Strides in Development of Medical Education

Document Type : Review


1 Ph.D. in Pharmacology, Associate Professor, Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Ph.D. Student, Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


  Background & Objective: One method to evaluate and monitor the effectiveness of the general medicine curriculum is the collection of results of research in this field In this study research results on the extent of predefined general competency in the formal document of the minimum competencies of Iranian general physicians have been systematically integrated   Methods: The search strategy in this study included the searching of words doctor student interns or graduate and ability competency knowledge skill attitude or performance in the title abstract or keywords of articles All papers published from 2002 to 2014 in Persian language journals were retrieved from the Irandoc Iranmedex Magiran Medlib and SID databases   Results: After the removal of irrelevant or duplicate papers from 270 recorded papers 24 articles were selected and analyzed All studies were descriptive studies and most used selfreporting methods to assess the competency of physicians Reviewed articles focused on only 48% of subdomains of the formal document of the minimum competencies of physicians In 70% of assessed skills physicians competencies were estimated as low to moderate   Conclusion: Although these studies did not assess all skills mentioned in the formal document of the minimum competencies of physicians estimates show that the competencies of general physicians in assessed skills were not desirable It is recommended that future studies in this field to be managed


  1. Albanese MA, Mejicano G, Mullan P, Kokotailo P, Gruppen L. Defining characteristics of educational competencies. Med Educ. 2008;42(3):248-55 .
  2. Merl PA, Csanyi GS, Petta P, Lischka M, Marz R. The process of defining a profile of student competencies at the University of Vienna Medical School. Med Educ. 2000; 34(3):216-21.
  3. Yamani N, Fakhari M. Social Accountability of Medical Education Curriculum: Barriers and Implications. Iran J Med Educ. 2014; 13(12):1082-98. [In Persian]
  4. Ahmed R, Naqvi Z, Wolfhagen I. Psychomotor skills for the undergraduate medical curriculum in a developing country—Pakistan. Educ Health (Abingdon). 2005;18(1):5-13.
  5. Deputy ministry for education. Minimum competency expected from graduates determined in the Iranian general physician educational curriculum. Deputy ministery for education. Ministery of health and medical education. [cited 2014 Feb 20]. Available from:
  6. The Academy of Medical Sciences of Iran. Department of clinical siences. [cited 2014 Feb 20]. Available from :
  7. CookDJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997;126(5):376-80.
  8. Mulrow CD. Systematic reviews: synthesis of best evidence for health care decisions. Philadelphia: ACP Press; 1998.
  9. Changiz T, Malekpour A, Zargham-Boroujeni A. Stressors in clinical nursing education in Iran: A systematic review. Iran J Nurs Midwifery Res. 2012;17(6):399.
  10. Ahmadi MF, Porhemmat H. Knowledge and practice ofmedical interns about oral medicine in Hamadan University of Medical Sciences . J Qazvin Univ Med Sci. 2012; 16 (3) :89-92. [In Persian]
  11. Esmaeili MR, Abazari H, Mohammadi Kenari H. Comparison of medical students' and pediatric residents' practices in medical records at Amirkola Children Hospital. J Babol Univ Med Sci. 2010;12(supp1):6. [In Persian]
  12. Balaghafari A, Siamian H, Aligolbandi K, Zakeezadeh M, Kahooei M, Yazdani Charati J, et al. A study on the Rate of Knowledge, Attitude and Practice of Medical Students towards Method of Medical Records Documentation at Mazandaran University of Medical Sciences Affiliated Therapeutic and Teaching Centers 2003. J Mazandaran Univ Med Sci. 2005; 15(49):73-80. [In Persian]
  13. Poor Amiri A, Khalili G, Shokoohi M. Self-assessment of General Practitioners Graduated from Kerman University of Medical Sciences,  Iran,  inCompetency  to Diagnose  and  Treat  Orthopedic  Problems.  J Strides  Dev  Med Educ. 2013;  10(1):  1-12. [In Persian]
  14. Jalili  Z,  Nouhi  E,  Nakhaee  N.  The  Opinions of  Medical  interns  about  the  Acquired  Basic Clinical  Skills.  J  Strides  Dev  Med  Educ. 2006;  2(2):  80-7. [In Persian]
  15. Joolaee H,  Alizadeh  M,  Fallahzadeh  M, Baseri  A,  Sayadi  M.  Evaluation  of  Clinical Skills  of  Family  Physicians  in  Fars  Province by  Means  of  Observed  Structured  Clinical evaluation.  J  Strides  Dev  Med  Educ.  2011; 7(2):  92-8. [In Persian]
  16. Hosseini Nejad  S,  Bozorgi  F,  Taleshi  Z, Montezer  S,  Amini  Ahi  dashti  H,  Goli  Khatir I,  et  al.  Levels  of  Knowledge  and  Skills  of Medical  Interns  in  Mazandaran  University  of Medical  Sciences  about  Cardio-Pulmonary Resuscitation, 2011.  J  Mazandaran Univ  Med Sci. 2013;  22 (97):98-103. [In Persian].
