Communication Development Training in Dental Education

Abstract

This study has examined how Saudi Arabian dental practitioners perceive leadership and communication development programs in their field. The study utilized a researcher-administered survey questionnaire which includes closed and open questions. The questionnaire, called the Dentist Perception Survey Questionnaire, was initially developed by Victoroff et al. (2008). The data was analyzed using descriptive analysis methods. The outcome was positive, with majority of the respondents showing positive attitudes towards leadership development programs. The study supports that of Victoroff et al. (2008) and suggestion was made to introduce such programs in Saudi Arabian dental schools.

Introduction

This chapter presents the background information on the topic under investigation. Following the background, the researcher will discuss the problem statement, research objectives, research questions, justification for conducting the study, the scope and study area as well as the limitations of the study. The chapter will conclude by highlighting the organization of the paper.

Background

Leadership development

The term “leadership” is often confused and used interchangeably with the word “management.” However, there are certain characteristics of leadership that clearly distinguish it from management. Leaders are far-sighted, that is, they are able to look into the future and see certain aspects of their firms/organizations, teams and units (Levin, 2003).¹ Therefore, they are required to have an external antenna that evaluates the market dynamics, external forces and activities of their rivals. While focusing on the future, leaders also need to be at par with what is going in the day-to-day activities of their organizations, hence the need to have a double vision (Christensen, 2004).² Leaders are also involved in the alignment of vision, goals, values and culture of the organization (Ryan, 2008).³ Leaders are highly influential people both in their organizations and outside their organizations. Leaders focus more on creating change in their organization so that the organization can meet the prevailing and often-changing market conditions.

Whereas some of these skills are inborn in some individuals, majority of these skills can be learned and nurtured through proper training. One of the critical issues facing organizations is that employees are often not given the opportunity to practice some of these leadership skills. Because of lack of practice, many employees find it challenging to apply them when the need arises. In order for any firm or organization to succeed, it is imperative for the staff to have the ability to achieve the objectives of the firm/organization. The local and global markets as well as the external environment change at a fast rate. Expectations from customers are also increasing on a year-to-year basis as customers become more aware and knowledgeable about their needs. The ability of any firm/organization to overcome these challenges is directly related to the skills and competencies of its employees. This necessitates the development of leadership skills of the employees (Ryan, 2008).

Communication development

The ability to communicate effectively, both orally and in written form, is a key stepping stone to career and personal advancement. People who lack adequate communication skills find it difficult to make the move either upwards or sideways. Effective communication skills are even more crucial for people planning to go into self-employment as they will need them to gain, hold and enlarge their client base. Substantial evidence suggests that people who lack a diversity of well-developed communication skills find developing their careers a big challenge. This is not surprising given that considerable amount of time is spent communicating with colleagues, managers and clients, and therefore the quality of such communication has a significant impact on people’s relationships with all these partners (Ellis, 2009).⁴ Given the importance of communication skills in the professional and career worlds, it is important for employees and managers alike to develop them.

Communication skills are many and varied and therefore it is not possible for an individual to develop all of them at a given point in time. Developing effective communication skills is thus a long process that begins with the motivation to learn. Besides the motivation, learners also need to be actively involved in the learning process. The learning process needs to be viewed as both relevant and important and the learning should be associated with the existing knowledge and understanding. Most importantly, any communication development programme should incorporate feedback mechanism through which the participants give their own opinions about the program and any progress made (Ellis, 2009).

Dental education and practice

The dental healthcare setting offers an exceptional environment in which a wide range of health care can be provided. In many developed countries, people have, for some time now, visited the dental practitioners more often than the medical practitioners. People in these countries seek medical advice when faced with discomfort or if they are experiencing symptoms that necessitate medical attention. The idea of the regular, six-month dental check-up is widely recognized and is relevant to many members of the public. In the recent past, health practitioners and public health care initiatives have accepted the idea of regular visits as part and parcel of a preventive approach to health instead of a curative approach. The increase in the number of dental visits has enabled collaborative patient care plans in which professionals from different medical fields interact and work together for the overall wellness of the patient.

In the dental setting, a patient can be part of the practice for some number of years and in some cases for a lifetime. In addition, the dental practitioner can extend care to the patient’s family and friends thus gaining knowledge and understanding of the multifaceted social and economic factors that affect the patient’s health and care. Remseier and Suvan (2011)⁵ argue that “the dental setting, therefore, provides a privileged situation in which the dental professional can realize the opportunity to form a long-standing and supportive relationship in health care management with his or her patient” (p. 7). Unfortunately, this opportunity is usually underutilized or totally ignored when the clinician takes a more conventional role.

Significance of leadership and communication development training in dental education and practice

Like any other profession, leadership and communication skills are important in the dental profession. Almost sixteen years ago, dental education was described as being at a crossroads, and from many angles, it still remains so. The dental education and practice lacks adequate dental leaders who are ready to challenge the existing prototypes. Only a handful of dental students express the willingness to explore the rich intellectual and service life that the dental practice provides. Even fewer students are ready to join other scholars and community leaders in the field, a necessity for the profession to grow into a vivacious and evidence-based subject in the twenty-first century. In order for these trends to change, leaders in the dental practice need to defy the current cultural norms so as to prepare students to have a significant influence on the future of the profession as well as its important role in the health care setting. This can only be realized if dental schools are ready and prepared to broaden their academic mission and provide opportunities in leadership development (Taichman, Green & Polverini, 2009).⁶

John Kotter, professor of leadership at the Harvard Business School, argues that “leadership defines what the future should look like, aligns people with that vision, and inspires them to make it happen despite the obstacles” (cited in Victoroff, Schneider & Perry, 2009).⁷ There is a great need in the dental field to go beyond the norm and do extraordinary things, more so in this twenty-first century. The hurdles and barriers that the members of the profession continuously face as they work to enhance oral health, as well as the great necessity for effective leadership to overcome these hurdles, have all been voiced in all areas of the dental profession, such as clinical practice, education, dental research, and dental public health.

