Strides in Development of Medical Education

Document Type : Original Article


1 Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran

2 Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of General Courses, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

4 Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran


Background: Specialized and subspecialized medical education is of key importance in the higher education system due to the special role of residents in various fields in the educationalmedical system of universities and the important role of graduates of these fields as specialized and subspecialized physicians in the community health system; therefore, the examination of their views on desirable education can lead to the improvement of the quality of education.
Objectives: The present study aimed to explain the views of residents of Kerman University of Medical Sciences, Kerman, Iran, on desirable education. Methods: This study was performed using qualitative content analysis. A total of 17 participants were selected by purposive sampling in the academic year of 2019-2020 from the educational hospitals of Kerman University of Medical Sciences and interviewed in face-to-face and semistructured manners. After collecting the data, all the interviews were implemented and reviewed, and categories were extracted.
Results: Data analysis led to the extraction of six main themes, including capable clinical professors, effective clinical environments, comprehensive planning, comprehensive and preventive educational rules and regulations, efforts to improve educational processes, and educational management.
Conclusion: Health promotion is one of the needs of today’s society. Clinical education should be responsive to society, and the desirability of this education will lead to community health promotion. In this regard, it is suggested that education and health officials take an effective step toward improving residency course education by proper planning, performing continuous evaluations of the status of residency education, and considering the factors affecting the desirable clinical education.


