López-Jornet P ⁽¹⁾, PhD, MD; Martínez-Beneyto Y⁽¹⁾, PhD, MDS ; Camacho-Alonso F⁽¹⁾, PhD, MDS; Toralla-De León O ⁽²⁾, DDS.

(1) Depatment of Estomatology. University of Murcia, Spain.
(2) Department of oral pathology. University of San Carlos, Guatemala.

Correspondence
Pía López Jornet
Clínica Odontológica Universitaria,
Hospital Morales Meseguer
Avda. Marqués de los Vélez s/n
Murcia 30008. Spain
Tel # 34 968 230061
Fax # 34 968 239565
Email: majornet@um.es

ABSTRACT
Objectives: The objective of this study was to investigate the hours dedicated to study and to leisure activities during term time by dental undergraduate students at the universities of Murcia (Spain) and San Carlos (Guatemala).
Study Design: The sample population included 310 dental students, 142 students registered at the University of Murcia (UMU), Spain, and 168 registered at the San Carlos University of Guatemala (USAC). The questionnaire included different sections (geographical items, grade and hours devoted to study and free time).
Results: The questionnaire was answered by 56.2% of those asked. The students from Murcia spent 27.9 ± 21.4 hours per week on extracurricular activities, while those from San Carlos (Guatemala) spent 23.3± 15.3 hours/week (p=0.03) on such activities. There was a significant difference to study (p<0.001) in total hours/week (35.7± 13 UMU compared with 50.7± 19 USA)
Conclusions: Considerable differences in the number of hours devoted to study and leisure pursuits by both groups of students in the two countries reflecting the different culture and the health education system of the students.
Key words: dental students, curriculum/standards, dental education, quality education, dental schools, university

INTRODUCTION
The challenge to modern universities and educational institutions, including dental schools, is to select students who are most likely to succeed by satisfactorily completing the educational programme, and to make a positive contribution to their profession and the public (1). In many countries of the world, entry into dental school is a highly competitive process.
Within the European Union dental schools may have very different syllabuses as regards the number of hours dedicated to the different topics (theoretical, practical), the teaching methods used and systems of evaluation. (2). It is for this reason that efforts are under way to homogenise such matters. (3). It is indispensable that in the future all professional leaving university should have been exposed to similar course contents. The Bologna Declaration of 1999 established that such homogenisation should be completed by 2010 within the area known as The European Area of Higher Education (4).
This project will make it possible to compare undergraduate and postgraduate dental education across Europe. The introduction of a system of credits (ECTS, European Credit Transfer System), will recognise and accept similar studied material from the many countries involved. This will enable greater mobility of students, international curricula, inter-institution cooperation and integrated programs of research (5-9).
A substantial number of studies have explored the influence of university courses and training, as well as of different dental school curricula on the development of oral health attitudes and behaviour in dental student (5)
Dental education in Murcia University and San Carlos University follows an odontological model, with the difference that Guatemala dentistry is a independent faculty, while Murcia it is closely linked with the Medicine Faculty, based on the old stomatological approach to dental education (6). In both countries, the odontology programme lasts 5 years.
The object of the present work was to study the hours that the students spent during term time, the hours spent by the students studying and the time spent on leisure activities by students following a degree course in odontology/dentistry at the universities of Murcia (Spain, UMU) and San Carlos (Guatemala, USAC)

MATERIALS AND METHODS
A descriptive study was made of dental students belonging to two public universities: Murcia (Spain, UMU) and San Carlos (Guatemala, USAC). The sample consisted of 310 (142 UMU y 168 USAC ) during the 2005-6 academic year. The criterion for inclusion in the study was to be enrolled in an undergraduate dental programme, while exclusion the criterion for exclusion was the refusal to take part in the questionnaire.
The investigation took place during April-May, 2006. Participation was voluntary, anonymous and confidential. The questionnaire consisted of several blocks of items, the first of which was of a social-professional nature (sex, age, year of study, university) and the second on the number of hours spent studying or in leisure pursuits (culture, sport, social activities) expressed as hours/week.
The section devoted to study provided information on the hours spent in theoretical/practical classes and self study, including the hours spent in dental clinics with patients.
The questionnaire was previously tested by a cognitive pre-test procedure to ensure that the questions were suitable, understandable and acceptable to the students concerned. For this pre-testing procedure, 20 students from UMU were chosen for their closeness and accessibility to the research team.
The questionnaire was in all cases conducted by professors and lecturers from both universities, after an introductory talk on the objectives of the study and the method to be used in completing the questionnaire. Attendance of classes, study and practical work were calculated on a five day basis to ascertain the daily workload, while leisure activities (cultural, sport, religious, political, etc) were calculated on a seven day basis, although it was understood that most would refer to the weekend.
The data were analyzed by SPSS^® 13.1 for Windows (SPSS, Inc., Chicago, IL, USA). A descriptive study was made of each variable. The associations between the different quantitative variables were studied using Student t- test (statistical significance was accepted at p≤0.05).