In recognition of the need to build effective leaders, formal leadership development programs have been instituted for the dental professionals. These leadership programs include: the American Dental Education Association (ADEA)’s Leadership Institute, which was instituted in 2000 to build future academic dental leaders; the Executive Leadership in Academic Medicine (ELAM) Program for Women, which is focused on building leadership skills of senior women faculty at schools of medicine, dentistry, and public health; and the Institute for Diversity in Leadership program, which was created by the American Dental Association in 2003 to develop the leadership skills of dentists belonging to racial, ethnic and gender minority groups. There are more of such programs created by different states such as the Ohio Dental Association’s annual Leadership Institute, which was created in 2002. The American College of Dentists also provides online learning modules for the development of leadership skills (Victoroff, et al., 2009).

Effective communication skills are also important for developing effective leaders. Any good leader should be able to share knowledge and information to communicate a sense of importance and eagerness to his followers and colleagues. If a leader is not able to pass a message across plainly and inspire other people to act on the message, then there is no need to have the message in the first place. Communication has been defined as “the act or process of transmitting information about ideas, attitudes, emotions, or objective behaviour” (Dixon, Belnap, Albrecht & Lee, 2010, p. 35).⁸ Communication is a two-way process of exchanging thoughts, feelings, and/or ideas. Communication can take various forms such as verbal and nonverbal. Both verbal and non-verbal communication forms are important in passing a message across clearly.

In the dental care setting, like in any other health care setting, effective communication between the dental professional and the patient plays an important role in the provision of effective care and avoidance of medical errors. The dental practitioner should ensure that any information shared with the patient, such as information on diagnosis, treatment and medicine is clearly understood by the patient. An effective communicator is able to organize and convey information in a timely matter. After communication of the message has been done, the individual should substantiate the information to make sure that the receiver has understood that particular message (Dixon et al., 2010).

Problem Statement

The landmark study by Victoroff, Schneider and Perry (2008)⁹ found that dental students to a large extent perceive leadership as a part of their profession and would therefore be willing to take part in leadership training programs if offered by their respective institutions. In addition, in another study (Turner & West, 2006)¹⁰ almost seventy percent of the participating deans of dental schools stated that leadership development training was the most important element in preparing dental professionals to become deans. Leadership development in this particular study experience was viewed by the participants to be more crucial than the ability to teach dentistry, knowledge of budget and finance, and carrying out research (Taichman et al., 2009).

Although leadership development programs have been going in other fields, the same cannot be said of leadership development in the dental profession. Leadership development is still in its formative years in the dental education and practice. Indeed, the above-mentioned dental leadership development programs were started not earlier than the year 2000. To make the situation worse, the current formal leadership development programs mainly focus on mid-career dental practitioners who are already in leadership positions or are on their way up the career ladder. There is little, if any, emphasis placed on leadership development of dental students, even though common sense has it that the years of dental schooling may offer the most important opportunity to motivate, support, and enhance the development of future dental leaders. The dental profession and its clients could therefore benefit greatly by taking advantage of this existing opportunity (Victoroff, et al., 2009).

Research Objectives

The main objective of this study is to explore dental professionals’ perceptions towards leadership development, their perceived importance of leadership skills for dentists and their interest in participating in proposed leadership development activities during dental school, practice and their perceptions of the value of such leadership develop­ment activities.

The specific objectives of this study include:

1. To identify the perceptions of dental professionals’ towards development of leadership and communication skills
2. To assess the need for leadership and communication training at different levels of dental education, training and practice
3. To identify the possible content areas and objectives of a future training and educational program from the perspectives of newly qualified dentists

Research Questions

The research questions for this study include:

1. How do dental professionals feel about leadership development?
2. How do dental professionals feel about communication development?
3. Is there any need for leadership and communication training at different levels of dental education, training and practice?
4. What are the possible content areas of a future dental training and educational program?
5. What are the possible objectives of a future dental training and educational program?

Justification

This study aims to examine the perceptions of dental professionals towards the development of leadership and communication skills. Research into the perceptions of dentists on leadership and communication development of dental professionals has only recently been carried out, with the first known study being that of Victoroff et al. (2008). Since then, only a handful of similar studies have been carried out. Therefore, there is a gaping knowledge gap in the literature concerning the perceptions of dentists on leadership and communication development. Dentists’ perceptions are important in informing about the content areas of leadership and communication development required. The perceptions are also critical in giving information about the gap that exists between dental theory and practice. In addition, dentists’ perceptions influence their motivation to take part in such leadership and communication development programs. If the dentists have a negative perception, they are highly likely not to participate in such a program, and vice versa. In short, the success of a leadership and communication development program largely depends on the perceptions of the professionals.

Besides having few studies in the literature on the problem under investigation, majority, if not all, of the studies have been conducted in the Western countries. This study is unique in that it aims to examine the perceptions of dentists on leadership and communication development in an Arab country, in particular the Kingdom of Saudi Arabia. Given the differences in the cultural norms and beliefs, it would be interesting to see how the results of this study compare or contrast with those of other studies, more so the study by Victoroff et al. (2008).

Scope and Study Area

The study will be carried out in King Abdulaziz Dental Centre – Central Region, Kingdom of Saudi Arabia (KSA). In addition, the study will involve seven other primary health care centres namely: YDC, Um alhamam, Deirab, D3, Prince bader housing, A and B2. There are one hundred and four (104) dental staff, categorized into different groups such as: 25 dental general practitioners (GP), 20 assistant consultants, 35 associated consultants, and 24 consultants, working in King Abdulaziz Medical City – Central Region- Riyadh. These dental staff will be invited to take part in the study by responding to the questionnaire anonymously and voluntarily.

Study Limitations

Time and money constraints are expected since the geographical location of this study is vast. A delimitation to time constraints will be to prepare a time schedule. Convenience sampling technique (the use of participants from only one region) used in this study poses the other main limitation. While this technique can dramatically lower search costs, it comes at the expense of introducing bias because the technique itself reduces the likelihood that the sample will represent a good cross section from the entire Saudi Arabian population. It is hoped that results from this study will be useful to policy makers to inform the introduction or creation of leadership and communication development programs in the country’s dental schools.

