فهرست مطالب

Advances in Medical Education & Professionalism - Volume:6 Issue: 3, Jul 2018

Journal of Advances in Medical Education & Professionalism
Volume:6 Issue: 3, Jul 2018

  • تاریخ انتشار: 1397/04/25
  • تعداد عناوین: 8
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  • Mohamed H. Ahmed Pages 97-101
    Introduction
    The portfolio can be seen as a tool for assessment of a variety of learning activities that differ in content, usage, and assessment. The portfolio not only meets the learner’s educational needs but also the political and public reassurance demand that the health professional has achieved the required competency of the curriculum that allows him or her to practice safely with or without supervision in the health organization.
    Methods
    An in-depth search on Google Scholar, Medline and PubMed was conducted using the terms “reflection and portfolio” with especial emphasis on undergraduates. All the manuscripts collected were critically reviewed regardless of the date of publication.
    Results
    Even though the systematic review showed the limited effect of the educational impact of the portfolio on the undergraduate, numerous benefits can be seen, e.g. improvement in the relationship between students and tutors, an increase in general knowledge, awareness and reflection. Reflection for medical undergraduates in portfolio per se was associated with improvement in communications skills, professionalism and better achievement in postgraduate studies and increase in experiential learning. Interestingly, the portfolio was shown to be useful for undergraduate and tutors in filling the gaps of learning in clinical surgery, urology and geriatric medicine. In addition, for dental and nursing students it was associated with an increase in professionalism, clinical competency, and self-confidence. Lack of integration of reflection throughout the curriculum of the medical school was considered one of the main problems.
    Conclusion
    Further research is needed to address the following questions (i) it will be of interest to assess if there is any difference in reflective portfolio between students from problembased learning (PBL) curriculum and those from traditional curriculum. (ii) Assess the difference in reflective portfolio between community-oriented and PBL curriculum and PBL and traditional curriculum (iii) if there is any difference in the reflective portfolio in these three curriculums, it will be of interest how this can alter the evidence base of the educational effects of the portfolio. In other words, is there any curriculum that will consistently produce evidence based educational effects of the portfolio?
    Keywords: Medical education, Reflection, Portfolio
  • Tayebeh Mahvar, Mansoureh Ashghali Farahani, Aidin Aryankhesal Pages 102-114
    Introduction
    Classroom management is leading the class by setting the class schedule, organizing the procedures, supervising the learners’ progress, and predicting and solving their problems. Students’ disruptive behaviors and classroom management are the most important challenges and concerns of the teachers. The current review aimed to analyze the classroom management techniques and strategies used to cope with the students’ disruptive behaviors.
    Methods
    The present study was systematic review. The articles in Science Direct, PubMed and Scopus databases and Google Scholar search engine were searched using the keywords of classroom management, students’ disruptive behaviors, difficult students, and confrontation strategies during 2000-2017. A total of 31 articles were included in the study for analysis.
    Results
    The results showed all the techniques and strategies used and teachers’ challenges in dealing with students’ disruptive behaviors were included in conflict management strategies, which were classified into three categories, i.e. cooperative and problem solving strategies, avoidance strategies and punishment strategies. Moreover, the studies mostly emphasized the use of cooperative and problem solving strategies, and the most highlighted methods were making effective mutual communication with students to correct their negative behavior, training and preparing the teachers for dealing with the students’ disruptive behaviors and using various teaching methods and approaches based on the classroom situation.
    Conclusion
    To cope with the challenges of students’ disruptive behaviors, the teachers can use different strategies. Also, sufficient knowledge and skills about teaching, familiarity with the relevant and influential disciplines in dealing with students and making effective communication in the class can be helpful in developing and enjoying more effective skills in classroom management.
