Research and Development in Medical Education
Volume:4 Issue: 1, 2015

It was not long after we found ourselves in a Ph.D. course that we were tentative about one of the subjects. At first we found class attendance a bit difficult, as we thought it would be conducted in a monotonous way with formal content delivered traditionally. We were totally wrong. We were taken aback by a different method of teaching from our instructor. This was a gratifying teaching experience from our instructor's side that encouraged us and our other classmates to be thrilled to attend class. And that was games!!!

Higher education institutions are expected to clarify their educational quality, and there should be an educational quality assurance system that measures the aspects of quality institutions. Educational evaluation is a formal process that uses data collection and program assessment to evaluate the effectiveness and/or value of an educational organization, program, process and curriculum. There are many different models and approaches used to evaluate higher education all over the world, and countries often adopt or develop these models to evaluate educational performance. The purpose of this study is to examine types of evaluation and audit models in educational settings all over the world. A systematic review was conducted from March to May 2014 using two search engines, Google Scholar and PubMed, and three databases, Scopus, ScienceDirect and Emerald Insight, to search for articles with no study design limitation. We also searched the Scientific Information Database and Magiran databases for Iranian articles. We used a list of key words: evaluation, audit, educational audit, educational evaluation, academic evaluation, academic audit, model, method, education, college, school, department, university, higher education institution and mixed them with “AND” and “OR” as a search strategy. Thirty-two papers completely related to the research questions were finally studied. Results showed that educational evaluation is done at these levels: university, school/college or institution, department or group, educational program or curriculum, course evaluation and practice placement or training evaluation. For each level there are some researcher-developed models or pre-determined models that the authors applied. The majority of studies focused on the college and school level, but in Iran the departmental level was the most important. The quality evaluation criteria, procedures and indicators should be student centered, and reflect the institutional mission and values. Institutions can adopt models of evaluation that exist and use benefits of these or develop a model.

In medical and clinical education, creating critical thinking and promoting clinical reasoning abilities are the highest aims and results of education. The main aim of this study was to assess the efficacy of digital case scenarios versus print/paper case scenarios on clinical reasoning in problem-based learning (PBL). If a study used the multimedia scenario case interventions, video case scenarios and online-guided scenarios as digital case PBL, we would consider it eligible. The study was a systematic review and meta-analysis. A comprehensive search for all randomized controlled trials, systematic reviews and meta-analyses for digital case scenarios versus paper case scenarios in PBL were conducted using Medline (Ovid), Scopus, ISI Web of Science and CINAHL. Google Scholar was used to follow the bibliographies of the related papers to create an exhaustive data set. Search results were limited to the years 2003-2013. Our searches yielded 65 hits. After initial screenings of the titles and abstracts, we assessed the full texts of studies. Five eligible studies with 222 students were included in the meta-analysis. The meta-analysis showed that both of the digital and paper-based scenarios have similar impacts on clinical reasoning. But the review of papers showed that 73% of students are more satisfied with digital scenarios in comparison with paper-based scenarios and found that digital scenarios are 90% more time saving than paper-based scenarios. According to the results of meta-analysis, efficacy of digital-based scenarios is similar to the efficacy of paper-based scenarios while simultaneously creating more satisfaction and saving the time of students and teachers; therefore, it is suggested that electronic PBL be used rather than paper-based in all levels of medical education.

Veterinary medical education; Psychometrics; Career influence; The purpose of the present study was twofold. First, we sought to evaluate the psychometric properties of a newly developed instrument designed to measure factors incoming veterinary medical students indicated were important (or not) in their decision to become a veterinarian. Second, we sought to produce a measure of these factors by utilizing a state-of-the-art psychometric modeling technique to produce an empirical hierarchy that illustrates the construct of interest and make appropriate inferences about the findings. The Career Influence Factors Survey (CIFS) was administered to an incoming class of veterinary medical students. Data were analyzed via the Rasch Rating Scale Model. The psychometric properties of the instrument were evaluated according to Messick’s framework of construct validity. Results indicate the Career Influence Factors Survey is a psychometrically-sound instrument capable of accurately and reliably measuring veterinary medical students’ motivations for becoming a veterinarian. Substantive results indicated issues pertaining to animal welfare were the most important in making the decision to become a veterinarian. Previous exposure to a particular animal or family pet was only moderately influential in students’ decision to pursue a career in veterinary medicine. Factors such as a desire to work on food production issues and anticipated earning potential tend to be of lesser importance to incoming students. We encourage others to utilize the instrument and/or adopt the methodology to evaluate the psychometric properties of other instruments. Substantive findings generally corroborated findings from previous studies, but may identify new insights for improving the recruitment of veterinary medical students.