Organization of the Paper

Chapter one has outlined the background of leadership and communication development in the dental education and practice. The main problem identified is that although leadership and communication development has been carried out for a while in other fields, it is a recent phenomenon in the dental profession. Given the importance of leadership and communication skills in the dental field, the perceptions of the professionals towards the same should be examined so that they can influence the creation of effective leadership and communication development programs. The rest of the paper is organized as follows: Chapter two contains a review of both theoretical and empirical studies conducted on leadership and communication development of dental professionals. Chapter three describes the conceptual framework and methods to be followed in this study. The survey instrument is attached as an appendix. Chapter four presents the results from the data analysis, followed by a discussion of the results, as they relate to the previous studies. The last chapter, chapter five, provides the summary of the entire paper, the policy implications as well as concludes the paper.

Literature Review

Introduction

This section presents a review of relevant literature, both theoretical and empirical. The first section will review studies conducted about leadership and communication development in different professions. The next section will focus on studies conducted on leadership and communication development in the dental profession. The last section will provide a general overview of the literature review, highlighting the major points and the common methods used for data analysis.

Leadership and Communication Development Programs in Other Professions

Schafer (2010)¹¹ carried out a study on effective leadership in policing. The author argues that leadership in policing has not been studied adequately as it deserves. Data was obtained from police supervisors who were taking part in the Federal Bureau of Investigation (FBI) National Academy program. The main aim of this study was to study effective leaders and leadership, giving attention to the characteristics and habits of effective and ineffective police leaders, efficacy of leadership, how leaders are developed, and the obstacles hindering the expansion of more effective leaders and leadership in the profession. The research used surveys to conduct the study, which were administered to more than a thousand police supervisors.

The researcher found that the respondents viewed effective and ineffective leaders as having totally contrasting characteristics and habits. Effective leaders were seen to possess integrity, strong work ethic, excellent communication skills, and were caring towards the employees. On the other hand, ineffective leaders were seen to lack all of these characteristics. The most commonly mentioned obstacles to the increase in the number of effective leaders were cultural, structural and political factors. The researcher concluded that majority of the traits mentioned are more related to personality traits and as a result, this could pose a big challenge to leadership development programs. He suggested that for such programs to be effective, they should incorporate mentorship and guidance programs rather than just focusing on leadership theories and perspectives (Schafer, 2010).

Dixon, Belnap, Albrecht and Lee (2010) conducted a study on the importance of soft skills in the corporate finance industry. The researchers argued that in the highly competitive market today, corporate finance professionals need not only the technical skills of their field but also different soft skills such as communication skills, organization skills and problem-solving skills. Soft skills have been defined as a mixture of both interpersonal and social skills, whereas hard skills consist of technical and administrative skills that are measurable. Although these two sets of skills are different in many ways, they complement each other. The researchers argued that recently, most firms have started recognizing the fact that employees’ soft skills are directly related to a firm’s overall success. Like the previous study, this study also contends that soft skills are not mainly developed through formal training but rather through personal experience and reflection (Dixon et al., 2010).

Development of soft skills can be done in different ways. One of these strategies is the use of role-play. Rao (2011)¹² examined how role-play can help to nurture soft skills in first-year Pharmacy students. He created a role-play model which he implemented in workshops during the first two semesters of a Pharmacy course. The students were required to play different roles including the role of a pharmacist and the role of a patient. The researcher then measured the participants’ perceptions about the usefulness of the approach in developing their skills during the two semesters. A total of 130 and 129 students took part in the first and second semester respectively. Analysis was done for verbal communication skills, information collection, counselling and giving advice, as well as accurate documentation of information. He found that role-play was useful in developing communication and information gathering skills but not the other skills (Rao, 2011).

Leadership and Communication Development Programs in the Dental Professionals

Kalenderian, Skoulas, Timothy and Friedland (2010)¹³ developed a leadership course for the Harvard School of Dental Medicine (HSDM). In the past, students enrolled in HSDM had been requesting for a practice management course to be incorporated into the core curriculum. Most of the graduates from the school were frustrated by the challenges of managing staff when doing their practice. The course was developed to help the practicing dentists overcome the challenges they face as practitioners, dental educators and community leaders. The course was meant to develop and nurture the leadership skills of the students. The course is titled “Dental Health Care Delivery: Concepts of Oral Health Leadership” (Kalenderian et al., 2010, p. 468) and has ten modules of leadership and management.

The aim of this particular paper was to describe the course and the results of the students who undertook the course as well as their opinion about the course. All the students passed the course although the grade depended on the participation and class attendance of the students. The overall evaluation of the course by the student was good. The course was given an overall rating of 4.23 on a scale of 1 (poor) to 5 (excellent). Most of the students said that the course was particularly useful in developing their communication and leadership skills in addition to clinical efficiency, minimization of medical errors, team building and practice management (Kalenderian et al., 2010). The study was conducted through both standard and customized questionnaires. Data was then analyzed using descriptive statistical methods including frequencies and percentages. What was common in the results of both questionnaires was that majority of the students argued that they needed more information on leadership skills including skills such as negotiation and communication. This study, like the previous study, supports the supposition that effective leadership goes hand in hand with good communication skills.

The study by Taichman, Green and Polverini (2009) is similar to that of Kalenderian et al. (2010) in that it involved the creation of a leadership development program for dental students called “the Scholars Program in Dental Leadership (SPDL).” The authors argued that the dental profession urgently requires leaders. Due to technological improvements, which have made the world much smaller and lives more complex, the dental profession faces increasing challenges as well as opportunities, which only effective leaders can overcome and grasp respectively (Taichman et al., 2009). More specifically, overcoming the challenges necessitates transformations in how dental professionals conduct their businesses, interact with their clients and other stakeholders, and educate future dental professionals. The purposeful introduction of the SPDL into dental and dental hygiene curriculum, though different from the existing paradigm, is a crucial program that would assist in preparing students to overcome the stated challenges. In the authors’ own words: “A student leadership program provides a novel educational milieu in which discussions on issues can occur and students can be engaged in broader concerns outside but essential to the usual realm of dental education” (Taichman et al., 2009, p. 1141).