  17. Khalili M,  Aghababaei  H,  Hosseinzadeh  A. Knowledge,  attitude  and  practice  of  general physicians  in  relation  with  oral  malignancies. J  Qazvin  Univ  Med  Sci.  2004;  8(3):  67-72. [In  Persian].
  18. Darvish  Moghaddam  S,  Zahedi  M.  Survey  of knowledge,  attitude  and  practice  among general  practitioners  and  internists  on Helicobacter  Pylori  in  peptic  ulcer  disease  in Kerman.  J  Kerman  Univ  Med  Sci.  2002; 9(2):  86-92. [In Persian]
  19. Rahmanian  K,  Nahal  H.  Assessment  of scientific  knowledge  of  general  physicians about  hypertension  and  type  2  dibetes mellitus  in  Jahrom,  Spring,  2002.  Armaghan Danesh. 2003;  8(29):43-50. [In Persian]
  20. Rahimi  M,  BadreddinM,  Mousavi  L, Mikaieli  L.  Knowledge  of  intern  and  extern medical students Amiralmomenin prevention and of hospitals control Boali methods and towards of nosocomial  infections.  Med  Sci  J  Islamic Azad  Univ  Tehran  Medical  Branch.  2006;  16 (2)  :107-11. [In Persian]
  21. Rashidi K, Afkhamzadeh A, Khodabandeh R. Prescription  Writing  Ability  of  Young Doctors  and  Medical  Interns  in  Kurdistan Province,  Iran.  J  Strides  Dev  Med  Educ. 2013;  10(1):42-9. [In Persian]
  22. Salimi S,  Jabbarzade  M,  Fotohi  A,  Fafahini F.  Evaluation  of  the  knowledge  level  of Iranian  medical  graduates  about  transfusion medicine. Scientifict J Iran Blood Transfusion  Organization.  2009;  5(4);275-9. [In Persian]
  23. Sayyah S.  CPR  knowledge  of  interns  of Qazvin  University  of  Medical  Sciences.  J Qazvin  Univ  Med  Sci.  2005;8  (4):98-100.  [In Persian]
  24. Fathololoumi  M,  Fatahi  Bafghi  A,  Safavi Naieni  A,  Mirzataheri  M,  Safavi  Naieni  M. Knowledge  of  general  practitioners  about acute  otitis  media.  Pejouhesh.  2006;  30(3) :235-241. [In Persian]
  25. Fotuhi  Ardekani  E,  Salehi  M,  Bashardoost  N, Yasini  S,  Soltani  H.  Yazd  Medical  Interns' Knowledge  on  LegalRules  and  Religious Orders  in  Medicine.  Iran  J  Med  Educ. 2010;10(2):184-9. [In Persian]
  26. Farajzadeh S,  Noohi  E,  Mortazavi  H.  Interns’ Communication with Patients during Interview:  the  Perspectives  of  Patient  and Observer.  Iran  J  Med  Educ.  2006;  6(2):7986. [In Persian]
  27. Fallah M,  Houshmand  B,  Joneidi  Jafari  A, Shamsai  F,  Bashirian  S.  Knowledge,  Attitude and  Research  Ability  of  General  Physicians and  Dentists  Graduated  from  Hamadan University  of  Medical  Sciences.  Iran  J  Med Educ. 2005;  5  (2)  :129-38.  [In Persian]
  28. Garrusy B,  Safizadeh  H,  Tajaddini  R.  The Knowledge  of  interns  of  Kerman  Medical Sciences University Regarding Child Maltreatment.  J  Strides  Dev  Med  Educ. 2006;  2(2):  109-15. [In Persian]
  29. Mahoori  A,  Hassani  E,  Noroozinia  H,  Amiri Kar  M.  Evaluating  the  knowledge  of  Urmia University  Medical  students  about  adult cardiopulmonary resuscitation. Urmia Medical  Journal.  2010;  21(3):260-5.  [In Persian]
