Methods

Ethics statement

This study was approved by the Ethics Committee for Social Sciences, Arts, and Humanities of the Pontificia Universidad Católica de Chile (ID: 24111002). All participants provided informed consent. To reduce the risk of identification, direct quotations were not included.

Personal characteristics of the research team

Interviewer/facilitator

The author conducted all interviews. When necessary, interviews were conducted with the assistance of a sign language interpreter. To ensure accuracy and minimize potential loss of meaning during interpretation, interview transcripts were reviewed and validated by participants before inclusion in the study.

Credentials

The researcher is a dentist (DDS), is a specialist in endodontics, and holds a master’s degree in education with a specialization in higher education.

Occupation

The researcher is a university faculty member at the School of Dentistry and was completing a master’s thesis in education, with a specialization in higher education, at the time of the study.

Gender

The researcher is female.

Experience and training

The researcher had 13 years of professional experience as a dentist and 11 years of experience as a university faculty member. At the time of the study, she held the academic rank of assistant clinical professor.

Relationship with participants

Relationship established

A previous professional relationship existed with some academic participants, as the researcher was a faculty member within the School of Dentistry where the study was conducted. However, the researcher did not hold a position of authority or direct evaluative role in relation to these participants. For the remaining participants, no prior relationship existed before the study. Additionally, the researcher was not teaching the student participants either prior to or during the study period.

Participant knowledge of the interviewer

Participants were informed during recruitment and through the informed consent process that the researcher was a university faculty member and a master’s degree candidate conducting the study as part of her thesis in higher education. They were also informed that the purpose of the research was to explore facilitators and barriers affecting the inclusion of students with hearing disabilities in clinical dental education, with the aim of contributing to more inclusive educational practices in higher education.

Interviewer characteristics

The researcher had professional and academic interests in inclusive education, clinical dental training, and accessibility in higher education. Given her background as both a clinician and a university educator, the researcher recognized that her experiences and perspectives could influence data interpretation. The study was motivated by an interest in understanding how students with hearing disabilities experience clinical education and how institutional and pedagogical practices may facilitate or hinder inclusion.

Theoretical framework and methodology

Methodological orientation

This study used a qualitative case study design with an inductive thematic analysis approach to explore facilitators and barriers affecting the inclusion of students with hearing disabilities in clinical dental education.

Theoretical framework

The study was informed by inclusive education and drew on both the social and medical models of disability to examine how individual experiences interact with institutional, pedagogical, and environmental factors in clinical education contexts.

Participant selection

Sampling

Participants were selected using convenience sampling based on their direct involvement in or experience with the inclusion of students with hearing disabilities in clinical dental education.

Recruitment approach

Participants were recruited face-to-face.

Sample size

Six participants were included: 2 students with hearing disabilities, 3 clinical instructors, and 1 Chilean Sign Language interpreter.

Non-participation

No participants withdrew from the study after agreeing to participate. However, 1 initially planned participant group, consisting of significant others identified through snowball sampling, was ultimately not recruited because of participants’ time constraints and recruitment difficulties.

Setting and context

Data collection setting

Data were collected in university settings associated with the School of Dentistry. Interviews were conducted in person.

Presence of non-participants

In interviews involving participants with hearing disabilities, a Chilean Sign Language interpreter was present when required to facilitate communication. No other non-participants were present during data collection.

Sample characteristics

The sample included 6 participants directly involved in clinical dental education at a Chilean university: 2 students with hearing disabilities, 3 clinical instructors, and 1 Chilean Sign Language interpreter.

Inclusion criteria varied by participant group. Students were required to be enrolled in the dental program and to have a hearing disability, as well as experience in preclinical or clinical training. Clinical instructors were required to have direct teaching experience with students with hearing disabilities in clinical or preclinical settings. The interpreter was required to have experience supporting students with hearing disabilities in the university context.

Participants were selected based on their direct involvement in inclusion processes within clinical dental education. Data collection was conducted during the first semester of 2025.

Data collection

Interview guide

Semi-structured interview and observation guides were developed by the researcher based on the study objectives and informed by methodological recommendations from the qualitative research literature. To strengthen methodological rigor, the instruments underwent temporal triangulation and were reviewed and validated by 3 expert judges with experience in the field. Recruitment and data collection procedures followed all guidelines established by the institutional ethics committee.

Repeat interviews

No repeat interviews were conducted.

Audio/visual recording

Audio recordings were used during interviews with participant consent. No video recordings were performed.

Field notes

Field notes were taken during and after interviews and observational activities to document contextual information and emerging reflections relevant to the analysis.

Duration

Interviews lasted approximately 60 to 90 minutes, depending on the participant and the use of interpretation support.

Data saturation

Data saturation was not formally established because of the small and highly specific nature of the sample. However, sufficient depth and recurrence of themes were identified to address the study objectives.

Transcript validation

Interview transcripts were returned to participants for review, feedback, and correction before analysis.

Data analysis

Number of data coders

Data coding and analysis were conducted by a single researcher, who performed open and axial coding and developed the thematic categories.

Coding framework

The coding process involved open and axial coding to identify patterns and develop thematic categories related to facilitators and barriers in clinical dental education. A structured coding framework was developed iteratively throughout the analysis. Because the entire study, including data collection and analysis, was conducted in Spanish, the coding framework and thematic categories presented in this manuscript were translated into English for publication (¹).

Theme identification

Themes were derived inductively from the data through an iterative process of open and axial coding. Categories and themes emerged progressively during analysis rather than being predefined before data collection.

Software

ATLAS.ti ver. 25.0 (ATLAS.ti Scientific Software Development GmbH) was used to organize, manage, and analyze qualitative data throughout the coding and thematic analysis process.

Participant validation

Preliminary interpretations and emerging findings were discussed face-to-face during the validation process to enhance credibility and confirm consistency with participants’ experiences.

Footnotes

1. Data availability

   Data files are available from https://doi.org/10.7910/DVN/EFKJ5T

   Dataset 1. Coding framework. ↩