Strides in Development of Medical Education

Abstract Background & Objective: In compatibility with the progress of universities and expansion of knowledge and science around the world Iran has also had significant academic progress in recent years However the vision of Iran for the following decades is very ambitious Much has to be achieved to reach the highest position in the region in development economy science and technology This qualitative study was designed to explore the strengths and weaknesses of universities Methods: This qualitative study had three phases In the first phase we explored the topic in brain storming sessions Then the themes raised in phase one were discussed deeply in unstructured interviews with selective experts around the country In the last phase we asked 30 selective academic staff from different medical sciences universities to categorize the issues based on their importance and their solutions using Delphi method Results: Our findings showed that improvement of international affairs were frequently stressed by our respondents In this domain the English skills of academic staff and students big revision in rules and regulations and encouraging the establishment of close scientific communication with academic organizations around the world were highlighted In addition most respondents believed that problems were understandable but our main conflicts were in finding applicable solutions and implementing decisions Conclusion: Our results showed that for a better presentation of Iranian universities in the international environment a new approach to long term reform programs is necessary In this plan special attention must be paid to the educational and research infrastructures

Abstract Background & Objective: Hidden curriculum is a broad category that includes all of the unrecognized and sometimes unintended knowledge values and beliefs that are part of the learning process in schools and classrooms The hidden curriculum and ethical education have an integral relationship The aim of this study is the explanation of teachers experiences in shaping hidden curriculum in the form of a qualitative research Methods: This is a qualitative research and data were analyzed using content analysis was applied Data were collected using indepth semistructured interviews and focus groups with 22 teachers in each group The participants were recruited by purposeful sampling from a mixed group of basic clinical and nursing sciences majors Results: Qualitative content analysis demonstrated 4 themes and 26 subthemes of the role of the teacher in shaping hidden curriculum The themes consisted of: 1 factors related to teacher empowerment 2 interpersonal relationships 3 the teachers personality and ethical characteristics 4 educational characteristics of the teachers performance Each category contained subcategories Conclusion: The result showed the role of teachers in shaping hidden curriculum and the role of this subject in academic social ethical and educational aspects of students Therefore we recommend that all teachers managers and educational executive managers pay attention to this important program and that inservice training be considered for faculty members

Abstract Background & Objective: Absence of students from the classroom is one of the problems in the medical sciences in recent years Failure to attend classes disrupts the dynamic teachinglearning environment and causes this environment to become boring and unpleasant The aim of this study was to evaluate medical students views on factors affecting their presence in classrooms in Sabzevar University of Medical Sciences Iran in 2011 Methods: 288 students participated in this crosssectional study For data collection a questionnaire containing 28 questions in 5 Likert types was used Results: 215 female (747%) and 73 male students (253%) participated in this survey 79% of participants were single The highest score was in the area of teacher characteristics (013 ± 076) The next highest scores were the course features (018 ± 0755) physical environment (017 ± 0747) and the student characteristics (014 ± 0747) respectively Conclusion: It can be concluded from the findings of this study that the most important factor involved in the increased attendance in classroom is teacher characteristics such as the content presented in the classroom or the teacher s interesting speech Course features or class time are also important Given this factor we hope educators and planners improve the teaching and learning process through the increased presence in classrooms

Abstract Background & Objective: Students academic decline is one of the major problems of higher education institute in the country For this reason many studies have been performed on this subject but they have achieved different results This study aims to collect and compare researches carried out nationwide on this subject Methods: Using the information on online systems and databases such as Iranmedex Sid Magiran PubMed Web of Science Google Scholar and Science Direct Eric the keywords Medical students educational failure academic growth and academic achievement were searched The papers were divided into two categories of related and unrelated Results: From the total of 152 papers the irrelevant articles were eliminated and from the 32 remaining papers only 9 articles had the required criteria for the study In terms of content analysis sex accommodating in dormitory employment marital status age pass rate noticeable gap between acquiring diploma and university entrance were considered as affecting factors on academic decline Conclusion: These factors can be considered as effective factors in academic decline since they are common in previous published articles However in these articles academic decline determinants are different and no specific cut point has been defined Due to the importance of the subject and its effects on academic decline it is recommended that it be specified

Abstract Background & Objective: Community oriented medical education has been considered by many universities The aim of this study was to determine the general practitioners (GPs) point of view regarding social medicine training programs (SMTP) Methods: This crosssectional study was conducted on GPs graduated from different Iranian medical Universities after 1985 in Babol Iran in 2010 Subjects were selected by simple randomized sampling method Data were gathered using a questionnaire consisting of three parts and analyzed using chisquare and Fishers exact tests by SPSS Results: In this study 130 GPs who had graduated 104 ± 57 years ago were evaluated Data showed some topics of SMTP like occupational health disease management executing a research project and presence in rural/urban health centers were more common in GPs graduated after 2001 in comparisons with counterpart group Moreover GPs who worked in rural health centers indicated to have more attention on mental health dental health elderly care disease management and social health assessment methods in curriculum of SMTP Conclusion: According to our findings mental and occupational health along with elderly care should be considered in social medicine curriculum of medical students Moreover appropriate revisions on SMTP and continuous education programs on these topics for GPs are recommended

