Original Article

Impact of a shorter university week on academic performance and

study–life balance of dental students
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Kamis Gaballah, Mohamed El Kishawi1, Eteman Ibrahim2, Sausan Al Kawas

Departments of Oral and Craniofacial Health Sciences and 1Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, 2University Dental
Hospital Sharjah, Sharjah, United Arab Emirates
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ABSTRACT
Background: The 4‑day workweek is gaining traction as a credible and effective alternative to conventional 5‑day workweek.
We aimed to investigate the impact of a 4‑day workweek on dental students’ academic performance and study–life balance.
Methods: A total of 284 dental students participated in answering an electronic questionnaire. The response scores, mean values, and
standard deviations were calculated. Internal consistency and associations between the scores were tested. Differences in responses
between preclinical and clinical year students were evaluated. SPSS was used for data analysis, with a significance set at P < 0.05.
Results: A total of 246 students reported satisfactory experiences with the new 4‑day university week. The majority preferred to
continue with the short‑week scheme. There were no statistically significant differences between preclinical‑ and clinical‑level
scores. A total of 73.3% of the students reported an increase in patient treatment and clinical procedures compared to the
previous year with a 5‑day schedule. Most students were satisfied with their weekly workload. They reported a significant
improvement in clinical performance with the new weekly plan. Introducing a 4‑day university week helped 76% of students
reduce the cost of attending college.
Conclusion: The introduction of the 4‑day study week at the College of Dental Medicine was welcomed by students across all
years of the program due to the improved academic achievement and clinical training opportunities it provided. They were also
satisfied with the longer weekend, as it helped them relieve stress, prepare better for examinations, and spend more time with
their family and friends.
Keywords: Four‑day week, dental education, dentistry

BACKGROUND school week offers advantages for both teachers and students,
it also presents some drawbacks. Teachers initially struggle
Schools in the North Central United States (US) have been to adjust their teaching objectives to a new schedule [3].
using the 4‑day school– week model since the 1930s. This Therefore, it is recommended that working hours be extended
was followed by more schools joining the new scheme in the during the day to cover the required learning outcomes. In a
1970s [1]. Between 2018 and 2019, a total of 24 states had single‑school study, 24% of teachers reported increased stress
at least one public school operating on a 4‑day school week. and weariness due to extended school days [4].
Around 1500 schools in 600 US districts have a 4‑day school
week [2]. Teachers are satisfied with the 4‑day week program, However, evidence shows that a 4‑day week may improve
leading to increased production. This aligns with research on student attendance [5‑7], which has been linked to better
4‑day workweeks and employee satisfaction [2]. While a 4‑day
Address for correspondence: Dr. Mohamed El Kishawi,
Department of Preventive and Restorative Dentistry, College of Dental Medicine,
Submitted: 07‑01‑2024 Revised: 02‑04‑2024
University of Sharjah, Sharjah, United Arab Emirates.
Accepted: 06‑04‑2024 Published: 17‑05‑2024
E‑mail: [email protected]

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DOI: How to cite this article: Gaballah K, El Kishawi M, Ibrahim E, Al Kawas S. Impact
10.4103/abhs.abhs_5_24 of a shorter university week on academic performance and study–life balance
of dental students. Adv Biomed Health Sci 2024;3:111-7.

© 2024 Advances in Biomedical and Health Sciences | Published by Wolters Kluwer - Medknow 111
 Gaballah, et al.: Four‑day university week in dentistry