Educational programs and curriculums are developed using underlying concepts of value. The development of values-based curriculum and access to education based on values requires clarification of the concept of value. This article is an interpretive review of the large body of diverse and complex literature on the concept of value in medical education. This project used critical interpretive synthesis (CIS) to carry out qualitative analysis and synthesis of the literature in critical interpretive style. The main review question was the clarification of the concept of value in medical education, which produced over related 800 articles; 70 articles related to the research objective were studied by purposive sampling. After identifying the main categories and sub-categories, a well-reasoned synthesis of the contradictory findings in different studies was conducted. New concepts and relationships between concepts were created using CIS of documentation related to the concept of value and the philosophy and place of values in medical education. To perceive the concept of value and its use in the design and development of medical curriculum, a loop of concepts related to the concept of value was created. A more useful means of understanding value is offered by the synthetic constructs of principle-, outcome-, and virtue-oriented values. This triad of value loops shelters institutional, programming, and curricular levels of the education system. This new theoretical conceptualization of value in the education system can be an appropriate guide for value-based educational programs and curricula in medical education in every context.

Morning report is an important teaching method for interns and externs. Achieving the objectives of morning report affects future performance. This descriptive cross-sectional study was conducted to analyze the effectiveness of morning reports. Viewpoints of 85 interns and externs at the cardiology wards of teaching hospitals of Mashhad University of Medical Sciences in the academic year of 2012-2013 were investigated. The instrument for data collection was a researcher-made questionnaire. Data were analyzed by chisquare and independent t-test. Effectiveness was defined as the rate of the achievement of the goals of morning reports based on dividing the total score of the questionnaire (54 scores) into three parts of 0-17 (poor effectiveness), 18-36 (moderate effectiveness) and 37-54 (good effectiveness). The effectiveness of morning report sessions without the presence of residents was reported as moderate in hospital A, and the effectiveness of morning report sessions with the presence of residents in hospital B was reported as moderate in the opinion of interns and poor in the view of externs. There was no significant difference between the viewpoints of interns in hospitals A and B with regard to the effectiveness of morning report sessions (p=0.169). Results indicate that the higher academic level of subjects discussed in morning reports with presence of residents caused a reduction in the participation rate of interns and externs, thereby decreasing their learning and satisfaction. However, without the presence of residents, the students’ feelings of fear and anxiety were reduced and their satisfaction was heightened.

The educational environment is one of the fundamental considerations that affect the quality and effectiveness of an education. The purpose of this study is to evaluate the educational environment in general and to compare the environment before and during clinical education. This descriptive cross-sectional study was performed on 138 midwifery students in 2014. The data was randomly collected from among the students based on their "student number." This study used the Persian version of the DREEM questionnaire, and the questionnaires were filled out anonymously. The range of the scores is 0-200. The data were analyzed statistically with SPSS software (version 20), by the use of a t-test and the significance level less than 0.5. In total, 138 students with an average age of 21.5±2 participated in this study. The general average score of the students was 114±23, which shows a positive perception. Findings indicate that 76.1% (N=138) of students believe that the educational environment needs to be developed and improved, and 23.9% (N=138) believe that there are more negative points of the educational setting than positive ones. There was no significant difference between the scores of 5 of the domains among the clinical and non-clinical students. The findings in the present study reveal that the students have more positive than negative perceptions of the midwifery educational system. The weak points should be considered and new educational strategies should be implemented that lead to effective learning and training.