Abstract Background & Objective: In the 21 century using computers and the internet are necessary Computers and internet provide professors and students with the possibility of accessing scientific information very quickly The aim of this study was the evaluation of skills and use of computer and internet among professors and postgraduate and undergraduate students in Kerman University of Medical Sciences School of Dentistry Methods: In this crosssectional and descriptiveanalytic study a questionnaire was given to 51 professors 42 postgraduate and 241 undergraduate dental students of Kerman University of Medical Sciences After completing the questionnaires data were analyzed using chisquare test Results: Statistical analysis showed that the rate of access to computers at home and universities among professors and post and undergraduate students was 882% 847% 854% respectively 98% of professors 95% of postgraduates and 94% of undergraduate students use the internet The most rate of computer use was 052 hours during the day 874% of professors 714% of postgraduates and 71% of undergraduate students do not need education for using the internet Professors and assistants use of computers for academic activities was higher than students Conclusion: Skills and use rate of computers and internet was higher in professors in comparison with other groups and there were no statistically significant difference between men and women in three groups

Abstract Background & Objective: Educational influentials (EIs) are individuals who can positively influence their peers These individuals play a key role in knowledge transfer and knowledge translation process Having knowledge of their characteristics is very important in detecting these people There is a paucity of information in the medical field especially in nursing regarding this context The aim of this study was to find the main features of an EI nurse in a local hospital setting Methods: This research was a qualitative study that was performed by a focus group discussion (FGD) method Sixteen nurses who worked in Afzalipour Hospital affiliated with Kerman University of Medical Sciences Iran were selected The main question was “when you face a clinical problem who do you consult with for the answer?” which meant “what kind of characteristics does this person have?” The content of the interview was recorded and analyzed by content analyses method after documentation and finally main themes and their subcategories were obtained Results : The main characteristics of EL nurses were classified as following: high knowledge communicative skills decisionmaking humanistic behaviors and clinical experience and skills Conclusion: Apart from clinical experience and skills the other characteristics identified for EI nurses were obtained in other studies The new feature that is explored in this study may indicate the fact that clinical skills and experiences have an important role among nurses

Abstract Background & Objective: The aim of this article was to explore the use of new information and communication technology (ICT) in medical education in Mashhad University of Medical Sciences as a single case study Methods : The research method was descriptive The study population consisted of students and faculty member of Mashhad University of Medical Sciences Iran Stratified sampling was used to investigate information technology in academic environments To investigate the ideal situation a random sampling method was applied Questionnaires observation survey and other methods were used to study ICT in higher education Results : There was a significant difference significantly higher than the mean between ICT use and the ideal condition in some cases and lower than the mean in others (P < 001) In some cases the difference was not significant which showed the moderate use of ICT The use of ICT is mainly in areas such as Word However its other possibilities like communication are not used Both groups had a positive attitude toward ICT and assessed their skills as moderate (P < 001) Conclusion : Results indicated a significant positive relationship between these three variables in both groups (P < 001) The ideal situation according to teachers and students included ICT training online library and improving infrastructure particularly internet speed They believed the main challenges to be their lack of skills educational policy and financial managerial cultural and infrastructural issues

Abstract Background & Objective: Knowledge maps graphically draw a branch of science and help to describe it more precisely This research was conducted to study the scientific productivity and collaborative coefficient of medical education authors during 20022011 Methods: This descriptive study was done using scientometric techniques The papers indexed in Web of Science were searched using medical education keywords The retrieved records were entered into Excel and HistCite Citation analysis techniques were used and the map was drawn Results: The rate of productivity was 28% 10123 retrieved records were published in 1506 journals and most were published in Medical Education Journal 5791 educational institutes contributed to publishing papers Van der Vleuten published more papers than other authors The collaborative coefficient was moderate 122 countries contributed to publishing these papers and USA was the most active country Finally 5 clusters were identified including learning methods in medical education job depression the effect of working hour reduction on health services evaluation of professional competency in medical education and the relationship between medical sciences and industry Conclusion: Medical education follows an ascending trend in scientific productivity The results of the current study can be used in future planning and help this field to improve