performance and examination scores. The shorter weekly of this change on students’ social lives due to an extended
timetable also reduces student distraction and increases weekend and whether students prefer to continue with
confidence, enthusiasm, and discipline [1,8]. The extended this schedule or revert to a traditional 5‑day week. It is
weekend allowed students to complete assignments and hypothesized that students will perceive their clinical and
prepare for class. All of these elements can help students academic performance, as well as their social lives, to be
succeed academically, improve their mental health, and either positively or negatively affected by the 4‑day workweek
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enhance their overall life satisfaction. A timetable with fewer schedule compared to the traditional 5‑day schedule.
trips may also benefit students who commute [9]. A recent
study on cognitive exhaustion is also relevant to scheduling MATERIALS AND METHODS
changes and academic results. Pope and Fillmore reported
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that students who were required to take advanced placement Ethical considerations
examinations achieved lower test scores [10]. Evaluating The Research Ethics Committee of the University of Sharjah
cognitive fatigue is straightforward, as advanced placement approved this study (approval number: REC‑21‑10‑17‑1).
examination dates change every year. Although students have Survey participants were voluntarily enrolled, and their
less time to recover between days during the school week, identities were not disclosed in the final report. The only
a long weekend may still benefit their performance. Others personal information that was collected was the students’
were concerned that students might lose knowledge due to sex and academic year. Potential candidates were informed
the gap created by an extra day off [11]. The main issue is about the aims and methods of the study before providing
that longer school days require more concentration, which consent to participate. Academic progress was not affected
may be harmful to younger students [8,11,12]. According to by participation or questionnaire results. The university’s data
our literature search, no dental school has attempted a 4‑day protection regulations were followed when processing and
dental education week. storing research data.

Study design
On January 1, 2022, the Government of Sharjah initiated a
This was a cross‑sectional analytical study that followed the
4‑day workweek, which was subsequently adopted by the
STROBE guidelines.
College of Dental Medicine. Following this transition, 1st‑ and
2nd‑year students did not take any additional online classes.
Settings
However, during the clinical phase, students were mandated
This study was conducted at the College of Dental Medicine
to attend online sessions on Sundays for about half a day,
at the University of Sharjah, United Arab Emirates.
covering approximately two‑thirds of the academic year.
This adjustment aimed to streamline student schedules Participants
and eliminate the need for campus commutes. Previously, Undergraduate dental students in their preclinical and clinical
clinical facilities operated for 40 h/week, offering 57 clinical years were selected using purposive sampling.
training hours for students in years 5, 4, and 3. However,
the transition to a 4‑day university workweek presented Sample size calculation
a challenge for the college due to the planned increase in During the current school year, 547 students were registered in
clinical training hours. With the new scheme, clinical facilities the Bachelor of Dental Surgery (BDS) program. The sample size
now operate 32 h/week. Nevertheless, through careful was calculated with a 95% confidence level to ensure that the
resource management, the college successfully increased true value falls within ± 5% of the reported value. The minimal
the available clinical training hours to 68 for students in years number of participants required for the study was set at 226.
5, 4, and 3. While the college expanded its clinical training
opportunities, it extended its second‑semester calendar to Research instrument
17 weeks from the previous 15 weeks. This extension was An electronic questionnaire was used for data collection. First,
necessary to ensure compliance with the minimum training the questionnaire captured general demographic information
duration required by the United Arab Emirates Commission about the students, such as sex, age, and academic year. The
of Academic Accreditation. questionnaire then focused on four main domains. (1) The
general experience of the students with the introduction of
This study aimed to investigate students’ reactions to the 4‑day working week at the College of Dental Medicine
implementing a 4‑day workweek and explore their perceptions involving three questions. (2) Academic teaching and student
of how this change impacted their clinical and academic performance, comprising four questions that investigated
performance. In addition, it seeks to understand the effect students’ satisfaction with teaching and learning and how

112 Advances in Biomedical and Health Sciences / Volume 3 / Issue 3 / July-September 2024
 Gaballah, et al.: Four‑day university week in dentistry