Health services managers are responsible for improving the efficiency and quality in delivering healthcare services. In this regard, Health Services Management (HSM) programs have been widely established to provide health providers with skilled, professional managers to address those needs. It is therefore important to ascertain the quality of these programs. The purpose of this study was to synthesize and develop a framework to evaluate the quality of the Health Services Management (HSM) program at Kerman University of Medical Sciences. This study followed a mixed-method sequential explanatory approach in which data were collected through a CIPP survey and semi-structured interviews. In phase 1, participants included 10 faculty members, 64 students and 90 alumni. In phase 2, in-depth semi-structured interviews and purposeful sampling were conducted with 27 participants to better understand their perceptions of the HSM program. All interviews were audio-taped and transcribed verbatim. NVivo N8 was used to analyze the qualitative data and extract the themes. The data analysis revealed both positive and negative attitudes toward the HSM program. According to the CIPP survey, program objectives (74%), curriculum content (59.5%) and graduate skills (79%) were the major sources of dissatisfaction. However, most respondents (n=48) reported that the classes are well equipped and learning resources are well prepared (n=41). Most respondents (n=41) reported that the students are actively involved in classroom activities. The majority of respondents (n=43) pointed out that the instructors implemented appropriate teaching strategies. Qualitative analysis of interviews revealed that a regular community needs assessment, content revision and directing attention to graduate skills and expertise are the key solutions to improve the program’s quality. This study revealed to what extent the HSM program objectives is being addressed. Learning barriers, further suggestions and modifications are provided to improve the quality of the program. It will serve as an initiative for future research on the systematic evaluation of the HSM program.

This study aimed to examine the effects of early clinical exposure to mother and child healthcare on the knowledge and attitude of Tabriz medical school basic sciences students. As a sample, 152 of the third semester students were selected, of whom 25 were randomized to the experimental group and the rest, 127 students, were considered the control group. The results of the study showed that there was a significant difference between the attitudes and knowledge level of the control group who did not experience early clinical exposure and the experimental group who were given clinical exposure with regard to intervention training. Finally, considering the results, it could be acknowledged that training in the intervention of early clinical exposure could affect the level of students’ knowledge and attitudes.

Evaluation is an essential phase in the management cycle that can ensure the proper implementation of activities. So, this study was conducted to develop an assessment tool for the educational and research performance of PhD students in schools of health management and medical informatics. First, the researchers extracted the primary criteria related to the performance of PhD students from literature review and interviews with experts. Experts then reviewed five aspects of the criteria: relevance, clarity, simplicity, necessity and feasibility, and the content and face validity of each tool were assessed. In addition, the value and the coefficient for each criteria and indicator were reviewed based upon their impact on academic performance and success in the future careers of students, and the framework of the scoring tool was determined. The researchers identified 22 and 19 items related to assessment of research and education performance respectively. After carrying out the necessary analysis, the CVR and CVI were calculated to be 92 and 95 percent, respectively, and were approved. Then, 12 experts placed values on the chosen items out of a total of 100 points. They considered 70 points for the research and 30 for the education aspects, distributing the scores between the areas and related aspects with regard to their importance. The experts determined the minimum required score for each area or aspect as well. Given the comprehensiveness of this tool, the researchers believe that this tool can lead to the improvement of student performance and success in their future careers.

Medical education is constantly discussed by experts due to its close relationship with the public health from the perspectives of relevance, appropriateness and responsiveness to community needs. There is no consistent general model to evaluate the social accountability of medical schools. This study was conducted to develop indicators of social accountability in medical schools. Criteria and indicators of social accountability were developed during three stages. In the first stage, after a deep review on the Global Consensus on Social Accountability of Medical Schools (GCSA) and several papers we developed baseline areas, criteria and indicators. In the second stage, during the first round of the Delphi, the tables draft was sent to twenty medical education experts. Then, comments were collected and classified in the first meeting of the focus group discussions and necessary reforms were implemented in the tables. In the third stage and second round of Delphi, the set of revisions were sent the same selected experts. The suggested reforms were applied after collecting the instructors’ comments in the second focus group discussions. Five members of the focus group discussions were selected based on their relevant knowledge and experience in social accountability issues. Ten areas, twenty-eight criteria and ninety-five indicators were developed after three stages of study with two rounds using the Delphi method and two focus group sessions. To clarify the criteria and indicators, we tried to make the developed indicators and criteria practical so that they could be used in the social accountability evaluation of medical schools. According to the importance and key role of social accountability in the medical schools mission, using comprehensive indicators can result in better accreditation and evaluation of medical schools. This study has prepared applicable and comprehensive indicators for evaluation of different aspects of social accountability in medical schools.

Since the ultimate goal of medical education is to improve health, all the efforts of custodians’ and service providers’ training must meet the needs of society. The World Health Organization defines social accountability as guiding commitment toward education, research and medical services in line with the prioritizing the health requirements of the community, region and world. This cross - sectional study was conducted in two phases, including observation and documenting the activities and programs of the Tabriz University of Medical Sciences. Tabriz University of Medical Sciences has taken some steps towards social accountability in medical education, including determining the priorities of health and disease in the province, presenting health and disease training programs in the local media, preparing appropriate community-based teaching fields, empowering faculty members in new teaching and assessment methods and training the students based on the community health requirements. Despite all of these activities, it is still necessary to evaluate social accountability indicators in this university for further achievements towards comprehensive social accountability.