Abstract Background & Objective: In Iran evaluation is one of the most important bases of medical education and one of the best criteria for the categorization of medical universities Therefore we aimed to compare some methods of evaluation for medical students Methods: The target group included all basic level medical students studying medical mycology during the fifth semester The tested methods of evaluations were: development test posttest class reports and final exam Three groups of evaluation were compared as a course plan of mycology for nine sessions Results: There was a significant direct relation between the midterm and final exam so that the increased midterm and posttest marks caused improvement in the final exam Moreover there was a relative correlation between the class reports and final exam Conclusion: The results of the present study showed that each tested continuous evaluation is able to improve the final exams

Abstract Background & Objective: There are many reasons that it is necessary to change the culture educational environment and curriculum of medical education toward addressing and developing the fundamentals of medical professionalism The primary objective of this study was to assess the attitudes of residents about training professionalism in the School of Medicine in Guilan University of Medical Sciences Iran Methods: This descriptive study was conducted on 189 residents of Guilan University of Medical Sciences based on a questionnaire adjusted to culture and ethical issues of Iran in 201112 The reliability and validity of the questionnaire was confirmed The data were analyzed by ttest and using the Stata statistical software Results: In this study 140 residents from 14 fields participated with mean age of 322 ± 449 years More than 50% of residents rated the success of medical professionalism education programs as medium to high More than 40% of them have considered the effect of role model educators in the education of these principles to be great 629% of residents agreed with the theoretical–practical teaching of these principles Conclusion: The degree of success of educational programs in various fields of medical professionalism was acceptable but needs improvement The residents acknowledge that they learn the principles of professionalism from their educators in a hidden educational curriculum but believe that they must also be taught in theoretical and practical units

Abstract Background & Objective: Preidentification of practical educational objectives and provision of equal learning opportunities corresponding to the objectives for students are among the needs of the educational system that should be fulfilled using the clinical handbook (Logbook) The current research tried to assess the effect of using this handbook on the learning of the students of the department of obstetrics and gynecology Methods: This quasiexperimental study was carried out on 117 medical students composed of trainees and interns in the academic year 20102011 The students were randomly divided into an experimental group and a control group The experimental group participants were trained with the help of the logbook while the control groups training followed the normal established method The skills of the two groups were evaluated at the end of the term through direct observation based on a checklist Results: The average of the total scores of the trainees and the interns of the experimental group was significantly higher than that of the control group (P < 005) However with regard to a number of skills there was no difference between the scores of the trainees of the two groups Conclusion: The Logbook is efficient but not sufficient for teaching clinical skills and therefore there should be an appropriate ground for a more efficient usage of the book

Abstract Background & Objective: After preparing the health scientific road map universities of medical sciences should play their role in this regard This study aimed to identify the main challenges of Kerman University of Medical Sciences Iran in achieving the goals of the health scientific road mapMethods: This study was conducted as a qualitative study The study population consisted of KMU`s top managers and experts Purposeful and snowball sampling methods were used 25 interviews were conducted in 2012 Using a semistructured interview the challenges of Kerman University of Medical Sciences in achieving the goals of health scientific road map were investigated A framework method was applied for the data analysis Results: At the end of this qualitative study 10 basic concepts consisting of policy making and management financing and facilitating processes development and promotion of human resources development and promotion of education research dissemination of knowledge entrepreneurship services provision culture and norms and facilitating communication and 46 subgroups of challenges were identified Conclusion: Given the importance of achieving the goals of health scientific road map and the importance of medical sciences universities in this regard Kerman University of Medical sciences must develop a comprehensive plan to reduce the challenges

Abstract Background & Objective: Telemedicine is the use of new communication and information technologies to provide clinical services health care and transferring of information for care of patients from a geographical distance The aim of this research was to determine the views of medical students on the development of telemedicine procedures in the Mazandaran University of Medical Sciences Iran Methods: A sample of 90 medical students was selected randomly in the first semester of study of 201112 The students views were assessed using a questionnaire of 33 questions consisting of three parts: demographic data questions in five areas (organizational factors technological factors stakeholders agents information literacy and environmental factors) and student use of the various areas of technology (computers internet medical websites medical applications and etc) Results: In the questions concerning the scope of the organizational factors 655% of students had a positive opinion in regard to admission to the structural changes in the organization Among the factors of technology 867% of students had positive views on broadband access in the factors of stakeholders 589% on empowering the private sector in implementing telemedicine in the information literacy 755% on students skills in using computers and the Internet and in the environmental factors 800% on economic factors for the plan Conclusion: Students believed the role of economic factors (cost appropriate technology and etc) to be more important than cultural factors (physicianpatient interaction culture community support willingness of the family and etcetera)

