Final-year dental students' perceptions of education and guidance at an Irish dental school, regarding antibiotic prophylaxis to prevent infective endocarditis in dentistry

Conflicting guidance regarding the use of antibiotic prophylaxis for infective endocarditis may lead to confusion among dental students, thereby impacting both their educational development and their capacity to implement guidelines in clinical settings. To enhance the quality of teaching and learning in this vital area, this study seeks to investigate dental students' perceptions of their education concerning antibiotic prophylaxis for the prevention of infective endocarditis. This qualitative descriptive study consisted of face-to-face focus group interviews. All registered final-year dental students attending Trinity College Dublin in the academic year 2024-2025 were invited to participate voluntarily. Semi-structured interview schedules were utilised. Audio recordings were transcribed using an artificial intelligence (AI) recorder and subsequently checked and edited for accuracy. Open coding was developed inductively using thematic content analysis by two authors (VP and CP) independently. Codes were further analysed using closed coding techniques, yielding final codes and the development of subthemes and themes. Trustworthiness and methodological rigour were considered throughout. Data from four focus groups were analysed (n = 18). Three themes were identified. Firstly, Education encompassed teaching and assessment, clinical application during training, and student suggestions. Variability in the delivery of teaching, lack of assessment methods in senior years, and inadequate clinical exposure were highlighted. Secondly, Use of Guidelines explored students' application, awareness of infective endocarditis guidelines, as well as the impact of the range of guidelines on their learning. Inconsistent knowledge, understanding, and application of infective endocarditis prophylaxis guidelines were revealed amongst the undergraduate cohort. The presence of multiple international guidelines contributed to confusion, leaving students uncertain about which guidelines to follow. Lastly, Future Practice addressed patient-related concerns, students' apprehensions regarding antibiotic prescribing, and their reliance on senior support. Participants expressed fears about risks to patients, including adverse side effects associated with antibiotics, how their limited knowledge of guidelines could influence patient rapport, and their anticipation of relying on medical and/or senior colleagues for support during early clinical practice. Findings indicate that students would benefit from greater curricular alignment regarding infective endocarditis prophylaxis. This should include expert-led didactic teaching that clearly emphasises the specific guidelines students are expected to follow, increased clinical exposure to patients at risk of infective endocarditis, assessment through clinical logbooks and examinations, alongside an opportunity for structured feedback on students' learning experiences.