  1. Guyatt G, Cook D, King D, Nishikawa J, Brill-Edwards P. Evaluating the performance of academic medical education administrators. Eval Health Prof. 1999 Dec;22(4):484-96. doi: 10.1177/01632789922034428. [PMID: 10623402].
  2. Spencer J. Learning and teaching in the clinical environment. BMJ. 2003;326(7389):591-4. doi: 10.1136/bmj.326.7389.591. [PMID: 12637408]. [PMCID: PMC1125480].
  3. Lowenstein AJ, Bradshaw MJ. Fuszard's innovative teaching strategies in nursing. 3ed. Burlington, Massachusetts: Jones & Bartlett Learning; 2004.
  4. Ramani S, Leinster S. AMEE Guide no. 34: Teaching in the clinical environment. Med Teach. 2008;30(4):347-64. doi: 10.1080/01421590802061613. [PMID: 18569655].
  5. Kennedy TJ, Regehr G, Baker GR, Lingard LA. Progressive independence in clinical training: a tradition worth defending? Acad Med. 2005 Oct;80(10 Suppl):S106-11. doi: 10.1097/00001888-200510001-00028. [PMID: 16199447].
  6. Handfield‐Jones R, Mann K, Challis M, Hobma S, Klass D, McManus I, et al. Linking assessment to learning: a new route to quality assurance in medical practice. Med Educ. 2002 Oct;36(10):949-58. doi: 10.1046/j.1365-2923.2002.01315.x. [PMID: 12390463].
  7. Tavakoli M, Khazaei T, Tolyat M, Ghorbani S. The Quality of clinical education from the viewpoints of students and instructors of paramedical and nursing-obstetrics schools of Birjand University of Medical Sciences. Daneshvar Medicine. 2014: 21(110). [In Persian]
  8. Ghafourifard M, Bayandor A, Zirak M. Clinical education status in educational centers affiliated to Zanjan University of medical sciences from nursing and midwifery students’ viewpoint. J Med Educ Dev. 2016;8(20):9-20. [In Persian]
  9. Abedini S, Aghamolaei T, Jomehzadeh A, Kamjoo A. Clinical education problems: the viewpoints of nursing and midwifery students in Hormozgan University of Medical Sciences. Hormozgan Med J. 2009;12(4):249-53. [In Persian]
  10. Kermansaravi F, Navidian A, Imani M. Nursing students’ views toward quality of theoretical and clinical nursing education: A qualitative study. J Med Educ Dev. 2013;7(4):28-40. [In Persian]
  11. Shahbazi L, Salimi T. Clinical Education from the viewpoint of nursing and midwifery students. J Yazd Univ Med Sci. 2000;8(2):97-103.
    [In Persian]
  12. Stern DT, Williams BC, Gill A, Gruppen LD, Woolliscroft JO, Grum CM. Is there a relationship between attending physicians' and residents' teaching skills and students' examination scores? Acad Med. 2000;75(11):1144-6.
  13. Buchel TL, Edwards FD. Characteristics of effective clinical teachers. Fam Med. 2005;37(1):30-5. [PMID: 15619153].
  14. Leach D. Changing education to improve patient care. Qual Health Care. 2001 Dec;10 Suppl 2(Suppl 2):ii54-8. doi: 10.1136/qhc.0100054.
  15. Leach DC, Philibert I. High-quality learning for high-quality health care: getting it right. JAMA. 2006 Sep 6;296(9):1132-4. doi: 10.1001/jama.296.9.1132. [PMID: 16954493].
  16. Irby DM, Gillmore GM, Ramsey PG. Factors affecting ratings of clinical teachers by medical students and residents. J Med Educ. 1987 Jan;62(1):1-7. doi: 10.1097/00001888-198701000-00001. [PMID: 3795239].
  17. Seabrook MA. Medical teachers' concerns about the clinical teaching context. Med Educ. 2003 Mar;37(3):213-22. doi: 10.1046/j.1365-2923.2003.01437.x. [PMID: 12603760].
  18. Hoffman KG, Donaldson JF. Contextual tensions of the clinical environment and their influence on teaching and learning. Med Educ. 2004 Apr;38(4):448-54. doi: 10.1046/j.1365-2923.2004.01799.x. [PMID: 15025646].
  19. Ramani S, Orlander JD, Strunin L, Barber TW. Whither Bedside Teaching? A Focus‐group Study of Clinical Teachers. Acad Med. 2003 Apr;78(4):384-90. doi: 10.1097/00001888-200304000-00014. [PMID: 12691971].
  20. Abbaszade A, Borhani F, Sabzevari S. Nursing teachers perception of the challenges of clinical education and solutions: A Qualitative Study. Journal of Qualitative Research in Health Sciences. 2013;2(2):134-45. [In Persian]
  21. Assarroudi A, Heshmati Nabavi F, Armat MR, Ebadi A, Vaismoradi M. Directed qualitative content analysis: the description and elaboration of its underpinning methods and data analysis process. J Res Nursing. 2018;23(1):42-55. doi: 10.1177/1744987117741667.
  22. Elo S, Kyngäs H. The qualitative content analysis process. Eur J Biochem. 1977 Jun 1;76(1):79-83. doi: 10.1111/j.1432-1033.1977.tb11571.x. [PMID: 18352].
  23. Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing grounded theory. 4th ed. California: Sage Pub; 2014.
  24. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004 Feb;24(2):105-12. doi: 10.1016/j.nedt.2003.10.001. PMID: 14769454.
  25. Guba EG, Lincoln YS. Competing paradigms in qualitative research. J Handbook of qualitative research. 1994;2(163-194):105.
  26. Slootweg I, Lombarts K, Van Der Vleuten C, Mann K, Jacobs J, Scherpbier A. Clinical teachers’ views on how teaching teams deliver and manage residency training. Med Teach. 2013;35(1):46-52. doi: 10.3109/0142159X.2012.731108.
  27. Shaterjalali M, Yamani N, Changiz T. Who are the right teachers for medical clinical students? investigating stakeholders’ opinions using modified Delphi approach. Adv Med Educ Pract. 2018 Nov 8;9:801-809. doi: 10.2147/AMEP.S176480. [PMID: 30519136]. [PMCID: PMC6235154].
  28. Esteghamati AR, Baradaran H, Monajemi A, Khankeh HR, Geranmayeh M. Core components of clinical education: a qualitative study with attending physicians and their residents. J Adv Med Educ Prof. 2016 Apr;4(2):64-71. [PMID: 27104200]. [PMCID: PMC4827758].
  29. Adhami A, Nakhaei N, Fatahi Z. Residents opinion about the quality of education in different clinical groups of Kerman University of Medical Science. Hormozgan Medical Journal. 2003;7(1):33-8. [In Persian]
  30. Abedini S, Kamalzadeh H, Aghamolaei T. Perspectives of medical students regarding criteria for a good university professor, Bandar Abbas, Iran. Hormozgan Medical Journal. 2010;14(3):242-6. [In Persian]
  31. Adhami A, Haghdoost AA, Darvishmoqadam S, Shakibi Mr, Nouhi E. Determining valid criteria for evaluating clinical and theoretical teaching of the faculty of Kerman University of Medical Sciences. Iran J Med Educ. 2000;1(2):24-30.
    [In Persian]
  32. Navabi N, Jahanian E, Haji Ahmadi M, Parvaneh M. Criteria for a Desirable Teacher from the View Point of Students of Babol University of Medical Sciences. J Babol Univ Med Sci. 2010; 12 (5) :7-13.
  33. Boor K, Teunissen PW, Scherpbier AJJA, van der Vleuten CPMvdL J, Scheele F. Residents’ perceptions of the ideal clinical teacher—A qualitative study. European Journal of Obstetrics & Gynecology and Reproductive Biology. Eur J Obstet Gynecol Reprod Biol. 2008 Oct;140(2):152-7. doi: 10.1016/j.ejogrb.2008.03.010. [PMID: 18455863].
  34. van Vendeloo SN, Prins DJ, Verheyen CC, Prins JT, van den Heijkant F, van der Heijden FM, et al. The learning environment and resident burnout: a national study. Perspect Med Educ. 2018 Apr;7(2):120-125. doi: 10.1007/s40037-018-0405-1. [PMID: 29476425]. [PMCID: PMC5889377].
  35. Khorsandi M, Khosravi S. Investigation of the View of Nursing and Midwifery Students About Clinical Education Condition in Nursing and Midwifery College of Arak University of Medical Science. J Arak Univ Med Sci. 2005;5(1):29-32.
    [In Persian]
  36. Hassan Zahraei R, Atash Sokhan G, Salehi S, Ehsanpour S, Hassanzadeh A. Comparing the Factors Related to the Effective Clinical Teaching from Faculty Members' and Students' Points
    of View. Iran J Med Educ. 2008; 7(2):249-56.
    [In Persian]
  37. Beigzadeh A, Yamani N, Bahaadinbeigy K, Adibi P. Challenges and Problems of Clinical Medical Education in Iran: A Systematic Review of the Literature. Strides Dev Med Edu.2019;16(1): e89897. doi: 10.5812/sdme.89897.