Journal of Advances in Medical Education & Professionalism
Volume:4 Issue: 1, Jan 2016

Programs must demonstrate that their residents are taught and assessed in professionalism. Most programs struggle with finding viable ways to teach and assess this critical competency. UTHSCSA Family and Community Medicine Residency developed an innovative option for interactive learning and assessment of residents in this competency which would be transferrable to other programs and specialties. The innovative approach uses an asynchronous online format on Blackboard. Threaded discussions on Blackboard require thoughtful reflective writing after case assessment and critical evaluation of other resident posts. Participation, content and progress of all resident postings are monitored by administrative staff and faculty. Faculty can further engage the residents at any point to deepen the discussion and learning. 100% of all senior residents attained the required learning objectives. All were actively engaged in the assignments. Six cases have been developed using a Learning Matrix to demonstrate evaluation areas from the specialty specific competencies. Written feedback from residents verified the validity of case content in context of their current clinical practice. Postings by residents have provided value and insight for the faculty to access the professional development of our Family Medicine residents. The Clinical Competency Committee evaluates all third year residents using this information specific to the professionalism milestones. By using an asynchronous online approach to case discussion, all residents are involved with all aspects of this curriculum. More specific measurable learning outcomes are possible using this approach. Resident participation and engagement is easier to track and monitor than a lecture-based format and easier to capture valuable data than relying on evaluation feedback. Our Annual Review process will identify areas for improvement in the existing cases and help create supplemental cases based on a needs assessment by the faculty.

Stress is an important factor in the educational process. Teaching and learning are stressful processes. This stress can affect one’s ability and change his/her performance. The purpose of this study was to investigate stressors of clinical education from the perspective of medical students in Yazd University of Medical Sciences. This descriptive-analytic study was conducted in Yazd University of Medical Science during year 2014-2015. The sample size was 170 medical students who were selected randomly. The data were collected by a questionnaire including four components: interpersonal relationship, educational environment, clinical experience and the unpleasant emotions. A significance level of 0.05 was considered for analysis. The statistical analyses included descriptive statistics, ANOVA and T-tests, using SPSS software, version 14. The results showed that the highest domain score belonged to interpersonal relationship (3.33±0.3) followed by unpleasant emotions domain (3.3±0.3). The lowest domain score of clinical education stressors was educational environment (3.12±0.1). The results showed that the mean score of interpersonal relationship domain was more in women than in men (p<0.05). The relationship between teachers and students is an effective factor in all dimensions of clinical education stressors. So proper measures such as the promotion of scientific awareness of teachers and educational staff about factors that lead to stress and the best way to communicate with students should be taken to reduce the students’ stress.

Efficiency evaluation of universities and faculties is one of the tools that help managers to identify the departments’ strengths and weakness. The main objective of the present research was to measure and compare the technical efficiency of Shiraz school of medicine departments using Data Envelopment Analysis (DEA) technique. This cross-sectional and retrospective study was performed on clinical and non-clinical departments in research and education domains over the period of 2006 to 2011. Different inputs and outputs were considered for research and educational domain separately. Efficiency was measured based on the observed optimal performance. Findings showed that pathology and anatomy departments achieved the score of 100 in technical efficiency in education during 2006 to 2011. During this period, parasitology, psychiatric and pediatrics department’s achieved the score of 100 for technical efficiency in research domain. The lowest mean of relative educational efficiency belonged to orthopedic department; as to relative research efficiency, the lowest mean was shown in orthopedics and genetics departments. The mean technical efficiency of non-medical departments in education and research domain was 91.93 and 76.08, respectively, while the mean technical efficiency of the clinical department in educational and research fields was 91.02 and 82.23, respectively. Using multiple input and output in DEA technique provided a comprehensive evaluation of efficiency in Shiraz school of medicine departments. The DEA could successfully estimate the technical efficiency of the departments in research and educational fields. Moreover, the deficiency in each department was found; this could help them to plan for improvement.

Teacher evaluation, as an important strategy for improving the quality of education, has been considered by universities and leads to a better understanding of the strengths and weaknesses of education. Analysis of instructors’ scores is one of the main fields of educational research. Since outliers affect analysis and interpretation of information processes both structurally and conceptually, understanding the methods of detecting outliers in collected data can be helpful for scholars, data analysts, and researchers. The present study aimed to present and compare the available techniques for detecting outliers. In this cross-sectional study, the statistical population included the evaluation forms of instructors completed by the students of Shiraz School of Health in the first and second semesters of the academic year 2012-2013. All the forms related to these years (N=1317) were entered into analysis through census. Then, four methods (Dixon, Gauss, Grubb, and Graphical methods) were used for determining outliers. Kappa coefficient was also used to determine the agreement among the methods. In this study 1317 forms were completed by 203 undergraduate and 1114 postgraduate students. The mean scores given by undergraduates and postgraduates were 17.24±3.04 and 18.91±1.82, respectively. The results showed that Dixon and Grubb were the most appropriate methods to determine the outliers of evaluation scores in small samples, because they had appropriate agreement. On the other hand, NPP and QQ plot were the most appropriate methods in large samples. The results showed that each of the studied methods could help us, in some way, determine outliers. Researchers and analysts who intend to select and use the methods must first review the observations with the help of descriptive information and overview of the distribution. Determination of outliers is important in evaluation of instructors, because by determining the outliers and removing the data that might have been recorded incorrectly, more accurate and reliable results can be obtained.

