help improve the oral health in the community, can have financial security and career, can work independent of the government and at the same time, can have respect and high social status ^{[10, 11, 12]}. However, when they enter the university, they are directly engaged with university environment rules and specialized dental treatments, and as their awareness about the realities of the field of study and the future of the career increases, their attitudes are affected ^[6]. Lack of adequate motivation and positive attitudes toward the field of study can affect the academic performance of students and practical activities related to it ^[16]. In addition, lack of interest in the job leads to boredom and finally wasting of material and intellectual resources ^[13].

These results can be different in different countries in such a way that factors such as programs of dental schools and also the acceptance of dentists affect the students’ attitudes. In Karibe et al study in Japan and Sweden, there was a significant difference between the two countries in the attitudes and motivation toward dentistry; 44% of Swedish students were reported to have chosen this field of study to help people. While in Japan most of the students entered this field of study because of their family desires. In addition, Swedish students had significantly more tendency to continue their studies to become specialists compared to Japanese students ^[17]. In another study conducted by the author in Canada, Japan and Thailand, these results have been confirmed ^[18]. In a study by Yan et al in China and Japan, it was found that most of the dental students in China, contrary to students in Japan, expressed their desire to continue their studies in dental specialty courses and work in hospitals ^[19]. The results of this study indicated that post-graduates students had significantly better attitudes toward their field of study and the future of the career compared to under-graduate students. In fact, most post-graduates students choose their field of study based on their personal interest and more awareness than under-graduate students. Since cultural changes in our society are directed toward increasing people’s awareness about dental specialties, and most of them prefer to be treated by a specialist, post-graduate students’ are more confident about the future of their career.

The results of this study indicated no significant differences between the attitudes of dental students in basic and clinical sciences courses. Since the new educational programs for dental students oblige them to attend the clinic in addition to attending basic sciences courses to observe practical work of students after basic sciences courses at the chair side, and there is close relationship between students in different terms in dormitories, these factors can affect the formation of their attitudes. Furthermore, in this study the attitudes of male and female students toward their field of study and the future of the career were not significantly different. In a study by Hedayati et al, there were no differences in the attitudes of male and female students towards the field of study ^[13]. However, in Baharvand et al study, there were significant differences in the attitudes between male and female students, with most of male students having more positive financial views towards the future of the career ^[12].

Knowledge about factors affecting dental students’ attitudes is necessary because it can help us in educational regulations, educational planning, provision of proper facilities for practical and theoretical training, clinical planning to acquire the necessary skills and training of capable dentists in dental schools. Knowledge about attitudes is beneficial for predicting students’ performance in learning theoretical and practical lessons during the course and their professional behavior in the future ^[9]. Usually, success and achieving the goals need positive attitudes toward those goals. If the student is not interested in his/her field of study, he/she will not have successful education and career ^{[3, 4]}. Students are the principle members in every university. They will have an important role in different social organizations. Therefore, their attitude toward and satisfaction with their field of study and the future of their career are important factors to create motivation and improve their knowledge ^[20].

5. Conclusion

Based on the results of this study, half of the dental students exhibited poor attitudes toward the future of their career. Furthermore, post-graduate students exhibited significantly better attitudes toward their field of study and the future of their career compared to under-graduate students.

Acknowledgments

Financial support of this study provided by the Vice Chancellor for Research, Kerman University of Medical Sciences is warmly acknowledged. Also we thanks from Kerman Dental School Students that participate to this study.

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