مجله ایرانی آموزش در علوم پزشکی
سال نهم شماره 3 (پیاپی 23، پاییز 1388)

Most studies concerning clinical education of nursing students have been performed qualita-tively. This study was performed to more deeply investigate the students’ education at nursing clerkship and explore the experiences of nursing students, instructors, and hospital administrators from the clinical educa-tion of nursing students. In a qualitative study a semi-structured interview was done with 8 nursing students at the end of clerkship, four nurses working as ward administrators, an education supervisor, and two supervising instructors. Qualitative content analysis was employed for analyzing the data. Six central variables were realized (emerged) including lack of readiness for entering into clinical learning environment, undesirability of student assessment process, lack of advantageous relationship between the nursing school and the hospital, ideal planning for clerkship shifts, deficiency in clinical educa-tion, and the effects of clerkship on hospital and patient's affairs. According to the findings of the study, it is necessary for the nursing administrators to place more effort to resolve the present problems specially the relationship between the nursing school and the hospital, and to renovate hospital into a favorable learning space to meet educational goals of nursing clerkship.

In order to resolve the existing problems of clinical education such as low-level proficiency of nursing graduates in achieving essential competencies and skills at the end of nursing education and the necessity of employing new methods of education for promoting the quality of clinical education, this study was performed to investigate the effect of clinical education associate on nursing student's learning compared to contemporary method. In a quasi-experimental study, 60 students of nursing school passing clinical medical surgical course were selected along an academic semester through census and using simple randomization. They were divided into two groups. The first group was taught by clinical education associate method and the second one experiences the contemporary technique. After two weeks of learning, the student's cognitive and skill areas were evaluated using questionnaire and checklist. Data was analyzed by SPSS software using independent t test, paired t, Fisher, and Chi². Both methods were effective in promoting student's learning area. But the mean difference of student's skills in two groups was not significant while a statistically significant difference was observed in cognitive learning of student. The effect of these two models on learning clinical skills in students was similar but cognitive learning area in group 2 (contemporary method) was higher than the group of clinical associate model. It seems that it is more effective to use contemporary model. According to the dissimilarity of the findings of this study with that of similar studies, it is recommended to search for more evidences in bigger samples and different wards.

Active Learning Method (ALM) is a model in which students are active in the class. This aim of this study is to compare stability of information and satisfaction of students in classic method of lecture and active learning method. This descriptive cross-sectional study was performed on 48 medical students (29 females and 19 males) selected through census sampling method and spending their physiopathology courses in Yazd Shahid Sadoughi University of Medical Sciences. Some sessions from the courses of «respiratory, digestive, and urinary diseases» were selected. Two forms for assessing student's satisfaction were used as pretest and post-test. The stability of information was assessed by 8 essay questions one month after teaching. SPSS software was used for data analysis using descriptive statistics, Mann Whitney and McNemar tests. Fifty six percent of students were generally satisfied with the project implementation. The median for stability assessment exam in classes held using ALM was 5 while it was 3. 42 for classes using lecture method which had a significant difference (P=0. 00). Active learning method increases information stability in student's mind after the teaching session.

Nowadays, the attitudinal aspect of community dentistry course and the way in which this course is taught is critically important. The aim of this study is to compare the presentation of theoretical community dentistry course through workshops using PBL method with that of contemporary method of lecture. In this quasi experimental study, 64 dental students of Tehran University of Medical Sciences who took the course of community dentistry in second semester of academic year of 2006-2007 were entered into the survey through census. They were randomly allocated into two groups of experiment and control each including thirty two. The course of community dentistry was taught to control group through traditional method in 17 lecturing sessions meanwhile this course was instructed to experiment group through problem based learning method. A questionnaire was used for gathering data. Data was analyzed by SPSS software using descriptive statistics and Chi². The improvement in attitude of PBL group was significant in contrast with that of traditional method group. In post-test, the mean score of knowledge and attitude of the group attending in workshop was higher than that of traditional group but the difference was not statistically significant. The mean score of satisfaction and transferring educational concepts was significantly higher in the group attending in workshop. Eighty one percent of the workshop attendees were satisfied with the method employed in the course. The new method of education has been successful in its achievements as forming a positive atti-tude in students and making them eager for community dentistry issues.

Teaching some clinical skills to students of medicine and paramedics for the first time on patients is unsafe therefore, a number of skills are primarily practiced on models. This study was conducted in order to determine the effect of practical training in clinical skills center. This quasi-experimental study was performed on 60 students entering the university in 2003-2004. The intervention group received the training on clinical skills (ventilation, laryngoscopy, and tracheal intubation) in clinical skills center before stepping into clinic, but the control group did not receive the training. The performance of the students of both groups was evaluated at the end of the term through direct observation checklist and it was compared in two groups using descriptive test, Chi², and Fisher. The mean score of the investigated skills was compared by t test. The difference of the accuracy rate of the skills of ventilation, laryngoscopy, and tracheal intubation in two groups of intervention and control was significant using Fisher test. In addition comparing the skill of chipset intubation and fixing it in trachea and the manner of fixation and making sure about its placement in two groups revealed a significant difference. Training and practical performance of critical skills on models before performing it on patient may reduce detriments due to lack of proficiency by improving student's abilities.

