مجله ایرانی آموزش در علوم پزشکی
سال دهم شماره 1 (پیاپی 25، بهار 1389)

Success in achieving scientific outcomes is of special importance for students studying overseas and inland. The aim of this study was to investigate national and international documents and evidences considering factors affecting overseas student's academic achievement in recent years. The main keywords used in this study were: academic success, scholarship, foreign student, and overseas students and search engines included Web of Knowledge, Scopus, Pubmed, and Google Scholar. The results were combined and the obtained articles were divided into three categories of related, semi related, and not-related based on thematic relationship with study subject. Almost 28000 records were found through these 5 internet databases. Out of 204 articles under investigation, 27 articles met the criteria for inclusion in the study. In performing content analysis, main cases included: fluency in English and the language of the place of the study, the effect of demographic factors, the educational programs before detaching students to overseas, the effect of socioeconomic, personal and familial factors, and the ability to communicate with supervisor. Fluency in English and the language of the place of the study is among superior characteristics of scholarship students. Additional factors such as supervisor, personal features of every individual and living condition are among important factors.

Employing exclusively electronic learning is not possible for practical and clinical courses. But, using a combination of different educational approaches seems to be sensible. The aim of this study was to compare the effectiveness of mixed method of electronic and small group education with that of small group only method. Seventy two students of Introductory Clinical Medicine (ICM) course in School of Medicine attended this quasi-experimental study in Isfahan University of Medical Sciences in the year 2008. They were randomly divided into two groups. The experiment group received a CD of Schwartz physical examination a week before running the sessions and they were asked to practice chest physical examination before attending small group training sessions. Chest physical examination skills were taught to both groups using small group training approach, one week later. Students’ learning was measured through an Objective Structured Clinical Examination (OSCE) and the scores achieved by each group were compared. Student's viewpoints regarding the mixed method, was asked through a questionnaire. The results were analyzed by SPSS software using inferential statistics such as T-test. The mean score of the test in the experiment group was significantly higher than that of the control group. Also, the mean score for following detailed technical points in examination was higher in the experiment group compared to the control group. Making use of e-learning in the mixed approach facilitates active and deep learning. Despite the difference in the scientific source of the CD and the one used in small groups, a significant effect on learning was observed in the mixed method. Therefore, before providing the needed electronic sources relevant to the curriculum, using the existing sources would be useful.

To clarify mortality trend, enhancing the knowledge of physicians and clinical coders who play their role in coding based on ICD book is crucial. This study was performed to investigate the knowledge of physicians and clinical coders on the rules and guidelines of determining mortality causes. This descriptive cross-sectional study was performed on 152 health care providers (physicians and disease coding experts) employed in hospitals affiliated to Kashan University of Medical Sciences in the year 2008. The research tool was a researcher-made questionnaire including items about mortality rules adapted from ICD-10 book of World Health Organization which was completed by study participants. Study data was analyzed by SPSS software using descriptive and inferential statistics such as Chi². General knowledge of the population under investigation regarding the rules was 38.4%. Specialists and individuals with more than 5-10 years experience enjoyed the highest knowledge level (44.9% and 41.7%). Participants’ knowledge on mortality general rules was 11.2% which was interpreted as very weak and their knowledge on optional mortality rules was 29.6% which was deciphered as weak. Also, their awareness about modified regulations of mortality was at average level with 47.3%. Study population’s knowledge on mortality rules and guidelines in death certification, approved by WHO is weak which calls for necessary education in order to respect the rights of decedent’s relatives. It is also recommended to consider adequate supervision on execution of these rules and guidelines.