Research in education is a globally significant issue without a long history. Due to the importance of the issue in Health System Development programs, this study intended to determine research priorities in medical education, considering their details and functions. By determining barriers existing in research in education progress, it is tried to make research priorities more functional by recommending acceptable strategies. This is a qualitative-descriptive study in two descriptive phases. The goal of these phases was to determine research priorities subcategories in medical education by Nominal Group Technique (NGT) and two rounds of Delphi method. Through the first phase, subcategories of research priorities were determined, using Nominal Group Technique under medical education experts’ supervision. Through two rounds of Delphi, a questionnaire was constructed based on the subcategories. Eventually, research priorities were determined based on their highest score (scores more than 7 out of 10). In the first phase (NGT), 35 priorities in 5 major fields of medical education were presented. In the second phase, priorities were scored, using Delphi method. Medical Ethics and professionalism gained the highest scores (7.63±1.26) and educational evaluation the lowest (7.28±1.52). In this stage, 7 items were omitted but 2 of them were added again after experts’ revision in the third round of Delphi. According to the results of the present study and based on previous studies, it really seems that the fields of “Learning and Teaching Approaches” and “Medical Ethics and Professionalism” were more important. Because of financial and resource limitations in our country and the importance of research priorities, it is recommended to frequently study “research priorities determination program” at universities.

Establishment of effective communication between the clinician and patient is essential in order to increase the effectiveness of treatment. These skills have been less investigated among dental students. This study aimed to evaluate communication skills of dental students in Shiraz with patients through direct observation, patients’ perspectives and students’ self-assessments. This cross-sectional study enrolled the fifth and sixth year dental students and one of each student’s patients who was chosen using simple random sampling method. We used a checklist for data collection. Students’ communication skills were assessed at three steps of the student-patient interview – at the beginning of the interview, during the interview, and at the end of the interview. The checklist was completed by three groups: 1) an observer, 2) the patient and 3) the student, as self-assessment. The validity of the checklist was confirmed by clinical professors and the reliability was determined by Cronbach’s alpha test. Data were analyzed using descriptive statistics and Student’s t test. A repeated measure MANOVA was used to compare the mean communication skills in the researcher, patients, and students at each step of the patient interviews. There were 110 students (mean age: 22.3±8.4 years) and 110 patients (mean age: 32±8.8 years) who completed the checklists. Overall, the communication skills of dental students were rated as good according to the patients. However, the observer and student participants rated the skills at the moderate level. We observed significant differences between communication skills in all three groups and in the three steps of the patient interviews (p<0.001). According to patients’ beliefs and students’ selfassessments, there were no differences between male and female students in communication skills in the three steps of the patient interviews (all p>0.05). However from the observer’s viewpoint, female students showed better communication skills during the interviews (p=0.001). There was a degree of failure in communication skills of dental students with patients in the interview process. It will be necessary that communication skills be taught, particularly for students involved in clinical practice.

Integration of public health and medical education has been thought to have an important role in medical students’ training. Shiraz University of Medical Sciences has developed an MD/MPH dual degree educational program for the talented volunteer students. The aim of this study was to assess the students’ viewpoints about various aspects of Shiraz MD/MPH program. This cross-sectional study was conducted on Shiraz undergraduate medical students, who were enrolled in MD/MPH program. A self-structured questionnaire in Persian consisting of 4 parts was used; it included demographic factors including 16 questions which evaluated the students’ perspective of the goals, content, skill development, applicability and meeting their expectations; 7 questions evaluating the self-reported increase of knowledge; and 3 multiple choice questions to assess the students’ motivations and opinions on the impact of the program on their future career. Descriptive statistics was used for data analysis. All MD/MPH students (89) with a mean age of 21.4±1.34 participated in this study. Forty one of the students (46.1%) were male and 48 (53.9%) female. Overall, 86.1% of them had positive views about the goals of the program; also, 83.5%, 81.2% and 81.9% of them reported a positive viewpoint about the contents, the applicability and development of specific skills, and meeting their expectations, respectively. The students’ most frequent motivation was “learning how to research systematically” (73%). The majority of the students reported this program to be moderately to highly effective in increasing their knowledge in the provided courses. The students had a positive view about almost all of the aspects of the MD/MPH program; this may be indicative of the program being successful in delivering the goals, increasing the students’ knowledge and skills, and meeting their expectations to date. Students’ enthusiasm for the educational program may lead to their motivation for better learning and thus in the program’s success.