Although experts put emphasis on student assessment by the teacher, an established method is self-assessment. The aim of this study was to compare student's self-assessment to evaluation by teachers in obstetrics clerkship course for midwifery students of Shahrekord University of Medical Sciences. This descriptive study was performed on 71 students of 3rd semester of midwifery in Shahrekord University of Medical Sciences who passed obstetrics clerkship course in years of 2006 to 2008, and 7 midwifery instructors trained these students during the course. The data was gathered using a form for obstetrics clerkship. The form was developed by midwifery department members based on headings of the course being used for student assessment at the end of each semester. The evaluation form was completed by instructors and the students themselves at the end of the semester. Data was analyzed by SPSS software using descriptive statistics and paired T test. Mean and standard deviation of the total score of instructor's assessment and students self-assessment was 55.90±5.8 and 57.40±6.2 respectively out of total score of seventy. It was 16.50±1.72 and 16.12±1.55 out of total score of twenty. No significant difference was observed between the mean score of assessment by instructors and the mean score of student's self-assessment. The results of instructor's assessment and that of students were similar. This may indicate that students can judge their own performance, to some extent, similar to their instructors. Student's opinions on their own performance and using it by instructors in student assessment may help in correction of contemporary evaluation scores.

Palliative care in patients with incurable diseases requires creativity in providing services in the best possible way. Therefore, the effect of Synectic model on student's writing creativity and academic performance was investigated in this study. It was a quasi-experimental study performed on 2 groups of nursing students of Tehran University of Medical Sciences in the first semester of 2007-2008 academic year. The control group consisted of 28 and the experiment group included 32 students. After the written pre-test about the concept of children's pallia-tive care, the synectic model was employed for the experiment group and the usual method for the control group. Then, the post-test was held for both groups and they also wrote an essay on palliative care. Data was analyzed by SPSS software using descriptive statistics and inferential tests including Mann Whitney, chi², and Fisher exact test. The mean for pre-test scores was 2.8 for the control group and 2.5 for the experiment group which showed no significant difference before the intervention. But after the intervention in post-test, the mean for the control group was 3.8, while it was 4.8 for the experiment group which showed a statistically significant difference. Moreover, investigating student's essay texts showed a significant difference between the two groups concerning creativity in writing. With regard to the results of this study, employing synectic method enhances academic perfor-mance and writing creativity of nursing students regarding children's palliative care.

Evaluation is an ongoing process which contemplates student's recognition, their learning promotion, and the necessary changes for achieving educational objectives. The aim of this study was to examine the capabilities of dental students of Shiraz University of Medical Sciences through determining their viewpoints toward the amount of their achievement to learning objectives of practical and theoretical courses of orthodontics in academic year of 2007-2008. In this descriptive cross-sectional study performed in academic year of 2007-2008, 122 dental students (86 female and 36 male) passing the courses of theoretical orthodontics (1, 2, and 3) and practical orthodontics (1, 2, 3, and 4) were selected as study sample. Questionnaires were developed for each one of the orthodontics courses and delivered to the students. At the end, each score given to the ability mentioned in the questionnaire by the students themselves was calculated based on total score of one hundred. The data was analyzed based on descriptive statistics indices including mean, standard deviation, one-way analysis of variance, and Tukey HSD. The mean of student's agreement for ability to achieve the objectives of the courses of theoretical orthodontics 1, 2, and 3 were 76.6, 72.6, and 76.8 respectively (out of total score of one hundred). For the courses of practical orthodontics 1, 2, 3, and 4 they were 77.6, 70.8, 75.8, and 68.4, respectively. The courses of theoretical orthodontics 3 and practical orthodontics 1 had the best agreement in achievement ability and the courses of theoretical orthodontics 2 and practical orthodontics 4 had the lowest agreement in achievement ability according to the student's viewpoints. From the student's viewpoints, their ability in achieving educational objectives of orthodontics is desirable. Even though, revealing the weakness and the strength points of them in each of orthodontics courses, it seems that there is a need to revise and modify the educational program of this part.

Academic specialty nursing courses are so limited in our country, being available just in a few schools. This study was performed in order to determine the necessity for having specialty education programs in MS level and the type of educational program needed. This descriptive cross-sectional study was performed through year 2008 in schools of nursing and midwifery of the country. The study population was faculty members of the schools of nursing and midwifery who were selected clustery and randomly (n=300). A questionnaire was sent to schools of nursing and midwifery. Nursing faculty members were asked to send the completed questionnaires back to nursing organization. Data was analyzed by SPSS software using Chi². 76.6% of participants believed that graduates of nursing MS are not efficient in clinical settings. 92.7% stated that presenting specialty clinical courses is necessary in MS level. From these person's viewpoints, the reasons for establishing these specialized courses are prioritized as follows: promotion of service quality, the increasing requirement of society for specialized function of medical professions, establi-shing a desirable occupational position for nurses, and reducing the expenses of health services. MS graduates are not efficient enough in clinical settings, so it calls for making some revisions in educational courses of MS level. It is recommended to conduct more comprehensive researches on this area considering evaluation of educational programs.

In recent years, one of the ways for enriching medical student's curriculum and training them as physician-scientists has been acquainting them with other sciences such as biotechnology. In this study conducted as a workshop for student's acquaintance with biotechnology, medical student's viewpoints towards its advantages was investigated. A seven day biotechnology workshop was held in school of pharmacy in which 15 medical students who were members of talented student's office participated. At the end, through a descriptive study, the participants filled a questionnaire consisting of 86 items in 7 areas concerning their viewpoints toward the program. Data was analyzed by SPSS software. Satisfaction rate with the workshop was very high (4±0.2). The workshop effects and achievements were assessed as positive (3.9±0.49). They ascribed medicine and biotechnology as closely associated and believed that getting familiar with biotechnological issues was necessary for medical students. With regard to positive viewpoints of medical students towards acquaintance with biotechno-logy and necessity of this matter in medical sciences, it is recommended to enrich general medicine curricu-lum using the subjects of this field of science.