  30. Moattari M,  Fallahzadeh  M.  Senior  Medical Students'  Self  Evaluation  of  their  Capability in General Competencies  in  Shiraz University  of  Medical  Sciences.  Iran  J  Med Educ. 2008;  7(2):371-7. [In  Persian]
  31. Maghbouli  L,  Aghamohammadi  D,  Jhaleh Naderi  N,  Maghbouli  M.  Attitude  of  senior medical  students  on  the  use  of  opioid  to manage  patients'  pain.  Iran  J  Med  Educ. 2011;11(3):299-300.  [In Persian]
  32. Managheb  S,  Mohammadi  M.  Knowledge and  Attitudes  of  Clinical  Teachers,  Family Physicians,  and  Medical  Interns  towards Giving  Bad  News,  a  Study  in  Jahrom University  of  Medical  Sciences.  Iran  J  Med Educ. 2011;11(5):436-43. [In Persian]
  33. Mahram M,  Mahram  B,  Alijani  H.  A  survey on professional  skills  among  general practitioners  of  Health  Service  Centers  in Qazvin  Province.  J  Qazvin  Univ  Med  Sci. 2010;  14 (2):54-61. [In Persian]
  34. Barnsley L,  Lyon  PM,  Ralston  SJ,  Hibbert EJ,  Cunningham  I,  Gordon  FC,  et  al.  Clinical skills in junior medical  officers:  a comparison  of  self-reported  confidence andobserved competence. 2004;38(4):358-67. Med  Educ.
  35. Jensen  ML,  Hesselfeldt  R,  Rasmussen  MB, Mogensen  SS,  Frost  T,  Jensen  MK,  et  al. Newly  graduated  doctors'  competence  in managing cardiopulmonary arrests assessedusing  a  standardized  Advanced  Life Support  (ALS)  assessment.  Resuscitation. 2008;77(1):63-8.
  36. Burch  VC,  Nash  RC,  Zabow  T,  Gibbs  T, Aubin  L,  Jacobs  B,  et  al.  A  structured assessment  of  newly  qualified  medical graduates. Med Educ. 2005;39(7):723-31.
  37. Chao  A,  Chou  WH,  Huang  HH,  Yeh  YC,  Lin CJ.  Evaluation  of  tracheal  intubation:  A retrospective  study  of  skill  acquisition  by medical  students  in  the  operating  theater.  J Formos Med Assoc. 2013 ;20:  1e5.
  38. Girgis  A,  Sanson-Fisher  RW,  Walsh  RA. Preventive  and  other  interactional  skills  of general practitioners, physicians: perceived surgeons, and competence  and endorsement  of  postgraduate  training.  Prev Med. 2001;32(1):73-81.
  39. Stolarek  I.  Procedural  and  examination  skills of  first-year  postgraduate  doctors  do  not improve  with  clinical  experience  alone.  N  Z Med  J.  2007;  120(1253):U2515.
  40. Old  A,  Naden  G,  Child  S.  Procedural  skills of first-year postgraduate doctors at Auckland  District  Health  Board,  New Zealand. N Z  Med  J.  2006;119(1229):U1855.
  41. Goodfellow PB,  Claydon  P.  Students  sitting medical  finals--ready  to  be  house  officers?.  J R Soc Med. 2001;94(10):516-20.
  42. Moercke  AM,  Eika  B.  What  are  the  clinical skills  levels  of  newly  graduated  physicians? Self-assessment  study  of  an  intended curriculum  identified  by  a  Delphi  process. Med Educ. 2002;36(5):472-8.