    Keywords: Problem behavior, Learning, Problem solving, Punishment
  • Jose Sebastiao Afonso, Pedro Sousa Martins, Geraldo Felipe Barbosa, Luiz Ferreira, Manoel Joao Batista Castello Girao Pages 115-122
    Introduction
    Medical schools face increasing challenges to accommodate new health care needs. However, little has changed regarding the students’ education. In addition, educators face the challenge of improving their teaching approach, making it suitable and effective for the new generation. The purpose of this work was to describe and contextualize the application of active pedagogical methodologies using the virtual learning environment (VLE) as a tool to improve the students’ performance.
    Methods
    This research is a quantitative and qualitative case study, carried out in one faculty of medicine in the state of Amazonas. Given a total population of senior students in this faculty, the number of participants corresponds to a proportion of 75% in the period of two years. This work required a paradigm shift, by focusing on interactive and technological teaching,professionalism, mentoring, communication, and feedback. Courses using virtual learning environment (VLE) should be prone to interaction, dialogue, collaboration and, asynchronously, autonomy. One of the key aspects of VLE content production is to select appropriate subject matters and texts to be discussed. It is through the VLE contents that the mediation of knowledge construction process and the participants’ interaction takes place.
    Results
    The improvement over the pre-test evaluation was evident, ranging between 12.59 and 50.9%, depending on the subject matter, to 81.31% in the final evaluation. In addition, the students expressed consistently positive opinions regarding the use of VLE.
    Conclusion
    The use of VLE as a pedagogical tool, in an interactive format and appropriate to the transmission of information and knowledge construction, was adequate for an evident improvement in the cognitive performance of the senior students of medicine. In addition, the positive evaluation of the students regarding the pedagogical methodology used constitutes an added value of this approach.
    Keywords: Teaching, Education, Medical, User-computer interface
  • Mahnaz Samadbeik, Donya Yaaghobi, Peivand Bastani, Shahabeddin Abhari, Rita Rezaee, Ali Garavand Pages 123-129
    Introduction
    Virtual reality is a new method for training different medical groups. Based on this technology, professionals and students of various medical sciences can determine their level of competence for medical treatment before any performance on the patient. Therefore, the aim of this study was to identify the applications of virtual reality technology for training the medical groups.
    Methods
    This is a scoping review study conducted in 2016. Articles were retrieved through the search of related keywords in databases such as Pub Med, Scopus, Web of Sciences, Springer, and Google scholar. Then, after applying the entry criteria, 21 papers were selected from a total of 1343. Data extraction was done by a data collection form. The collected data were summarized and reported using content analysis technique according to the study purpose.
    Results
    The findings of the study indicated that 11 cases (48%) have used virtual education technology for laparoscopic surgery training. Using virtual reality has improved learning in 17 (74%) studies. A higher accuracy in medical practice by people trained through VR has been reported in 20 (87%) studies.
    Conclusion
    The results indicate that the application of virtual reality capabilities plays an important role in improving the performance of different medical groups. According to the results, it can be suggested that virtual reality capabilities should be used to train different medical groups based on their individual and collective needs.
    Keywords: Virtual reality, Training, Clinical trials, Technology
  • Arezou Farajpour, Mitra Amini, Elham Pishbin, Zahra Mostafavian, Somayeh Akbari Farmad Pages 130-136
    Introduction
    Nowadays according to competency based curriculum, selecting an appropriate assessment method is inevitable. This study aimed to investigate application of Direct Observation of Procedural Skills (DOPS) in undergraduate medical students.
    Methods
    This is a cross sectional study conducted during emergency ward rotation in last year medical students using consensus sampling method. Each student performed 2 procedures at least twice under the observation of 2 assessors using modified DOPS rating scales designed for each procedure simultaneously. Correlation between DOPS score and final routine exam was measured. Face and content validity was determined by the panel of experts. Moreover, through the test-retest and interrater reliability, the correlation of each score and total score was investigated. The spent time was calculated too. The statistical analysis was carried out using SPSS version 18.