Self directed learning has become a focus for nursing education in the past few decades due to the complexity and changes in nursing profession development. The relationship between self directed learning and learning styles is detectable in different learning situations. This study was performed to determine nursing student's readiness for self-directed learning and also identify their learning styles and find out the association between these two concepts. In a descriptive study in the year 2006, 178 BS, MS, and PhD nursing students in Isfahan University of Medical Sciences were selected through stratified random sampling method. Data gathering instruments included 3 questionnaires of demographic features, Guglielmino`s self-directed learning readiness scale, and the Kolb's learning styles inventory. Data was analyzed by SPSS software using descriptive and interferential statistical methods. Student's readiness for self-directed learning enjoyed a high level in majority of study units and the dominant learning style was the adaptive style. Considering the statistical analysis, no significant relationship was recognized between two main variables. Considering the high level of readiness for self-directed learning in a considerable portion of students and dominance of a single style among majority of them, adaptation and adjustment of teaching methods featuring such learning traits in students is recommended.

Members of the health care team in medical emergencies have little information about admitted patients and rely on several information resources in order to manage these patients. The aim of this study was to determine the information resources for medical students in emergency ward. This descriptive study was performed on 146 last year medical students attended in emergency ward of educational hospitals. Data gathering methods included observation and questionnaire. Data was analyzed using descriptive statistics and Pearson Correlation coefficient. Most of medical students (50 %) used patient and his/her file as information source. Medical students mostly used print sources for obtaining the needed information for patient's treatment. The results of this study underscore the importance of access to variety of information resources in emergency ward. It is recommended to plan educational programs for promoting student's awareness about Personal Digital Assistant (PDA) and using it for evidence-based decision-making.

Considering the important role of nutrition in health, attaining a high nutritional knowledge is essential for physicians. So, this study was performed with the aim of determining the level of resident's and intern's knowledge about nutrition in Shahid Beheshti University of Medical Sciences and Health Services. Sixty six interns and 70 residents were selected randomly out of the total target population in this descriptive cross-sectional study and received the nutritional knowledge questionnaire in hospitals affiliated to the medical university. They all filled and returned the questionnaires before the end of official working hour. Data was analyzed by SPSS software using ANOVA, and chi². The level of nutritional knowledge was weak in 25.3%, average in 61.3%, and good in 13.4% of the participants. But none of the participants had a very good level of nutritional knowledge. The mean score for correct answers was 50.28. Ninety three point seven percent of residents and interns had no idea about the relationship between overconsumption of Vitamin C in pregnancy and infant’s dependency to this Vitamin and 80.3% were also not aware of the relationship between overconsumption of Protein and Calcium excrete. Among the participants, 96.5% knew no comprehensive reference on nutrition and no one identified any website or journal in the field of nutrition. This study affirmed the results of preceding studies implicating the necessity of enhancing nutritional knowledge in medical universitie's curriculum and during clinical activities.

Predetermining practical educational objectives and confronting students with equal educational opportunities based on the objectives, thorough logbook is regarded as part of their final evaluation. Investigating the manner of completing different parts of the logbook by interns in emergency ward is the aim of this study. This descriptive cross-sectional retrospective study was performed on all logbooks filled by interns from April 2006 to May 2007 in emergency ward of Imam Khomeini Hospital. Data was analyzed by SPSS software using descriptive statistics. In total, 388 internship logbooks were investigated which belonged to 221 male (56.96%) and 167 female (43.03%) interns. Considering all concerned activities, 75.98% of interns at least one time, 49.36% one time less than expected, and 32.25% completely performed, participated, or observed the activities expected in the ward. By using logbook in emergency ward, interns could be guided in performing activities expected in the ward but effective use of logbook requires further familiarization of interns with logbook as well as proper supervision on the manner of its completion. The present logbook needs some modifications. It is recommended to design a comprehensive logbook in order to have a uniform education throughout the entire internship course and cover all practical educational objectives.