  43. Smith GB,  Poplett  N.  Knowledge  of  aspects of  acute  care  in  trainee  doctors.  Postgrad Med  J.  2002;78(920):335-8.
  44. Davis DA,  Mazmanian  PE,  Fordis  M,  Van Harrison  R,  Thorpe  KE,  Perrier  L.  Accuracy of  physician  self-assessment  compared  with observed  measures  of  competence:  a systematic review. 2006;296(9):1094-102. JAMA.
  45. Caspi O,  mcknight  P,  Kruse  L,  Cunningham V ,Figueredo  AJ,  Sechrest  L.  Evidence-based medicine:  discrepancy  between  perceived competence  and  actual  performance  among graduating  medical  students.  Med  Teach. 2006;28(4):318-25.
  46. Hodges  B,  Regehr  G,  Martin  D.Difficulties in recognizing  one'sown  incompetence: novice  physicians  who  are  unskilled  and unaware  of  it.Acad  Med.  2001;76(10 Suppl):S87-9. 
  47. Isfahan  University  Of  Medical  Sciences. Minimum  competency  of  general  physician  . June  2007.  [cited  2013  Mar  12].  Availabe from: altavanmandipezeshkanomoomikhordad1387 .pdf. 
  48. Vukanovic-Criley  JM,  Criley  S,  Warde  CM, Boker  JR,  Guevara-Matheus  L,  Churchill WH,  et  al.  Competency  in  cardiac examination  skills  in  medical  students, trainees, physicians, and faculty: a multicenter  study.  Arch  Intern  Med. 2006;166(6):610-6.
  49. Liu  M,  Huang  Y-S,  Liu  K-M.  Assessing  core clinical  competencies  required  of  medical graduates  in  Taiwan.  Kaohsiung  J  Med  Sci. 2006;22(10):475-83.
  50. Nasr  AR,  Oreizy  HR,  Abolghasemi  M. Educational  research:  an  introduction. (Translation).  Gall  MD,  Gall  JP,  Borg  WR. 6th  ed.  Tehran:  Shahid  Beheshti  University publication;  1996:  386.  [In  Persian
  51. Danaeefard  H,  Kazemi  SH.  Social  Research Methods:  Qualitative  and  Quantitative Approaches.  (Translation).  Neuman  WL.  7th ed.  Tehran:  Mehraban  book  publication; 2009:  509. [In Persian]
  52. Vieira  JE,  Cukier  A,  Stelmach  R,  Kasahara DI,  Gannam  S,  Warth  M.  Comparison  of knowledge  on  asthma:  doctors  completing internal  medicine  residency  anddoctors completing  medical  school.  Sao  Paulo Med J. 2001;119(3):101-4.
  53. Goldacre  MJ,  Lambert  T,  Evans  J,  Turner  G. Preregistration  house  officers'  views  on whether  their  experience  at  medical  school prepared  them  well  for  their  jobs:  national questionnaire survey. 2003;326(7397):1011-2. BMJ.
  54. Wouda  JC,  van  de  WielHB.  The communication  competency  of  medical students,  residents  and  consultants.  Patient Educ Couns.  2012;86(1):57-62.
  55. Lippa  LM,  Boker  J,  Duke  A,  Amin  A.  A novel  3-year  longitudinal  pilot  study  of medical  students'  acquisition  and  retention ofscreening eye examination Ophthalmology. 2006;113(1):133-9. skills.
  56. Peeraer  G1,  Scherpbier  AJ,  Remmen  R,  De winter  BY,  Hendrickx  K,  van  Petegem  P,  et al.  Clinical  skills  training  in  a  skills  lab compared  with  skills  training  in  internships: comparison  of  skills  development  curricula. Educ Health  (Abingdon). 2007;20(3):125.
  57. Aron  DC,  Headrick  LA.  Educating physicians  prepared  to  improve  care  and safety  is  no  accident:  it  requires  a  systematic approach. Qual 2002;11(2):168-73. Saf Health Care.
  58. Berridge EJ,  Freeth  D,  Sharpe  J,  Roberts CM.  Bridging  the  gap:  supporting  the transition  from  medical  student  to  practising doctor--a  two-week  preparation  programme after  graduation.  Med  Teach.  2007;  29(23):119-27. 141