Slavkin and Lawrence (2007)¹⁴ are also of the view that leadership knowledge and skills should be incorporated into dental education. The authors argued that leadership has been studied for more than forty years, with a focus on leadership and change of cultures, particularly in the private sector. The article by Slavkin and Lawrence (2007) describes a leadership course create by the authors titled “Dean’s Leadership Course” taught at the School of Dentistry at the University of Southern California. The course consists of topics such as communication, conflict management, budgeting, and change management, among others. The aim of the course was to foster the knowledge, principles and skills of leadership for the participants who consist of faculty, staff and students. The authors reflected upon the necessity for a broader and deeper insight into change, change agents, and leadership opportunities related to change. They believed that instilling leadership knowledge and skills would increase cooperation, collaboration and communication among the various partners involved (Slavkin & Lawrence, 2007).

The development of the leadership course was placed in the context of the non-profit sector but with complementary applications to the private sector. Participants were required to actively take part in the weekly discussions of text materials and real-world case studies and scenarios, as well as to assist each other through group work. At the end of the course, an evaluation was done to find out the usefulness of the course to the participants. The participants were asked to rate the course on a scale of 1 (low value) to 5 (high value). The authors found out that all the participants rated the course as having a high value and strongly suggested that the course should be made available to others. In addition to this evaluation, the participants were followed up several weeks after the course to find out how the course benefited them in their profession.

The feedback was overwhelmingly positive. Some participants stated that the course helped them to identify their strengths and the strengths of others and to capitalize on them. Others stated that the course helped them to rely on the team spirit, more so if major changes are needed in an organization. Others cited the significance of communication and how they had started communication programs in their organization in which faculty members participate. Yet others recognized that there are different leadership styles and that there is no one-style-fits-all; different circumstances require different leadership styles (Slavkin & Lawrence, 2007). This is important for all leaders, both current and future.

The study by Victoroff, Schneider and Perry (2008) is the platform upon which this particular study is conducted. Victoroff et al. (2008) were interested in finding out the perceptions of dental students on leadership development. The researchers began by arguing that “effective leaders are needed to move the dental profession forward, building on past accomplishments, meeting new challenges, and leading innovation and change” (p. 982). Beyond this need, the researchers recognized that there was no research that had been conducted to examine the views of students regarding the importance of leadership skills or their willingness to participate in any leadership development program while undertaking their dental education. Their study was meant to fill this literature gap.

Victoroff et al. (2008) administered a forty-seven-question self-administered survey to all students taking part in the D.M.D program at the Case Western Reserve University School of Dental Medicine. The survey consisted of forty-two closed-ended questions and five open-ended questions. Out of a target population of two hundred and seventy two students, two hundred and twenty five students responded, giving a response rate of eighty three percent. The data collected was then analyzed using SPSS 14.0 statistical software.

Majority of the respondents agreed or strongly agreed that: dentists should have leadership skills; they have the potential to become future leaders; and that leaders can be built through learning. Majority of the participants also agreed or strongly agreed that they would take part in a leadership development program, if offered (Victoroff et al., 2008). These positive perceptions of the participants towards leadership development programs motivated the researchers to design a pilot leadership development program for dental students in the same institution.

The pilot program, as described by Victoroff, et al. (2009), had three main themes, namely: knowledge, skills, and inspiration. All the students of the dental school were invited to take part in the program. The program consisted of sessions on public speaking, leadership-related talks and networking sessions, which allowed the students to interact with others in the same profession. The participants were then evaluated to find out their responses towards the program. Majority of the respondents (81 percent) stated that the program was either useful or very useful. 85 percent stated that they would be willing to take part in the program if offered the next year. The researchers argued that such leadership development programs are feasible. The conclusion made was that “although it is too early to determine the long-term impact of leadership development programs offered during students’ pre-doctoral education, efforts should be made to do so in the future as the profession seeks effective ways to develop tomorrow’s dental leaders” (Victoroff et al. 2009, p. 317).

Overview of Literature Review

The review of the literature has highlighted some important points relevant to this study. To begin with, the review has made clear the relationship between communication and leadership. Effective leaders must also have excellent communication skills which enable them to pass a message across clearly. Second, some studies support the view that leadership skills are inborn while others support the view that leadership skills can be learned. This contrast may have arisen from the different schools of thought on leadership in which the respondents believe. Majority of the studies on respondents’ opinions showed that most respondents have positive attitudes towards leadership development programs and that they would be willing to participate in them if such a program was offered. Indeed, such claims were tested by several studies including Victoroff et al. (2008), Slavkin and Lawrence (2007) and Taichman et al. (2009) through the creation of pilot leadership programs and courses.

The review of the literature also showed that the most appropriate research design for conducting a similar study is the administration of survey questionnaires to respondents. Based on this outcome, this study proposes to follow a similar approach, as discussed in the next section.

Research Methodology

Introduction

Based on the conceptual objectives and hypotheses developed in chapter I, this chapter presents the methodology to be employed in collecting and analyzing data for the study. The chapter comprises a description of the study design, study population, sampling frame, study sample and sampling procedures, data collection instruments and procedures as well as methods employed in analyzing and interpreting data.

Study Design

The study uses a descriptive research design. This design provides measures such as mean, median, frequency and percentages of each variable under investigation (Trochim & Land, 1982; Chandran, 2004).^{15, 16} The choice of the study design is also based on the literature review. From the review, almost all the studies used descriptive design and this study is a replication of the study by Victoroff et al. (2008), which also used descriptive research design. Descriptive research design will also most suitably enable comparison of results with the results of Victoroff et al. (2008). Hence the researcher will be able to identify any similarities or differences between the perceptions of the Saudi Arabian dental practitioners and students from Case Western Reserve University School of Dental Medicine towards leadership development programs.

