Crossing into clinics: a mixed-methods study of dental students’ transition

BACKGROUND: The transition from preclinical to clinical training in dental education represents a critical developmental phase characterized by increased workload, patient responsibility, and professional socialization. Evidence from Pakistan remains limited, particularly from mixed-methods perspectives. This study examined dental students' perceptions of preparedness, workload, patient interaction, knowledge application, and learning experiences, while also exploring contextual challenges and support systems influencing this transition. METHODS: A sequential explanatory mixed-methods study was conducted among third- and fourth-year Bachelor of Dental Surgery (BDS) students at Dow University of Health Sciences, Karachi. Quantitative data were obtained from 245 students using a validated questionnaire, and qualitative data were collected through 15 semi-structured interviews. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed using thematic analysis. RESULTS: Students reported generally positive perceptions across all domains, with the most favorable ratings observed for learning during clinical training, followed by knowledge application and professional socialization. Workload received comparatively lower ratings, reflecting ongoing adjustment challenges. Although domain means exceeded the neutral midpoint, the magnitude of these differences was modest, indicating moderate rather than strong endorsement. Gender-based differences were observed, with female students reporting comparatively lower perceptions in workload, patient interaction, and knowledge application domains, suggesting potential variation in transition experiences. Qualitative findings complemented these results by identifying four key themes: transition challenges, experiential learning, support systems, and internal motivation. Students described an initial period of anxiety and adjustment, followed by gradual confidence development facilitated by patient exposure, supervision, and peer support. CONCLUSIONS: The transition to clinical training is a demanding though developmental phase shaped by the interaction between workload pressures and available support systems. While students reported generally positive experiences, the findings indicate moderate levels of preparedness rather than unequivocal readiness. Structured orientation, guided patient exposure, and supportive learning environments remain essential to enhance adaptation, confidence, and professional growth.