their academic performance changed after the introduction of General experience

the 4‑day working scheme. (3) Clinical training for clinical‑year The majority of students, 246 (87%), reported a satisfactory
levels only, which involved four questions exploring students’ experience with the introduced 4‑day workweek at the College
perceptions of how a shorter working week would impact their of Dental Medicine, while only one‑tenth (28) of the students
training. (4) The psychosocial advantages and disadvantages expressed dissatisfaction with the new weekly scheme. The
of the new scheme, comprising five questions aimed at majority preferred to continue with the 4‑day study week for
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investigating the impact of a shorter working week and the the upcoming academic years and did not wish to revert to the
implementation of an extended weekend on their study–life 5‑day study‑week scheme [Table 1]. There was no statistically
balance. The questionnaire was validated by four experts in significant difference between the students’ responses in
the field to ensure content validity and was pretested on a the preclinical and clinical phases. The correlation analysis
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group of 20 participants who were excluded from the study. revealed significant correlations between the total item
Appropriate adjustments were made to each question. scores for questions 7 and 13 (r[284] =0.51, P < 0.001), 7 and
Cronbach’s α was used to assess the reliability of the 21 (r[284] =0.53, P < 0.001), and 13 and 21 (r[284] =0.56,
questionnaire and the correlation between the questionnaire P < 0.001).
items (α = 0.79).
Clinical training
Data collection Clinical training questions were directed at clinical‑phase
The questionnaire was administered face‑to‑face using students (120). Approximately three‑quarters of the
students acknowledged an improvement in the number
electronic tablets during the second semester of the academic
of treated patients and clinical procedures by 88 (73.3%)
year 2022–2023. The participants were allowed up to 20 min
compared with the previous academic year with a 5‑day
to submit their responses.
training scheme. Only 22 students (18.3%) welcomed
the idea of having additional clinical training sessions
Data analysis
on the weekends. Statistical analysis of the responses
All data were coded and de‑identified before the analysis.
to these questions showed statistical significance, as
Tests of normality were applied where appropriate using
illustrated in Table 2. Correlation analysis showed significant
normal probability plots [13] and equal variance tests [14].
correlations between the total scores of questions
The percentages of responses and overall scores for all
8 and 9 (r[284] =0.83, P < 0.001), 8 and 20 (r[284] =0.14,
participants in the questionnaire were calculated. Mean values
P < 0.05), 8 and 22 (r[284] =0.16, P < 0.01), 9 and
and standard deviations for each question were calculated
20 (r[284] =0.18, P < 0.01), 9 and 22 (r[284] =0.19, P < 0.01),
according to the method described by the field [15]. Internal
and 20 and 22 (r[284] =0.24, P < 0.01).
consistency reliability was assessed by Cronbach alpha (α) [16].
Pearson product‑moment correlations were used to test the Academic teaching and performance
association between scores in each domain. A Chi‑square Most preclinical 122 (74.4%) and clinical 101 (84.1%) students
test was conducted to assess differences in the level of were satisfied with their weekly learning loads. Less than
agreement (i.e., agree, not sure, and disagree) between the one‑third of the preclinical and clinical students reported
preclinical‑ and clinical‑year levels. An independent Student’s having less time to meet their professors and advisors.
t‑test was used to assess the effect of sex and academic year However, two‑thirds of the participants were not concerned
differences on the outcome scale scores. All data analyses about this. Participants reported a significant improvement in
were conducted using SPSS (version 28.0; SPSS Inc., Chicago, their clinical performance with the newly introduced weekly
IL, USA), and the statistical significance for quantitative and plan. This sentiment was shared by a similar number of
categorical data was set at P < 0.05. preclinical and clinical students, with 93 (56.7%) of preclinical
and 69 (57.5%) of clinical students. Approximately half of the
RESULTS participants denied that they would be negatively affected by
the relatively heavy number of college days under the new
Study population time scheme, one‑fifth were uncertain, and only one‑third
In total, 284 participants agreed to participate and believed that it would negatively impact their academic
responded to the invitation. The participants consisted of performance. Responses regarding the potential impact of
164 (57.7%) students enrolled in the first 3 years of the the new time scheme on students’ academic performance
program (preclinical) and 120 (42.3%) students enrolled in are summarized in Table 3. Correlation analysis showed
the 4th and 5th years (clinical). There were 217 female students significant correlations between the total item scores
(76.4%) and 67 male students (23.6%). for questions 10 and 16 (r[284] =0.45, P < 0.01), 10 and
Advances in Biomedical and Health Sciences / Volume 3 / Issue 3 / July-September 2024 113
 Gaballah, et al.: Four‑day university week in dentistry

Table 1: Summary of student’s responses on their overall experience of the 4‑day university week.
Questions Year level Agree (%) NS (%) Disagree (%) Mean score (SD) t‑test, P Pearson χ2; P
General experience
7. Rate your experience Preclinical 141 6 17 5.77 (1.5) 0.31 0.94
regarding introduction of the Clinical 105 4 11 5.95 (1.5)
4‑day university week week at
Total 246 (87) 10 (4) 28 (10) 5.86 (1.5)
the College of Dental Medicine
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13. Do you prefer to continue Preclinical 129 20 15 15.07 (5.7) 0.742 0.965
with the 4‑day university week Clinical 93 15 12 14.84 (6.0)
for the next academic year
Total 222 (78) 35 (12) 27 (10) 15.0 (5.8)
(2022–2023)?
21. Would you like to see Preclinical 28 return to 5 days 25 111 continue with 4 days 7.53 (3.2) 0.501 0.556
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the academic week back at Clinical 21 13 86 7.79 (3.2)