RESULTS
The Spanish and Guatemalan curricula has five study levels. The questionnaire was given to all undergraduate odontological students at UMU (n=252) and in USAC (n=300). The rate of reply was 56.16% (n=310). No completed questionnaire had to be eliminated because of an insufficient number of questions answered (50%), lack of comprehension or suitability of the replies (no modifications in the replies).
Of those who completed the questionnaire 32.2 % were men, with a mean age of 23.50 (± 3.85) years, and 67.8 % were women, with a mean age of 22.07 (±2.94).

Free time activities
The students of UMU dedicate more time to extra-curricular activities than their Guatemalan colleagues (27.9 ± 21.4 hours compared with 23.3± 15.3 hours per week), (p=0.03). The greatest difference was in the time devoted to leisure pursuits 14.1 ± 12.6 hours for UMU students compared with 10.5 ± 8.9 hours for USAC students) (Table1).

University studies
The mean time spent by each the students as a whole is 44.1 ± 18.56 h, with Guatemalan students spending a significantly greater time (p< 0.001) on their university studies (50.7 ± 19.3 h) than the Spanish students (35.7 ± 13.6 h). The greatest difference (p<0.001) concerned the time spent in theoretical classes, which varied from 12.8 ± 6.6 h for UMU students to 19.1 ± 8.7 h for USAC students. There was a significant difference (p<0.001) in the time that students spent with patients in a clinical situation: (7,1 ± 4,1 h compared with 14.8 ± 8 h) (p<0.001) (Table 2).

DISCUSSION
The ECTS credit system attempts to estimate the real time spent by students at their studies; it also reflects the time needed by the average student to pass the exams of a given topic (class time, contact with patients practicals, preparing for examinations, self study, looking for information, time spent in tutorials, projects etc., evaluations and other related activities.) In most European countries a degree in dentistry involves a total of 300 ECTS credits, where each credit corresponds to 25-30 hours, split over the 5 or 6 years an undergraduate course lasts (RD 1125/2003, UE 2000) (9,10).
Two important models have evolved in dental education: Odontology and Stomatology, the former tending to be more independent of medicine, and the latter more closely linked with General Medicine (6).
In general, the average UMU student spends 36 hours per week at their studies, which is near that required by the Bologna guidelines (RD. 1125/2003) (8) but considerably below the 51 hours the average USAC student spends studying. UMU is currently engaged in the process of European convergence and is adjusting its curriculum to the ECTS credit system, while USAC is distancing itself from the European idea.
As regards free time, UMU students spend an average of 27.9 hours compared with the 23.3 hours of USAC students. Within this context, it is the time spent relaxing that shows the greatest difference (14.1 hours versus 10.5 hours).
In many Europe dental schools the basic and medico-biological science subjects predominate in the first 2-3 years of the undergraduate curriculum, while in the last 2 years general medical subjects are usually encountered along with dental clinical subjects (10).
Traditionally, the dental curriculum in Spain has been divided into two parts: a basic science and preclinical phase, followed by a clinical phase, a situation common among different countries of the European Union. It also involves early patient contact of 60 hours per year spread over 30 weeks, which is slightly below the 32 hours common on Guatemala.
A common profile for dental studies is overdue since the educational and training programmes of different countries vary greatly. Both in Europe and the Americas, the exact range of the Odontology should be established as first step to harmonisation.

AKNOWLEDGEMENTS
This study was carried out in a joint project between the dental faculties of USAC and UMU, under the auspices of the Agencia Española de Cooperación Internacional (AECI) nº project B/4124/05.
The authors express their gratitude to the schools involved in this study, especially the dental students, for providing their time and valuable information.

REFERENCES

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Table 1. Activities University Murcia ( UMU) – University Guatemala USAC