Study Population

The study population includes one hundred and four (104) dental staff, categorized into different groups such as dental general practitioner (GP), assistant consultant, associated consultant, and consultant, working in King Abdulaziz Medical City – Central Region- Riyadh. These dental staff will be invited to take part in the study by responding to the questionnaire anonymously and voluntarily.

Sampling Techniques

The researcher selected the sample by using both purposive and convenience sampling techniques. Purposive sampling is normally used when the researcher wants to use participants who will achieve the major objective of the study (Hesse-Biber & Leavy, 2005).¹⁷ This will ensure that only those participants who are most likely to make a significant contribution to the study are selected. In this case, only dental professionals are relevant to this study. In addition, the sampling technique provides focused information and saves time and money. Out of the total target population of 104 dental practitioners working in King Abdulaziz Medical City in the Central Region of the Kingdom of Saudi Arabia, the researcher was able to contact 70 to take part in the study. Given that some of the staff work the night shift and others the day shift, the researcher decided to use only those who work the day shift for ease of follow-up. The main disadvantage of purposive and convenience sampling techniques is that they are not probabilistic sampling techniques and therefore the results from the study cannot be used to make generalizations about the entire population of dental practitioners in the entire Kingdom of Saudi Arabia.

Sample Size

According to Schindler and Cooper (2001),¹⁸ a sample is a small representative group selected for study. Kombo and Tromp (2006)¹⁹ emphasize that the sample must represent the target population in all aspects. Leedy and Ormrod (2005)²⁰ assert that in descriptive research, 10% of the population forms a representative sample. But where the 10% of the population is too large, the researcher can ensure that a representative sample is attained by giving everybody in the population an equal chance of participating in the study. In this study, the researcher selected a sample of 70 participants, which represents 67.3 percent of the target population. The response rate from the sample was 100 percent. That is, all the 70 sampling members fully participated in the study.

Data Collection Methods

Primary sources were used to gather data for use in the analysis. This entailed collecting information directly from the field.

Primary Data

Primary data was gathered through researcher-administered questionnaire because:

1. Chances of respondents forgetting to fill in and return the questionnaire are minimal.
2. Although this personal touch can consume much time, the certainty level of getting feedback is high.
3. The personal contact with target sample means the researcher/research assistants ensured that only the right people filled in the questionnaire.
4. It also reduced the time taken to complete and return the questionnaires since the researcher/research assistants collected the filled-in questionnaires immediately after the interviewing session.

Data Collection Procedures

Written applications/requests were sent to relevant authorities for authorization to carry out the study. In particular, the requests were sent to the administration of King Abdul-Aziz Medical City in the Central Region of the Kingdom of Saudi Arabia. A letter was sent to the chairman of all the Dental Departments in Central Region – to ask their permission and acceptance to start the study with their dental staff. The administration was also requested to allocate a suitable time for the completion of the questionnaires and to facilitate all services needed to collect the data. As soon as permission was granted, the study proceeded in the following chronology:

1. Recruitment of four research assistants;
2. Conducting training and briefing for the assistants on the study objectives, data collection process and study instrument administration;
3. Research assistant familiarization with the study instruments through research instrument dummies;
4. Revision of the data collection instruments based on comments and advise from supervisors and results of the pilot study;
5. Reproduction of required copies for data collection upon approval by supervisors;
6. Administration of data collection instruments in the selected area;
7. Collection of duly completed research instruments, debriefing of research assistants;
8. Assessment of filled in questionnaires through serialization and coding for analysis.

Data Collection Instrument

This study utilized a researcher-administered survey questionnaire which includes closed and open questions. The questionnaire was initially developed by Victoroff et al. (2008). The instrument is called the Dentist Perception Survey Questionnaire, which contains 42 closed ended questions with categories or rating scale type responses (ranging from strongly Agree to Strongly Disagree or from Very Effective to Not Effective) and five open ended questions. The closed ended questions were designed to assess importance of leadership abilities for dentists and whether or not leadership skills can be learned. This original questionnaire was administered to dental students in a North American Midwestern dental school. For the purpose of this study, the researcher however, modified this lengthy questionnaire to ensure its contents are relevant and specific to a Saudi Arabian dental education context. Permission was sought from Victoroff et al. (2008) to utilize their questionnaire.

Analysis and Interpretation of Data

The researcher examined all the completed questionnaires. Next, the data were filled in the Microsoft Excel database program. The data was then imported into SPSS 17.0 statisctial software. The data as it was could not be analyzed and it therefore necessitated cleaning and coding. Any invalid responses were cleaned. For instance, in a couple of cases, some respondents gave response 3 to questions that only required a Yes/No response, coded as 1 or 2, respectively. In these instances, the researcher cleaned the data by changing the value 3 to 2. But this happened in only two instances. Otherwise, the rest of the data was clean. Coding was then done to make it easy and possible for quantitative analysis to be conducted. Coding involved giving numerical values to the responses. This process was done for all the categorical questions. Questions that had Yes and No responses were given codes 1 and 2 for the responses, respectively. Questions that required the opinions of the respondents, for instance, responses which were in the form of strongly disagree to strongly agree were coded 1 to 5, respectively.

The next procedure after coding was the analysis of data. Descriptive measures of central tendency, such as mean, mode, median, minimum, maximum and standard deviation were used to explore the nature of the variables. Tabular and graphical presentations were also used to show the various variables in the study. For the variables on perceptions of the respondents, bar graphs were used to show the distribution of the various responses among the respondents.

The interpretation of the data was then done by comparing how the different responses were distributed across the respondents. Reference was also made to the results of Victoroff et al. (2008). Any differences or similarities between these two studies were highlighted.

Validity and Reliability of the Research Instrument

Validity

According to Chandran (2004), validity is concerned with whether the findings are really about what they appear to be. Validity is defined as the degree to which an instrument measures what it is supposed to measure for a particular research purpose. In this study, instrument validity was established by seeking expert opinion and pilot testing of the data collection and observations made used to further enhance content validity.