5 days? (r)
Total 49 (17) 38 (13) 197 (69) 7.68 (3.2)
“%Agree: Percentage of agreement response, %Disagree: Percentage of disagreement response, (r): reversed score item, %NS: Percentage of not sure response, SD: Standard
deviation

Table 2: Summary of student’s responses on the impact of the introduction of the 4‑day university week on their clinical training.
Clinical training (clinical year levels only) Agree (%) NS (%) Disagree (%) Mean score (SD) t‑test, P Pearson χ2; P
8. How would you compare the number of patients seen over 88 (73.3) 13 (10.8) 19 (15.8) 7.6 (2.2) 0.000 0.000
the 2022 semester compared to 2021 semester? improved
9. How would you compare the number of patient 88 (73.3) 14 (11.6) 18 (15) 7.55 (2.4) 0.000 0.000
procedures performed over the 2022 semester compared to improved
2021 semester?
20. Would you be happy to take clinics on a Sunday? 22 (18.3) 11 (9.2) 87 (72.5) 14.52 (5.7) 0.005 0.008
22. Would you like to see the academic week reduced 37 (30.8) 13 (10.8) 70 (58.3) 4.63 (3.4) 0.005 0.008
further to 3 days?
“%Agree: Percentage of agreement response, %Disagree: Percentage of disagreement response, (r): reversed score item, %NS: Percentage of not sure response, SD: Standard
deviation

Table 3: Summary of student’s responses on the impact of the introduction of the 4‑day university week on the quality of
teaching received and academic performance of the students.
Academic teaching and Year level Agree, n (%) NS, n (%) Disagree, n (%) Mean score (SD) t‑test, P Pearson χ2; P
performance
10. How satisfied are you with Preclinical 122 (74.4) 4 (2.4) 38 (23.2) 5.09 (1.8) 0.009 0.139
the learning load during the 4‑dayClinical 101 (84.1) 2 (1.7) 17 (14.2) 5.62 (1.6)
work week?
Total 223 (79) 6 (2) 55 (19) 5.31 (1.7)
16. With the 4‑day work week, Preclinical 52 (31.7) 28 (17.1) 84 (51.2) 6.20 (3.2) 0.105 0.439
there is less time to meet with Clinical 31 (25.8) 19 (15.8) 70 (58.4) 6.82 (3.2)
instructors and advisors (r)
Total 83 (29) 47 (17) 154 (54) 6.52 (3.2)
14. How has your academic Preclinical 93 (56.3) improved 53 (32.3) 18 (10.9) 6.49 (3.0) 0.913 0.595
performance in examinations been Clinical 69 (57.5) 42 (35) 9 (7.5) 6.53 (3.0)
affected by introduction of the
Total 162 (57) 95 (34) 27 (10) 6.5 (3.0)
4‑day work week?
17. The longer college‑day in a Preclinical 52 (31.7) 35 (21.3) 77 (47) 5.79 (3.2) 0.219 0.302
4‑day work week has negatively Clinical 39 (32.5) 18 (15) 63 (52.5) 6.26 (3.2)
affected your ability to complete
Total 91 (32) 53 (19) 140 (49) 6.05 (3.2)
academic assignments (r)
“%Agree: Percentage of agreement response, %Disagree: Percentage of disagreement response, (r): reversed score item, %NS: Percentage of not sure response, SD: Standard
deviation

14 (r[284] =0.44, P < 0.01), 10 and 17 (r[284] =0.38, P < 0.01), beneficial for relieving stress and spending quality time with
14 and 16 (r[284] =0.34, P < 0.01), 14 and 17 (r[284] =0.32, family and friends. The exact proportion of students was
P < 0.01), and 16 and 17 (r[284] =0.53, P < 0.01). pleased with the length of the weekend for studying and
preparing for examinations.
Study–life balance
Most of the preclinical 151 (82.1%) and clinical 106 (88.1%) We also asked the participants if the shorter university
students, with an overall satisfaction rate of 91%, expressed week negatively affected on‑campus extracurricular
contentment with the new 3‑day weekend. They found it activities and their participation in such activities. Less than