    Results
    Totally 60 students did 240 procedures under DOPS. The face and content validity confirmed by an expert panel. The findings showed that there was a significant correlation between the scores of each test and the total DOPS score (r1=0.736**, r2=0.793**, r3=0.564**, r4=0.685**; p
    Conclusion
    The use of novel performance assessment methods such as DOPS is highly beneficial in order to ensure the adequacy of learning in medical students and assess their readiness for accepting professional responsibilities. DOPS as a practical and reliable test with acceptable validation can be used to assess clinical skills of undergraduate medical students.
    Keywords: Reliability, Validity, Feasibility, Satisfaction, Undergraduate, Medical
  • Jesse Ramey, Manish Prajwal Mane Manohar, Aminah Shah, Abdiwali Keynan, Shivaprakash Bayapalli, Tarig Fadlallah Altahir Ahmed, Sateesh Babu Arja, Sireesha Bala A., Yogesh Acharya Pages 137-141
    Introduction
    The standardized Patient Program (SPP) is a standard educational training method which provides the preclinical students a better clinical foundation by linking the realm of clinical medicine to basic sciences. It incorporates a modern simulation technique and enhances the ability of the students wherein they can practice, apply and learn the basics of patient encounter. The main objective of this study was to analyze the implementation and efficiency of the SPP in Avalon University School of Medicine (AUSOM).
    Methods
    A quasi-experimental “before-and-after” study design was conducted among the 3rd Semester (MD3) medical students at AUSOM. 24 students voluntarily participated in the study. The effectiveness of the program was evaluated after comparing the summative examination scores before and after implementation of the SPP (graded in 100 points system). Mean scores were calculated and a comparison of the change in scores was made, using a paired t-test in Stata (©Stata corp).
    Results
    The mean final summative clinical skills examination scores of the students before and after the introduction of the SPP were 78.46±6.62 (SEM: 1.35, range: 89-70) and 86.54±6.41 (SEM: 1.31, range: 98-65), respectively. There was a statistically significant increment (t=5.5058, p=0.0001) in the scores of the students after the introduction of the SPP.
    Conclusion
    Introduction and implementation of SPP at AUSOM at preclinical years increased the overall students’ performance in clinical skills. It is necessary that medical schools implement SPP early in preclinical years to strengthen learning and inoculate necessary clinical skills in medical students.
    Keywords: Education, Medical, Patient simulation, Clinical competence, Program evaluation
  • Chandar Sahanaa, Amit Kumar Mishra, Anandan Velavan, Sunderamurthy Bhuvaneswary, Mani Mercy Pages 142-143
    Dear Editor, Re-Orientation of Medical Education (ROME), a one month posting of undergraduate students in department of Community Medicine, is used not only to build up the knowledge, attitude, communication and clinical skills, but also to make the physician in contact with the community efficiently. In 1977, the ROME scheme aimed at developing medical doctors for the rural community in the vision of medical education, which later envisaged training a basic doctor to serve better at the first contact with rural and urban community (1, 2). During the posting, the students conducted house to house survey in rural and urban communities and prepared a detailed report of the research activities and planned intervention based on the needs of the community. World consumption of paper has grown 400% in the last four decades. About 35% of the total trees cut around the world are used in paper industries (3). To reduce the paper consumption, The Ugandan Ministry of Health advocated the use of smart phones in integrated community case management approach for health care providers for child health (4). Every year in ROME more than thousands of pages of papersare used for data collection. As a small initiative to save paper in this year (2018) ROME training, completely paper-less questionnaires were made and used. Smart phones were used as a tool for data collection and data entry. Even in the large scale surveys, data capture can be easily done (5). Epicollect5 software (developed by Imperial College London funded by the Wellcome trust) was used to collect data through a mobile app. The mobile based data collection has benefits over paper-based approaches. The Epicollect5 software enables the creators or managers to identify the errors and allows mid-course correction in minimal time. The instances of data entry error/missing data can be avoided by applying checks at the data entry point. The data are transferred to a central server near – instantaneously; therefore, the data are stored and backed up securely, and the risk of data loss is minimal. Epicollect5 is available for both Android (4.4) and iOS (8)-based mobile phones in play store and app store, respectively. There are various resources for mobile phone-based data collection solutions (6). As the students are familiar with the smart
    phones, training requirements were almost minimal. The students grasped it in almost realtime. It would be right to say the technology has imbibed the younger generation more, than being learnt by them.Use of mobile phones was so convenient, feasible and user-friendly to capture data (data collection as well as data entry). By the end of day 5 of data collection by a group of 40 undergraduate students, the total numbers of households covered were 963 and 3527 individuals. During the survey period, a batch of 150 undergraduate students collected the data of around 15575 individuals by using this mobile app. This actually reduced the time and costs involved in acquiring or maintaining dedicated tools for data capture. The app also gives an opportunity to collect audios, videos and GPS co-ordinates. As compared to previous year's ROME posting which were done in a similar setting with paper-based questionnaire; the total number of participants interviewed by a group of 30-35 students were around 2200 to 2600 over a period of 10 days of data collection which was followed by another 5 days of data entry in MS Excel/ EpiData software. Appropriate use of technology in research helped the students to minimize the hours spent in data collection and entry and provoked their interest in research since the app-based data collection was more interesting as compared to paper-based approach for them.