Abstract   Background & Objective: There are two basic learning approaches in academic education deep and surface If educational assessment is designed based on deep understanding it will lead to deep learning This study aimed to investigate conventional methods of assessment in medical surgical courses and its relationship with learning approaches in nursing students of Kerman University of Medical Sciences Iran in 2010 Methods: This is a descriptive analytic study A questionnaire consisting of three sections including personal characteristics assessment methods and the revised twofactor study process questionnaire (RSPQ2F) was completed by 198 nursing students Data were analyzed using SPSS and by means standard deviation frequency Students ttest ANOVA Pearson correlation and Rho Results: The most used assessment methods were multiple choice question (MCQ) and Direct Observation Procedural Skills (DOPS) The mean score of deep learning approach was 3427 ± 5006 and of surface learning approach was 3121 ± 552 Regarding the relationship between learning approaches and assessment methods results showed a significant difference (P < 005) MCQ and DOPS alone resulted in the surface approach but a combination of tests and projects in written and DOPS tests lead to deep learning approach in clinical tests (P < 005) Conclusion: Using MCQ and DOPS without concentration on reflection and problem solving lead to surface approach As common assessment methods in this study led to surface approach using projects in written and clinical assessment for deep approach lifelong learning and student empowerment for their future responsibilities is suggested

Abstract Background & Objective: Introduction of modern methods of teaching has created challenges in education especially in medical education Each of these methods has an application several advantages and disadvantages and a position The aim of this review was to examine the effectiveness of teaching methods in medical education Methods: This was a systematic review SID Magiran IranMedex IRANDOC SCOPUS Web of Science and published Iranian magazines were searched by two people manually with the keywords teaching learning and medical sciences They searched and selected articles by applying the quality criteria and research methodology 32 interventional studies (experimental and semiexperimental) were selected Sensitivity analysis was performed in respect to sample size study design and the impact of the intervention Synthesis of articles quality and sensitivity analysis were performed Results: Increased learning satisfaction interactions between learners data retention increase collaboration receive feedback and ideas via group discussion and themes such as professional communication skills discover solutions scientific knowledge increase learning and student satisfaction popularity and acceptance skills meditation and reflection on the problem considering various solutions and choosing the best solution a positive vision of their increase rising inner motivation creating interest in learning enjoyment of learning developing critical thinking study skills higher satisfaction improving teaching quality durability and increased efficiency in learning resulted from problem solving techniques metacognition packages and concept mapping Conclusion: The new methods of teaching that consist of problem solving techniques group discussion concept mapping and metacognition packages increase learning student satisfaction student participation and the durability of learning

Abstract Background & Objective: In educational systems evaluation is considered as one of the key elements The evaluation of university students on the educational processes is of specific value There has been no study on the evaluation of the Neurology Department Kerman University of Medical Sciences Iran through carrying out a poll Therefore we intended to improve the quality of education in the department through evaluation Methods: From among the medical students admitted in 2007 in Kerman University of Medical Sciences Iran 67 students participated in the present study The questionnaire used was prepared according to reliable sources and the professors points of view and considered validity and reliability The questionnaires data was entered into SPSS and it was statistically analyzed through descriptive and analytical statistical methods Results: 63 students (94%) rated the methodology of the professors of the ward and 62 students (925%) rated the methodology of the professors of theoretical courses a moderate or high score 65 students (97%) evaluation of good behavior of professors with students was moderate or high In terms of efficiency 35 students (522%) rated morning reports 28 students (417%) rated weekly conferences and 18 students (268%) rated journals a moderate to high score Conclusion: According to the medical students opinion the neurology department has a good position in general standards of medical education ethics and regulation However it has to reconsider some parts of educational procedures such as conferences and journal clubs which are held in collaboration with the residents

Abstract Background & Objective: Effective bedside care is the main objective of nursing education Correct clinical evaluation of students has been one of the toughest tasks for clinical nursing lecturers The objective of this study was the translation and psychometric evaluation of the clinical performance assessment scale among nursing students in Iran Methods: This crosssectional study was conducted with the objective of validating the Iranian version of the nursing students performance scale within the clinical setting The scale was translated from English into Persian by the backward and forward method Its face and content validities were determined 2 items was added in the content and face validity process In order to determine the construct validity exploratory factor analysis by convenience sampling method was carried out on 275 senior nursing students within clinical educational settings for 5 months Evaluation was conducted according to this scale Cronbachs alpha coefficient was used to measure internal consistency Results: The mean and standard deviation of students scores was 6398 ± 1335 Factor analysis indicated the extraction of three factors: the nursing process (10 items eigenvalue 899) professional behaviors (16 items eigenvalue 797) and technical skills (2 items eigenvalue 203) The reliability of the scale obtained by Cronbachs alpha coefficient was 092 Conclusion: The results of psychometric evaluation of the clinical performance assessment scale vindicated the reliability and validity of this scale and the potential for using this instrument in the nursing education field in Iran However the inclusion of the technical skills factor would need further balancing and expansion