Proper educational programs should have an active and dynamic nature and be revised and modified following the received feedbacks. Clinical learning guide if integrated with interactive logbooks is considered an appropriate tool for clinical learning enhancement by providing opportunity for more interaction among student, clinical environment, and instructor. Therefore, this study was performed with the aim of investigating the effect of using logbooks on student's learning. This quasi-experimental study was performed on 25 internship nursing students. Based on a Delphi study, a clinical learning guide integrated to logbook was designed and developed for ICU and CCU wards. Then, students were randomly assigned into two groups of control and experiment. The control group was trained through usual method and the experiment group was taught using logbook in selected wards. Student's clinical learning was assessed considering cognitive and psychomotor domains in both groups. The mean score of the experiment group in ICU ward in both cognitive and psychomotor domains was significantly higher than that of the control group. Although the experiment group's mean score in both domains in CCU ward increased compared to the control group but the difference was not significant. The increase in student's scores in both cognitive and psychomotor domains in ICU and CCU wards can be a motivation for applying this method in clinical education. Further studies on other educational wards are recommended in order to demonstrate the effectiveness of logbook on nursing student's clinical learning.

Accreditation is one of the most important quality assurance and improvement methods in medical sciences education, especially in the field of nursing clinical education. However, there are not compiled standards in this regard and employing international standards does not seem to be practical. Accordingly, the researchers in this study tried to develop the national standards for accrediting clinical nursing education based on international standards as well as the viewpoints of nursing education experts in Iran. This study was performed in multiple stages during the years 2004 to 2005. At first, using international standards of nursing education and the views of expert faculty members by Delphi technique, proper standards for the context of Iran were developed. Then, the proposed standards were investigated through a national survey using a designed questionnaire and the ones with more than 70% consensus were approved. At the end, the standards for clinical education were presented separately. Fifty five standards in 5 domains including faculty members and clinical preceptors, students, curriculum, clinical facilities and teaching-learning activities were proposed for the accreditation of clinical nursing education in Iran. The proposed standards had mostly more than 90% of optimum level. However, it seems that the lack of appropriateness of some standards is due to the present situation in nursing education system in Iran. So, these standards were revised or omitted based on expert's comments.

Different viewpoints have been presented concerning the impressions left by preinternship and basic sciences exams on student's education and quality of life. This study was performed in order to investigate medical student's viewpoints toward evaluation aptitude as well as advantages and disadvantages of these exams. Ninety one students based on census method were studied in this descriptive cross-sectional study Data gathering instrument was a researcher-made questionnaire. Following designing a tree diagram, scoring, and developing a question bank, the pilot study was performed. Then, based on the face and content validity, final questions were selected. Data was analyzed by SPSS software. Nineteen physiopathology students, 44 clerks, and 28 interns participated in this study. Students considered preinternship examination as necessary for evaluation of student's knowledge, but the same was not true about basic sciences examination. Both groups believed that examinations were not capable of assessing the student's endeavors during several years as well as their skills and attitude. Also, memorizing information for passing these exams would not prove helpful in dealing with patients. These exams exerting too much stress on students affect their life while the achieved results are provisional having no applicability. Most students do not believe in comprehensive exams as an appropriate method for assessing practical competencies while failing these examinations leads to a 6 month delay in their education. It is suggested to assess students using OSCE method in short intervals rather than these two comprehensive exams. It is also recommended to put more emphasis on final examinations of each ward.

The advance in educational sciences has demonstrated the effective role of behavioral theories in changing individual's knowledge, attitude, and habits. Therefore, in order to have efficient and effective training about nutrition especially in group education sessions, applying curriculum development principles in determining educational content is inevitable The problems and obstacles in having effective nutrition education in units dealing with nutrition education especially in group sessions includes: lack of effective models and strategies for nutrition education, relying only on routine diets and providing different and unreliable information by different members of the treatment team for the patients. These problems motivated us to present this article in order to attain three general objectives. First, introducing general principles for education and group counseling in order to enhance the efficacy of nutrition education second, investigating factors affecting the quality of nutrition education through pointing to some important subjects and the third, providing a clear description for some behavioral attitudes and their related learning activities which are effective in nutrition education. This work explains that achieving educational objectives for making proper changes in patient's behavior is due to development and designing an appropriate educational model and guide. In such model, the structure of educational sessions, the procedure for nutrition education, the educational content, the educational strategies, and learning activities are based on curriculum development principles in which related behavioral elements have been considered.