  • Shahram Yazdani, Fakhrosadat Hosseini, Ebrahim Kalantar Mehrjerdi, Mitra Amini Pages 144-145
    Dear Editor, Extracurricular activities for the gifted and talented students in Iran derive from the belief that students with high potentials are expected to make great help for the health care of the community. One of these activities is holding medical science Olympiads. In the previous meeting report about medical science Olympiad in year 2011, a unique experience of Islamic Republic of Iran was reported. The Olympiad was held in three areas of basic sciences, clinical reasoning and management byparticipation of high rank medical students from all over the country in two stages: individual and group (1-4). After performing 8 Olympiads in the country, the ninth Olympiad was held in September 2017 in Tehran, Iran differently with more emphasis on creativity and productivity. While creativity in health care is mostly supposed to be innovations in surgical devices, medications, and procedures, we believed that it also relates to other health care disciplines like basic sciences, medical education, philosophy of medicine and management. Creativity in these fields is a newer concept that may result in finding novel solutions to health care and educational problems and challenges such as improving patient care and coordinating care across multiple disciplines and difficult conditions. Shahid Beheshti University of Medical Sciences was the host of the Ninth National Medical Science Olympiad in September 2017 under direct supervision of Ministry of Health and Medical Education. This Olympiad was held in five areas including basic sciences, clinical medicine, medical education, philosophy of medicine and health care management. All top ranked students in medical sciences (such as medicine, pharmacy, nursing, health management, dentistry, etc.) from all over the country had the chance of participating in this Olympiad. In Iran integration of medical education and health care delivery system has started in 50 universities of medical sciences all over the country (5). 2151 students from these universities participated in the individual Olympiad exam. Then 30 teams in each of the five areas (total 450 teams) were selected 55 experts in five scientific committees constructed the Olympiad questions in individual and team stages. A unique experience in the Ninth Olympiad was using a novel and creative project based assignment for each team in each of the five areas. These projects were Evidence-based decision making, public private partnership, early clinical exposure, medical futility and autonomic modulation on the brain functional connectivity related to depression. 75 percent of the students stated that they were satisfied with these innovative and creative projects in different areas. 84 percent of the faculties reported that this kind of Olympiad increased students’ motivation and led them to compare issues friendly with each other in a scientific environment. 69.25 percent of the students reported that increasing the number of teams in this Olympiad for problem solving activities was a very good experience for them and ascertained that such activities should be included in the formal curriculum of medical schools. The main shortcoming in this Olympiad reported by the students was the competitive nature of the exam and subjectivity in scoring the projects in some areas. Performing such Olympiads is essential in discovering talented students and developing their capabilities to promote health systems. Although academic merit is not the only indicator of success in health science disciplines, designing additional programs for gifted and talented students is warranted to help academically talented students to further their knowledge.