Reliability

Reliability is the consistency of your measurement, or the degree to which an instrument measures the same way each time it is used under the same conditions with the same subjects. A measure is considered reliable if a person’s score on the same test given twice is similar. It is important to note that reliability is not measured, it is estimated. It is done to ensure consistency of the results from the research instrument used. Cronbach’s alpha was used to test the internal reliability of each of the composite constructs. Internal consistency estimates how consistently individuals respond to the items within a scale (Chandran, 2004).

Ethical Considerations

When conducting any study that involves human subjects, certain ethical standards must be upheld (Chandran, 2004). In this study, the researcher upheld the following ethical standards:

• Permission to carry out the study: any research involving human subjects must proceed only after permission has been sought from the relevant authorities. For this study, permission was sought from the researcher’s department as well as from the administration of the various dental departments of King Abdul-Aziz Medical City in the Central Region of the Kingdom of Saudi Arabia. The study proceeded after permission was granted.
• Informed consent: informed consent is the agreement give by participants to take part in a study after the details of the study have been revealed to them. Before conducting the study, letters were sent to the elements of the target population informing them of the study, its purpose, objectives, and potential benefits as well as requesting them to participate in the study.
• Anonymity: this entails not revealing the personal details of the respondents. To ensure anonymity, the respondents were not required to give their names or personal details such as address of residential area. This makes it easy for the respondents to give honest responses without fearing adverse consequences.
• Confidentiality: confidentiality entails not revealing the responses given unless only to the authorized persons.
• Reporting obligation: the researcher is also obligated to report the study’s findings as they are, without altering them to suit his or her a priori expectations. This ethical standard will be adhered to strictly by the researcher. The study’s findings will be made available after the preparation of the final draft, following permission from the researcher’s supervisors.

Summary

The chapter has described the methodology that was used in carrying out this research. Survey using descriptive design was employed on a sample of 70 respondents selected through purposive and convenience sampling techniques. The data collected was imported into SPSS 17.0 statistical software for analysis. The next chapter will present the results and findings.

Results and Discussion of Findings

Introduction

This chapter gives the results of the analysis followed by a detailed discussion of the results. The results of this study are then compared with those of Victoroff et al. (2008). From the targeted population of 104 dentists, 70 of them responded, giving a response rate of 67.3 percent.

Summary Statistics

55.7 percent of the respondents were male while 44.3 percent were female.

The minimum age of the respondents was 26 whereas the maximum age was 50. The mean age was 34.73 and the mode age was 27.

The earliest year of graduation of the respondent was 1985 while the most recent graduation year was 2008, giving a range of 23 years. The mode year of graduation was 2006, implying that the year 2006 had the highest number of participants graduating from college than any other year.

More than half (52.9 percent) of the respondents had Bachelor Degree at the time this study was carried out. This was followed by Master Degree (31.4 percent), Board Certification (11.4 percent) and only a small percentage (4.3 percent) had attained the PhD level.

Of all the respondents, none was working at a private care center at the time this study was being conducted. Majority of the respondents (65 percent) work at a primary care center while the remaining 34.3 percent work at a tertiary hospital.

Attending a communications course during dental school is important in shaping the dentists’ communication skills. However, only 15 (21.4 percent) of the 70 respondents had attended a communications course as part of their dental curriculum. Majority of the respondents did not attend such a course. The reason for this is a matter of guess on the part of the researcher. One of the reasons for this could be that most dental schools in the region do not offer such a course as part of the dental curriculum. It could also be that most respondents do not think that a communications course is important. However, this latter claim will be proven later in the analysis.

Similarly, attending a leadership course during dental school is important in shaping the dentists’ leadership skills. However, only 14 (20.0 percent) of the 70 respondents had attended a leadership course as part of their dental curriculum. Majority of the respondents did not attend such a course. The reasons for this trend are similar to those given for attending a communications course.

Opinions of the respondents on different aspects of communication and leadership development

Familiarity with the concept of communication skills and leadership

One of the questions asked of the respondents was to what extent they were familiar with the concept of communication skills and leadership. 25.71 percent of the respondents said they were neutral about the concept, majority of the respondents (54.29 percent) were of the opinion that they were familiar with the concept, while 20.0 percent strongly agreed that they familiar with the concept. The results are presented in figure 4.1.

Willingness to take part in leadership development program

The willingness of dental practitioners to participate in a leadership program is important for leaders in the field. This is especially true if a leadership development program is to be instituted and for it to be effective. Out of the 70 respondents, only 2.86 percent were neutral about their willingness to take part in a leadership development program. Majority of the respondents (52.86 percent) agreed that they would be willing to take part in a leadership development program while 44.29 percent strongly agreed that they would be willing to take part in a leadership development program. The results are presented in figure 4.2.

Importance of dentists having leadership skills

Another question that respondents were asked was whether they thought it was important for dentists to have leadership skills. 4.29 percent of the respondents were neutral on their belief about the importance of dentists having leadership skills. The majority of the respondents (54.29 percent) agreed that it was important for dentists to have leadership skills. A further 41.43 percent strongly agreed that it was important for dentists to have leadership skills. The results are presented in figure 4.3.

Potential to become future leaders

Respondents were also asked what they thought about their potential to become a future leader. This question is important in shaping leadership development programs for dental practitioners. If people feel they have the potential to become future leaders, they are likely to participate in leadership development programs so as to nurture their potential, and vice versa. 30.0 percent of the respondents were neutral about their opinions regarding their potential to become future leaders, while the majority (47.14 percent) agreed that they had the potential to become future leaders. An additional 22.86 percent strongly agreed that they had the potential to become future leaders. The results are presented in figure 4.4.

Many leadership skills can be learned

There are different schools of thought on leadership. One of the schools of thought is of the opinion that leadership skills are inborn; that is; leaders are naturally born with their skills and talents and therefore such skills cannot be learned. Another school of thought is of the opinion that leadership skills can be learned and nurtured. The respondents in this study were asked what they thought about the ability to learn leadership skills. Majority of the respondents (55.71 percent) agreed that leadership skills can indeed be learned. Additionally, 37.14 percent strongly agreed that leadership skills can be learned. Only 7.14 percent of the respondents were neutral about the ability to learn leadership skills. The results are presented in figure 4.5.

