The study was conducted in Ghaziabad city which is located in Western part of Uttar Pradesh, India. This was aquestionnaire based cross-sectional survey among the registered dental practitioners practicing in and around Ghaziabad city. A total of 268 dentists were contacted to be part of the study. The Institutional Review Board of Divya Jyoti college of Dental Sciences And Research, Modinagar, Uttar Pradesh, India, provided the ethical clearance for this study and informed consent was obtained from all the study participants prior to the study. Participation in the study was voluntary and confidentiality of data was maintained. SOAPC is a German version which measures diverse aspects concerning organizational culture in healthcare. Goetz K et al., adapted SOAPC for dental care and renamed as the SOADC [11]. The SOADC is comprised of 21 items. It is assessed using a five-point Likert scale, ranging from strongly disagree (score = 1) to strongly agree (score = 5). There are four predefined subscales of SOADC which includes: communication (four items); decision making (eight items); stress/chaos (six items); and history of change (three items). Data were collected from each practicing dentist and was personally approached by Principal Investigator requesting for participation in survey. After taking the consent and explaining the design of the study, the dentists were given two week time to respond to the questionnaire. The reminder was given through phone calls to return the questionnaire. Among all of the 268 dentists, 249 completed the questionnaire; 10 non reachable and 09 incomplete questionnaires were excluded from the study.

To check questionnaire validation, a pilot study was undertaken on 10% of the total population (n=27) which were not included in main study sample. It served as a preliminary study to check the feasibility and relevance of the study. Test-Retest was used to determine the reliability of the questionnaire and internal consistency of the questionnaire was verified by Chronbachs-Alpha (ᾳ=0.86). Construct validity of the questionnaire was evaluated using Spearman’s correlation coefficient between individual parameter/construct as well as overall score of the construct.

The analysis was performed using SPSS 18.0 (SPSS Inc., Chicago, IL, USA) and descriptive and analytical tests, including Mean, Standard Deviation, and Chi-square test were applied.

The questionnaire based study was carried out among the 268 dentists regarding the organizational attributes in dental-care practices. The total of 249 dentists responded to the questionnaire, generating the response rate of 92.91%. The study sample comprised of 151 (60.6%) males and 98 (39.4%) females and based on, level of qualification, and career prospective of dentists are summarized in [Table/Fig-1].

[Table/Fig-2] shows the distribution and mean for each item of SOADC of the dentists who responded to the questionnaire. Among 249 practitioners, 70.3% agreed that they have constructive work relationship with staff in communication. In decision making, 50.2% agreed that this practice encourage staff input for making changes and improvements. In contexts of “stress/chaos” and “history of change”, 32.9% and 41% of dentists neither agreed nor disagreed with the statement that they “feel overwhelmed by the work demands” and “practice has changed in how it does business of dentists” respectively.

[Table/Fig-3] represents overall distribution of mean scores.

[Table/Fig-4] shows the comparison of graduates and postgraduates which revealed that mean score for graduate and postgraduate was approximately same which is 3.54±0.60 and 3.55±0.62 respectively in case of communication. In case of decision making and stress/chaos, graduate has slightly less mean scores 2.39±0.91 and 2.24±0.86 as compared to postgraduate 3.34±0.78 and 3.01±0.63 respectively. For history of change, both graduate and postgraduate have approximately same mean scores which is 3.23±0.71 and 3.26±0.70 respectively.

[Table/Fig-5,6] shows no statistically significant difference (p>0.05) in the mean score of various dimensions of SOADC based on age group and gender.

The present study measures the psychometric properties of organizational attribute among dental practitioners and it shows good reliability of SOADC in Indian setting. The present study can be compared with only a single past relevant study conducted by Goetz K et al., in Germany [11]

In the component “communication” overall highest mean score of 3.73 was obtained by the subscale “When there is a conflict in this practice, the people involved usually resolve the problem successfully” which was in agreement to an earlier study published by Goetz K et al., (3.62) in Germany, the probable reason behind this might be because of the hierarchical and dental manpower variations in the two countries [11]. Communication illustrate if there is any problem, all members of the practice work as a team through consultation and meeting with one another. High scores indicate better communication [14].

In the item “decision making” overall highest mean score of 2.97 was obtained by the subscale “practice encourage staff input for making changes and improvements and dental staff are involved in developing plan for improving quality” which is lower with the scores obtained by Goetz K et al., in Germany, since the mean score of 3.72 and 3.89 respectively was obtained for the same question [11]. High scores on decision making reveals that in executing decision there should be participatory approach within practice and leader should consult from all the employees in the practice [15].

In “stress/chaos”, overall highest mean score of 2.75 was obtained by the subscale “the dentist in this practice very frequently feel overwhelmed by the work demands” which is slightly less as compared to score obtained by Goetz K et al., (3.57) [11]. The high scores of stress/chaos reveal that the practitioners feel overwhelmed by the workload [4]. If the work place is stressful and chaotic, there is often less communication and participation in decision making [14].

In the item “history of change”, overall highest mean score of 3.41 was obtained by the subscale “our practice has changed in how everyone relates” which is in slight disagreement with the scores of 3.16 obtained by Goetz K et al., for same question [11]. The variation in scores might be because of change in practice level which is accomplished with low communication decision making in high stress/chaotic work environment [14].

SOADC assess not only the condition that is important for working together but also which assure a good structure and process of dental care. It has been established that quality of dental care can be improved by good practice quality management system [5].

However, to our knowledge there is only one study that has used this instrument in dental care practitioner and the findings showed that job satisfaction is associated with communication, decision making and stress /chaos.

Till date, most of the studies regarding this concept have been carried out in other countries and no such study has been done in India. Therefore, there was not much literature available for comparison of this study which proved a major limitation.

Since, the study was based on self-perception attitude of the participant, it may lead to perception bias.

This was a cross-sectional study so it does not give a causal relationship thus a longitudinal study is required to further support our research.

As this study was a cross-sectional survey, it does not provide causality among the variability, therefore a longitudinal research would substantiate the conclusions of the study.

This study can act as a guideline to asses psychometrics analysis with the objective measurement of finesse and intelligence, temperament, skills, personality traits, and educational success in a healthcare system. But, before its application it has to be further analysed on a larger scale comparing different healthcare levels and setups.

SOADC is an instrument with good psychometric behaviours. Psychometric is immensely related with different form of organizational attribute for dental care (communication, decision-making, stress/chaos and history of change). In the recent year, improving patient safety must be the priority of practitioners. To provide safety and care to the patient, dental care practitioners must take organization attribute into consideration.