فهرست مطالب

  • سال شانزدهم شماره 1 (پیاپی 43، Dec 2019)
  • تاریخ انتشار: 1398/09/28
  • تعداد عناوین: 20
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  • Elham Jafari *, Shariar Dabiri, Foroogh Mangeli, Reza Baneshi Page 1
    Background

    According to the importance of the clinical pathology for diagnosis, decision making regarding preventive and minimally invasive methods, and treatment follow-ups, it is useful to familiarize medical students with better utilization of laboratory tests before clinical practice and incorporate them into the curriculum.

    Objectives

    The current study aimed at investigating the quality of education and satisfaction with clinical pathology course among medical students at physiopathology level initiated since 2014 at Kerman University of Medical Sciences for further systematization of the curriculum, and its efficacy in increasing students’ knowledge.

    Methods

    In the current interventional study, medical students at physiopathology level were enrolled and, after making necessary coordination with the Deputy of Education, a one-unit clinical pathology course was added to routine (five-unit) physiopathology course for the students attending the second semester of 2013 - 2014 academic year. Two groups of students attending internship program including 42 subjects that took the clinical pathology course and 42 other ones that did not take the course were consecutively enrolled. A questionnaire was distributed among the subjects in the two groups and the obtained data were analyzed with SPSS version 19.0 using chi-square test.

    Results

    Overall, the medical students in both groups believed that clinical pathology course was essential for both theoretical and practical education. Most of the students in the two groups perceived that the inclusion of clinical pathology course in physiopathology course was good. Both groups perceived the course as useful for better management of patients in postgraduate studies.

    Conclusions

    There is no theoretical and applied academic course with rational systematic training objectives in the clinical pathology field for better utilization of laboratory tests. It highlights the need for paying further attention and planning in this field.

    Keywords: Clinical Pathology, Learning, Medical Education
  • Reza Malekpour Afshar, Somayeh Noori Hekmat, Reza Dehnavieh, Monire Balochi * Page 2
  • Ali Akbar Haghdoost, Reza Goudarzi *, Maryam Ramezanian, Amir Javadi, Ali Darvishi, Ali Hosseinzadeh, Masoud Abolhallaje, Masoumeh Rahimi Page 3
    Background

    Because of resources deficiency, a well-funded budget system is very important for achieving organizational goals. Hence, providing a specific pattern for performance analysis is important to allocate funds to medical universities

    Objectives

    In this study, econometric method and linear regression estimation were used to investigate the economic behaviour of the budget allocation process.

    Methods

    Data used in the present study were panel data from medical universities obtained during an eight-year period. The explanatory variables in this model included the numbers of faculty members and students. Also, separate linear regression was estimated as a dependent variable for the levels of expenditure budget and total budget.

    Results

    Our findings showed that if budgeting is done solely based on faculty members, allocation of public budget for each faculty member is 113.7 million Tomans, and if it is performed based on students, the allocated budgets are 9.8, 2.2, and 25.9 million Tomans for each undergraduate, professional doctorate (medicine, pharmacy, and dentistry) and postgraduate student, respectively.

    Conclusions

    In general, budget allocation for university education sector had a strong relationship with faculty members and students. However, the place of budget consumption and performance quality indicators still remain unclear. The results of this study can be applied for quantitative modelling to predict and allocate budget to medical universities.

    Keywords: Academic Medical Centers, Budget Modeling, Resource Allocation
  • Behrooz Pouragha, Zohreh Ghazivakili, Roohangiz Norouzinia, Nafiseh Pakravan* Page 4
    Background

    Medical education is viewed as a challenging phenomenon, which can cause stress in learners and affect the learning quality. Considering the importance of basic sciences education, development of new pedagogical approaches is necessary to improve medical education. Role-play is an efficient simulation-based approach, which can improve the students’ perception and imagination. In basic sciences, immunology is of high relevance in clinical situations, as immunological disorders are becoming increasingly prevalent.

    Objectives

    Given the importance of deep learning in immunology, we integrated role-play in teaching immunology to medical students in order to promote deep and durable learning.

    Methods

    In this study, two independent classes of medical students were evaluated in two consecutive academic semesters in 2014 - 2015. In one class, only lectures were conducted, while in the other class, lectures, along with role-play, were integrated. Pretest and posttest scores were determined at the beginning and end of the semesters in both classes, and the scores were compared. Also, the students’ point of view was studied using a questionnaire.

    Results

    The pretest score, which indicated the students’ general knowledge of immunology, was not significantly different between the two classes. However, there was an increase in the score of students participating in the class, which integrated lecture and role-play. In addition, the score obtained by female students, who participated in the class with lecture and role-play, was significantly higher than that of female students in the lecture-based class. The results of the questionnaire revealed that the students were satisfied with the integrated teaching method and believed that their knowledge had improved.

    Conclusions

    Based on the findings, dramatization can make learning an exciting process and improve the students’ understanding of immunology concepts.

    Keywords: Medical Education, Immunology, Role-Play, Simulation
  • Fatemeh Mohtasham, Yunes Jahani *, Abbas Behrampour, Fariba Sharififar, Abbas Aghaei Afshar Page 5
    Background

    Evaluation of students’ scores helps us indirectly examine the status of education system in university departments.

    Objectives

    In this study, in order to assess the education system, consistency between the students’ scores was evaluated by measuring the Bayesian intraclass correlation coefficient (ICC) in postgraduate students of School of Public Health, Kerman University of Medical Sciences during 2013 - 2015.