Regarding the educational goals of university and academic performance, it seems that organizational citizenship behavior (OCB) is one of the effective variables in increasing the educational performance of university faculty members. The present study aims to investigate the relationship between organizational citizenship behavior (OCB) and educational performance of the faculty members of Tabriz University of Medical Sciences in 2013-14. Researchers selected 127 faculty members and 1,120 students from different grades in order to investigate the relationship between altruism, conscientiousness, sportsmanship, civic virtue and respect and the educational performance of faculty members. Generalized estimating equations (GEE) were used in this method. Data were analyzed using SPSS 21 software and the significance level of 0.05. There was a significant relationship between altruism and educational performance (P =0.043). There was a significant relationship between conscientiousness and educational performance (p=0.046). A significant relationship was observed between sportsmanship and educational performance (p=0.004). There was no significant relationship between civic virtue and educational performance (p=0.98). A significant relationship was observed between respect and educational performance (P>0.001). There was no relationship between citizenship behavior and gender of the faculty members (P> 0.05). The results of this study showed that the more faculty members have the spirit of cooperation and assistance to colleagues and students and try to understand the specific situations that students face, the more effective they are in increasing the educational performance at the university level.

Social anxiety is an important factor in peoples’ mental health. Good mental health while studying in university makes students able to deal effectively with numerous stressors that they experience. The purpose of this study was to determine and compare the social anxiety of nursing students in grades one to four of medical universities in Tehran. In this analytic cross-sectional study, 400 students from universities of medical sciences in Tehran were recruited by stratified sampling with proportional allocation. Data were collected during the first semester in 2010. Students completed a two-part questionnaire including the Liebowitz social anxiety questionnaire and a demographic information form. Data were analyzed using descriptive statistics methods and an analytical test by SPSS statistical software. There was no statistically significant difference in the total scores of social anxiety of first- to fourth-year students. The mean score of the avoidance of social interaction dimension in fourth-year students was significantly lower than in first year students (p<0.05). In regard to the relationship between social anxiety and interpersonal communication as an associated part of nursing care, decrease of social anxiety of students could play an important role in their mental health. According to the results of this study, it seems that the placement of students in the nursing education system does not produce any changes in their social anxiety.

Preparing students to take over job responsibilities is one of the most challenging duties of nursing schools. The focus of nursing education should be on helping students to achieve high levels of competence in nursing care and identify factors for reinforcing it. Since desirable results have not been reported on clinical competencies of nursing students, achieving skills to control their emotions could be effective. Thus, this study aimed to investigate the relationship between emotional intelligence (EI) and clinical competencies. In this correlational study, all nursing students in semesters 6, 7 and 8 were studied after determining the sample size in Tabriz University of Medical Sciences. The data were collected using three questionnaires of demographic data, the Emotional Intelligence Sharing – Sybrya and a short clinical competence. The data analysis was done through descriptive and inferential statistics using SPSS 18. The results of the present study showed that the total EI score and clinical competence of students was more than moderate. The relationship between total EI and clinical competence was significant. Among the subscales of EI, there was a significant relationship between social skills and clinical competence. The relationship between the total emotional intelligence score and clinical competence of students in this study indicated the necessity and importance of emotions in decision-making to act properly within a clinical setting. Therefore, taking part in courses designed for learning skills of emotion perception and stress management in the workplace seem to be essential.

Self-efficacy and learning motivation are two important variables for professional learning, leading to academic success. Nursing students’ learning motivation and self-efficacy have been considered in different studies separately, therefore this study aimed to investigate the relationship between self-efficacy and learning motivation among nursing students. This is a descriptive-correlational study, carried out at Tabriz University of Medical Sciences in 2013-14. Data was gathered with questionnaires about science motivation and self-efficacy for professional nursing competence and analyzed by descriptive and inferential statistics through SPSS software (version 13). The learning motivation and self-efficacy of the nursing students was 67.89±14.12 and 68.10±14.50, respectively. There was a significant correlation between learning motivation and self-efficacy (P < 0.001). Due to the significant relationship between learning motivation and self-efficacy in professional nursing competency, it is suggested that an increase in learning motivation could be associated with the promotion of self-efficacy in professional nursing competency in nursing students.