114 Advances in Biomedical and Health Sciences / Volume 3 / Issue 3 / July-September 2024
 Gaballah, et al.: Four‑day university week in dentistry

one‑quarter (68/286) of the students were concerned about several countries. Recently, there has been a significant
the potential negative impact. The remaining three‑quarters increase in research on reducing working hours. In the UK,
reported not experiencing any adverse effects from the new various think tanks, such as the New Economics Foundation,
weekly scheme. Similarly, 128 (87%) and 97 (80.8%) of the Women’s Budget Group, and the Institute for Public Policy
preclinical and clinical students acknowledged the benefits of Research, have conducted research and produced policy
the extended weekend on their personal study organization. briefings on the advantages and feasibility of implementing
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shorter working hours policies [17‑19]. Henley Business

Finally, introducing a 4‑day university week helped 215 (76%) School has published numerous business‑focused articles
students reduce the cost of attending college compared to on productivity and related metrics [20]. A UK pilot program
a 5‑day week in terms of transportation, dining, and other found that a 4‑day workweek benefits both employers and
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expenses. Only 18 (6%) participants disagreed, whereas employees. Many companies enjoyed it so much that they
51 (18%) were unsure about significant cost‑cutting. The continued the arrangement, with some workers preferring it
responses of the participants in this field are summarized in over the traditional 5‑day workweek [21].
Table 4. Correlation analysis showed significant correlations
between the total scores for the following questions: 11 and A 12 month trial of a compressed workweek that was
12 (r[284] =0.62, P < 0.01), 11 and 15 (r[284] =0.27, P < 0.01), conducted in Utah, USA demonstrated a promising impact
11 and 18 (r[284] =0.54, P < 0.01), 11 and 19 (r[284] =0.41, on sustainability [22]. The results revealed a significant 13%
P < 0.01), 12 and 15 (r[284] =0.31, P < 0.01), 12 and decrease in energy usage and staggering savings of $6 million
18 (r[284] =0.51, P < 0.01), 12 and 19 (r[284] =0.37, P < 0.01), in gasoline. In addition, over 82% of state workers expressed
15 and 18 (r[284] =0.37, P < 0.01), 15 and 19 (r[284] =0.20, an unwavering desire to continue with this schedule, which
P < 0.01), and 18 and 19 (r[284] =0.45, P < 0.01). could potentially reduce greenhouse gas emissions by
over 12,000 metric tons annually. This study emphasizes the
DISCUSSION impact of innovative ideas on sustainability.

The 4‑day workweek is gaining acceptance as a viable Education must evolve consistently to ensure that students
alternative to the traditional 5‑day workweek. This policy receive a high‑quality education. Content and teaching
involves reducing working hours without compromising methods must be continually expanded to meet personal,
performance or productivity. Pilot programs and positive professional, and social growth needs. Given that education
research have been successful, and the COVID‑19 pandemic emphasizes holistic development, it is important to adapt to
has accelerated societal changes toward flexible working current and future affairs. One of the changes implemented
patterns. The 4‑day week is no longer just a desirable program in education is a shift in academic calendars. Traditional
but a potentially achievable one across the economies of 5‑day school weeks have been replaced by 4‑day weeks, and