Practicing leadership is an effective way of learning leadership

Respondents were also asked if they thought practicing leadership is an effective way of learning leadership. 1.43 percent of the respondents disagreed that practicing leadership is an effective way of learning leadership. 20.0 percent of the respondents were neutral about the statement. Majority of the respondents (61.43 percent) agreed that practicing leadership is an effective way of learning leadership while 17.41 percent strongly agreed with the statement, as shown in figure 4.6.

Listening to others’ perception about own leadership is effective

Another question the respondents were asked was whether they thought listening to other peoples’ perception about their leadership is effective. Majority of the respondents (51.43 percent) were neutral about this question. 32.86 percent and 15.71 percent agreed and strongly agreed with this statement, respectively. The results are presented in figure 4.7.

Attending educational program about leadership is effective

The review of the literature review showed that while some leadership skills are inborn, many of these skills can be acquired through formal and informal training programs. The belief of people about whether they believe they can acquire leadership skills through training is therefore important for the development of leadership programs. The respondents were asked of their opinion about whether attending educational program on leadership is effective in nurturing their leadership skills. More than half of the respondents (57.14 percent) agreed that attending educational leadership program is effective while an additional 37.14 percent strongly agreed with the statement. 4.29 percent of the respondents were neutral about this claim while a mere 1.43 percent of the respondents disagreed with the statement. The results are shown in figure 4.8.

Interviewing senior dental leaders is effective to gain leadership skills

Respondents were also asked if interviewing senior leaders is an effective way of gaining leadership skills. 8.57 percent of the respondents disagreed with the claim, while 25.71 percent were neutral about it. Majority of the respondents (54.29 percent), and 11.43 percent agreed and strongly agreed with the statement. Figure 4.9 shows the results.

Self learning is effective in learning leadership

Respondents were also asked if self-learning is an effective way of learning leadership skills. This question elicited the highest rate of disagreement, as compared to the previous questions. 17.14 percent of the respondents disagreed with the statement, while 22.86 percent were neutral about it. 45.71 percent agreed with the statement while 14.29 percent strongly agreed with it. Figure 4.10 gives the results.

Discussion of Findings

There is no much difference between the Saudi Arabian dental practitioners and the American dental practitioners in their opinions regarding leadership development programs for dentists. The need for such a program seems to be the same in the two different regions. This is well illustrated by comparing the results of this study with the results of Victoroff et al. (2008). This comparison is done in the next section.

Comparison of the results with the results of Victoroff et al. (2008)

Familiarity with the concept of communication skills and leadership

25.71 percent of the respondents were neutral about the concept, majority of the respondents (54.29 percent) agreed with the concept, while 20.0 percent strongly agreed with the concept.

Willingness to take part in leadership development program

2.86 percent were neutral; majority of the respondents (52.86 percent) agreed while 44.29 percent strongly agreed that they would be willing to take part in a leadership development program. In the study by Victoroff et al. (2008), respondents were asked if they would participate in a leadership development program if it was to be offered at their school. 42 percent agreed, 24 percent strongly agreed and 20 percent disagreed.

Importance of dentists having leadership skills

4.29 percent of the respondents were neutral; majority of the respondents (54.29 percent) agreed; and a further 41.43 percent strongly agreed that it was important for dentists to have leadership skills. In the study by Victoroff et al. (2008), 36.4 percent and 62.7 percent agreed and strongly agreed with the statement, respectively.

Potential to become future leaders

30.0 percent of the respondents were neutral; the majority (47.14 percent) agreed; while an additional 22.86 percent strongly agreed that they had the potential to become future leaders. In the study by Victoroff et al. (2008), 58.2 percent and 37.8 percent agreed and strongly agreed with the statement, respectively.

Many leadership skills can be learned

Majority of the respondents (55.71 percent) agreed that leadership skills can be learned; an additional 37.14 percent strongly agreed that leadership skills can be learned; and only 7.14 percent of the respondents were neutral about the ability to learn leadership skills. In the study by Victoroff et al. (2008), 53.3 percent and 42.7 percent agreed and strongly agreed with the statement, respectively.

Practicing leadership is an effective way of learning leadership

1.43 percent of the respondents disagreed; 20.0 percent of the respondents were neutral; majority of the respondents (61.43 percent) agreed; while 17.41 percent strongly agreed that practicing leadership is an effective way of learning leadership.

Listening to others’ perception about own leadership is effective

Majority of the respondents (51.43 percent) were neutral about this question. 32.86 percent and 15.71 percent agreed and strongly agreed with this statement, respectively. In the study by Victoroff et al. (2008), 76 percent of the respondents said that listening to others’ perception was a very effective or effective way of learning leadership. 20 percent said it was somewhat effective and only 4 percent said it was not effective.

Attending educational program about leadership is effective

57.14 percent agreed that attending educational leadership program is effective while an additional 37.14 percent strongly agreed with the statement. 4.29 percent of the respondents were neutral; while a mere 1.43 percent of the respondents disagreed with the statement. In the study by Victoroff et al. (2008), 75 percent of the respondents said that attending formal education programs was a very effective or effective way of learning leadership. 21 percent said it was somewhat effective and only 4 percent said it was not effective.

Interviewing senior dental leaders is effective to gain leadership skills

8.57 percent of the respondents disagreed with the claim, while 25.71 percent were neutral about it. 54.29 percent and 11.43 percent agreed and strongly agreed with the statement. In the study by Victoroff et al. (2008), 69 percent of the respondents said that interviewing senior dental leaders was a very effective or effective way of learning leadership. 28 percent said it was somewhat effective and only 3 percent said it was not effective.

Self learning is effective in learning leadership

17.14 percent of the respondents disagreed with the statement, while 22.86 percent were neutral about it. 45.71 percent agreed with the statement while 14.29 percent strongly agreed with it. In the study by Victoroff et al. (2008), 33 percent of the respondents said that self-learning was a very effective or effective way of learning leadership. 50 percent said it was somewhat effective and 17 percent said it was not effective.