Table 4: Summary of student’s responses on the impact of the introduction of the 4‑day university week and more extended
weekends on their study–life balance.
Study–life balance Year level Agree, n (%) NS, n (%) Disagree, Mean t‑test, P Pearson
n (%) score (SD) χ2; P
11. How satisfied are you with longer length of Preclinical 151 (92.1) 29 (1.2) 11 (6.7) 6.2 (1.3) 0.94 0.567
your weekend in sense of stress relief and quality Clinical 106 (88.4) 2 (1.6) 12 (10) 6.2 (1.5)
time with family and friends?
Total 257 (91) 4 (1) 23 (8) 6.21 (1.4)
12. How satisfied are you with the longer length Preclinical 151 (92.1) 3 (1.8) 10 (6.1) 6.12 (1.4) 0.996 0.424
of your weekend in sense of time availability for Clinical 105 (87.5) 3 (2.5) 12 (10) 6.12 (1.4)
studying and preparing for exams?
Total 256 (90) 6 (2) 22 (8) 6.12 (1.4)
15. The 4‑day work week has negatively affected Preclinical 42 (25.6) 72 (43.9) 50 (30.5) 5.0 (3.1) 0.004 0.011
on‑campus extracurricular participation (r) Clinical 26 (21.7) 37 (30.8) 57 (47.5) 6.13 (3.3)
Total 68 (24) 109 (38) 107 (38) 5.5 (3.2)
18. Overall, the 4‑day work week has a positive Preclinical 128 (87) 26 (15.9) 10 (6.1) 7.76 (2.8) 0.356 0.363
impact on your personal studies Clinical 97 (80.8) 20 (16.7) 3 (2.5) 8.06 (2.6)
Total 225 (79) 46 (16) 13 (5) 7.91 (2.7)
19. The 4‑day workweek at the college has Preclinical 122 (74.4) 33 (20.1) 9 (5.5) 7.64 (3.0) 0.856 0.462
helped you reduce the cost of attending the Clinical 93 (77.5) 18 (15) 9 (7.5) 7.83 (2.9)
college when compared to the 5‑day workday
Total 215 (76) 51 (18) 18 (6) 7.71 (3.0)
in terms of transportation, dining, etc.
“%Agree: Percentage of agreement response, %Disagree: Percentage of disagreement response, (r): reversed score item, %NS: Percentage of not sure response, SD: Standard
deviation

Advances in Biomedical and Health Sciences / Volume 3 / Issue 3 / July-September 2024 115
 Gaballah, et al.: Four‑day university week in dentistry

studies have shown that this change enhances student and to ensure consistency and comparability across all items.
staff morale and attendance [1]. The primary reason for this This adjustment may have simplified the complexity of the
shift was financing, as public schools were looking to cut costs responses and potentially limited the understanding of the
to accommodate restrictions on available budgets. Although variables under investigation.
saving on costs may not be significant, it has become an
underlying incentive for the shift [23]. Acknowledgements
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None.
Research conducted in Colorado schools [9] showed that
implementing a 4‑day school week leads to a discernible Authors’ contributions
improvement in academic performance in both reading and KG conceived the research concept and developed the
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math without any negative impact on student achievement. research design; ME developed the research design and
performed the data analysis; EI performed data collection
Some schools, but not all, experienced lower math and and analyzed the data; SA prepared the first draft, and all
language arts test scores after implementing a 4‑day schedule. the reviewers reviewed and approved the final draft of the
Schools with less time (29 h/week) spent in school had a slight manuscript. All the authors are responsible for the content
reduction in scores, whereas those with more than 32 h/week and integrity of this manuscript.
did not experience a change. The relationship between test
scores and the 4‑day school week varied depending on Ethical statement
the average number of hours the schools operated each The Research Ethics Committee of the University of Sharjah
week [24]. In this regard, the University of Sharjah has adopted approved this study (approval number: REC‑21‑10‑17‑1).
a 32‑h college week and additional limited off‑day activities to Written informed consent was obtained from the participants.
maintain standards and avoid any negative impact on student
Declaration of Helsinki
performance.
The authors confirm that the research was conducted in
A study of Oklahoma high schools [24] found that switching accordance with the Ethical Principles for Medical Research
to a 4‑day schedule improved psychosocial well‑being by Involving Human Subjects outlined in the Helsinki Declaration
reducing fighting incidents by 0.79/100 students and bullying of 1975 (revised 2013, https://www.wma.net/policies‑post/
wma‑declaration‑of‑helsinki‑ethical‑principles‑for‑medical
incidents by 0.65/100 students. However, there were no
‑research‑involving‑human‑subjects/).
changes to the other disciplinary issues. This shift did not have
an effect on attendance or college test scores.
Data availability statement
The data supporting the findings of this study are available
CONCLUSION
from the corresponding author upon request.
The introduction of the 4‑day study week at the College of Dental
Financial support and sponsorship
Medicine was welcomed by students across all years of the
Not applicable.
program. Students reported satisfactory experiences with the
new weekly schedule in relation to academic achievement and Conflict of interests
clinical training. They were also satisfied with the longer weekend, No conflict of interests declared.
as it helped them relieve stress, prepare better for examinations,
and spend more time with their family and friends. REFERENCES

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