In sum, although the two studies were conducted in two different regions with different cultures, the results are similar. The respondents in both studies have positive attitudes towards leadership development programs for dental practitioners. They expressed their willingness to take part in such a program. Majority of the respondents in both studies also believed that leadership skills can be learned. These findings are important and can inform the development of leadership and communication development programs in dental schools in the Kingdom of Saudi Arabia.

Objectives revisited

Objective 1: To identify the perceptions of dental professionals’ towards development of leadership and communication skills

In general, the perceptions of the dental professionals who took part in this study were optimistic about the development of leadership and communication skills.

Objective 2: To assess the need for leadership and communication training at different levels of dental education, training and practice

From the responses of the participants, there is a great need for leadership and communication training of dental practitioners at different levels of dental education, training and practice. This need comes out clearly from the willingness of the participants to take part in such programs. Given the diverse challenges dentists face in their practice, a leadership and communication development program would equip the dentists with skills and abilities to handle the challenges.

Objective 3: To identify the possible content areas and objectives of a future training and educational program from the perspectives of newly qualified dentists

This objective has not been clearly achieved in this study. A further study is required to identify the most important content areas and objectives of a future training and educational program. Such a study should incorporate open-ended questions covering these two issues.

Summary

This chapter has presented the results and findings of this study. The discussion section has given a summary of how the responses for each opinion question are distributed across the respondents. Comparison has then been made with the results of the study conducted by Victoroff et al. (2008). The next chapter will give the summary of the study, policy implications, conclusion and areas of further research.

Summary, Policy Implications and Conclusion

Summary

This study was carried out with the principal aim of examining the perceptions of dental practitioners in the Kingdom of Saudi Arabia towards leadership development programs. A review of literature revealed that leadership development of dentists is not as developed as in other professions. This is despite the many challenges that dentists face in their day-to-day practice, which necessitate strong leadership skills. The study area was the King Abdulaziz Medical City, located in the Central Region of the Kingdom of Saudi Arabia. Primary data was collected using a modified version of the Dentist Perception Survey Questionnaire originally developed and used by Victoroff et al. (2008). Data was analyzed using descriptive measures such as mean, mode, median, minimum, maximum, frequencies and percentages. The results of this study are similar to those of Victoroff et al. (2008) in that the perceptions of the participants towards leadership development programs are positive.

Policy Implications

From the preliminary analysis, only 21.4 percent and 20.0 percent of the respondents had attended a communications course and a leadership development course during their dental school. This shows that only a small proportion of the respondents had been exposed to such programs prior to the study. However, when asked whether formal leadership development programs would be effective in developing their leadership skills, 94.28 percent of the respondents either agreed or strongly agreed that it would be effective. Similar response was also given to questions on the willingness of the respondents to attend such programs and on the ability to acquire leadership skills through learning.

The policy implication of these outcomes is that leadership development programs are needed by dental practitioners in the Kingdom of Saudi Arabia. Such programs should therefore be introduced and instituted in dental schools across the country. Leadership development of dental practitioners should be done at all levels of the dental profession: from school to practice. Beginning the programs at the lowest level of the dental profession would indeed be important as it would expose students to the real-world situations they would face in their practice and would equip them with skills to handle different challenges.

Conclusion and Areas of Further Research

In conclusion, this study has examined how Saudi Arabian dental practitioners perceive leadership and communication development programs in their field. The outcome was positive, with majority of the respondents showing positive attitudes towards such programs. Although the study has significant implications, it is limited in several ways. These limitations form the basis upon which future studies can be undertaken.

To begin with, the study was conducted in only one region of Saudi Arabia and used non-probabilistic sampling techniques, namely purposive and convenience sampling techniques. This hinders the generalization of the study’s findings to the entire population of Saudi Arabian dentists. A future study can be conducted using random sampling techniques with a sample drawn from the entire population of Saudi Arabian dental practitioners. This would ensure the generalization of the findings.

Second, the study has been unable to achieve objective number three: to identify the possible content areas and objectives of a future training and educational program from the perspectives of newly qualified dentists. This was due to the lack of questions that focus on the leadership skills that the participants would wish to develop. A future study can be conducted to examine this. This is important because it would help leaders and administrators to know the exact needs of the dental practitioners and therefore to include those contents that are most required by the professionals. Without such knowledge, any leadership development program would fail to achieve its purpose.

Third, the use of descriptive statistical techniques only was too narrow. The descriptive statistics only enabled the researcher to identify the distribution of the various responses of the questions across the respondents. The researcher was therefore able to only have a general idea of how the Saudi Arabian dental practitioners perceive leadership development programs. The study can be enriched by using more sophisticated data analytical techniques such as logit or probit models. For instance, this study can be develop further to examine how factors such as age, highest education level, gender, place of work, and prior exposure to leadership and communication training programs influence the respondents’ perceptions towards leadership and communication development. Such a study can be conducted in different regions such as in the United States and in Saudi Arabia to identify any culture-related differences. These factors can be important in the success (or otherwise) of leadership and communication development programs in different regions.

Figures

Figure 4.9

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Appendix 1: Leadership and Communication Skills Questionnaire

This survey aims to identify the perception of dentists about leadership and communication skills in the dental field. Your honest answers and participation in filling out this questionnaire will be appreciated to achieve the main purpose of this study which is focused on perception related to leadership and Communication development. All identities will be kept confidential, and the results will be presented publicly when complete.

What is your gender?*

1. Male
2. Female

How old are you?*

Age………. * DD………../MM..……../YY…………..

When did you graduate from College? and from Which College did you graduate?* Bachelor Degree.

Graduation Year ……….. * College ……………University………………….

What is your latest degree achieved?*

1. Bachelor Degree
2. Master Degree
3. PhD Degree
4. Board Certification
5. Fellowship

Where do you work ?*

1. Tertiary Hospital
2. Primary Care Center
3. Private Clinics

Have you attended any course as part of your dental Curriculum about communication skills?*

1. Yes
2. No

Have you attended any course about organizational leadership?*

1. Yes
2. No