    Methods

    This cross sectional study was conducted on all postgraduate students of the School of Public Health of Kerman University of Medical Sciences during 2013 - 2015. The students’ scores were collected from the Office of Postgraduate Studies. First, the Bayesian ICC of students’ scores was calculated for all fields. Next, cluster analysis was performed on Master’s fields of study, and the Bayesian ICC was recalculated for each cluster. Data were analyzed using R 3.3.2 and OpenBUGS 3.2.3.

    Results

    Out of 117 postgraduate students, 102 (87.2%) were MSc students, and 15 (12.8%) were PhD students. The highest ICC was attributed to health education (ICC = 0.345) and the lowest to environmental health engineering (ICC = 0.023). Clustering was effective in most fields, and ICC of the clusters increased.

    Conclusions

    According to the results, consistency between the students’ scores was low in the majority of fields; therefore, it is necessary to modify and improve teaching and evaluation methods.

    Keywords: Intraclass Correlation, Academic Achievement, Students’ Scores, Bayesian, Cluster Analysis
  • Seyed Ali Hozni*, Mohammd Hakkak Page 6
  • Mohammad Reza Rajabalipour, Hajar Shafian, Abedin Iranpour* Page 7
    Background

    One of the most effective ways to prevent substance abuse is to promote addiction knowledge in influential social groups.

    Objectives

    The purpose of this study was to identify the current status of substance abuse education in medical universities of Iran in order to develop a targeted curriculum on drug abuse and include it in the curriculum of medical students.

    Methods

    In this descriptive library study, documentary (library) method and checklists were used for data collection. In order to identify the extent to which the existing units and courses deal with substance abuse and with the subject of addiction, the announced titles for active disciplines of the Ministry of Health and Medical Education were reviewed in 2017 - 2018.

    Results

    Of the 7685.5 units taught in different faculties of medical sciences universities in all disciplines except clinical residency programs.106.1% (optional or mandatory) are related to substance abuse. Of these, 49.5 units were related to the pathophysiology, treatment and pharmacology of substances, and 57.6 units covered topics related to prevention strategies and pathologies of substance abuse.

    Conclusions

    Despite the high importance of substance abuse issues for medical sciences students, a general unit for prevention and familiarity with the physical, psychological and social consequences of substance abuse does not exist in most of these disciplines. Therefore, it is recommended that studies be conducted to provide specific courses related to the substance abuse phenomenon or to consider substance abuse topics in the courses related to this subject.

    Keywords: Substance Abuse, Addiction, Medical Sciences, Units, Course Topics
  • Omolbanin Rahdar, Azizollah Arbabisarjou*, Somayeh Shahroudi Page 9
    Background

    Paying attention to students’ academic burnout and identifying the factors affecting it is one of the concerns of higher education authorities.

    Objectives

    The purpose of this study was to investigate the effect of quality of educational services and happiness on students’ academic burnout.

    Methods

    In this descriptive-analytical study, 477 students of Zahedan University of Medical Sciences participated in the academic year 2017 - 2018. The sampling method was stratified. Data were collected using the SERVQUAL Questionnaire, Isfahan-Fordyce Happiness Inventory (IFHI) and Breso Burnout Questionnaire. Then, they were analyzed by Pearson’s correlation coefficient, independent t-test, One-way ANOVA and Multiple linear regression using SPSS. P value less than 0.05 was considered significant.

    Results

    According to Pearson correlation coefficient, there was a significant relationship between students' happiness and academic burnout (P < 0.001), but there was no significant relationship between the quality of educational services and academic burnout (P = 0.060). The level of academic burnout was higher in male students than in female students (P = 0.003). Multiple linear regression analysis showed that only the students’ happiness variable significantly predicted variations in academic burnout (P = 0.001).

    Conclusions

    In order to reduce students’ academic burnout, effective factors such as happiness should be considered by the respective authorities and educational packages should be used to promote happiness and increase the quality of educational services.

    Keywords: Quality of Educational Services, Happiness, Academic Burnout, Students
  • Mansooreh Tajvidi *, Soheila Moghimi Hanjani Page 10
    Background

    The lack of clinical competence in nurses leads to problems in providing nursing services. Studies indicate that nurses lacking the required skills can endanger the public health in medical centers. Critical thinking is a factor that can affect nurses' clinical competence.

    Objectives

    The current study aimed at investigating the relationship between critical thinking and clinical competence in nurses.

    Methods

    The current descriptive-analytical and cross sectional study was conducted on 120 nurses selected by random sampling method. Data collection tools included the California Critical Thinking Disposition Inventory (CCTDI), as well as clinical competence and demographic information questionnaires. Data were analyzed with SPSS using Pearson correlation coefficient, linear regression, and t-test.

    Results

    Pearson correlation test showed a positive correlation between the total scores of critical thinking and clinical competence. Based on the results of the linear regression analysis, the tendency toward critical thinking could predict 28.4% of the clinical competence. The nurses mean CCTDI scores were at the positive level and their mean clinical competence scores were at the average level.

    Conclusions

    According to the obtained results, nursing authorities can organize practical workshops on the development of critical thinking of clinical nurses as one of the most important and operational strategies to improve nursing clinical competence and, ultimately, move towards optimal care.

    Keywords: Critical Thinking, Clinical Competence, Nurses
  • Mohammad Mahdi Hayatbakhsh Abbasi, Ali Hosseininasab *, Tahereh Alinaghi, Fatemeh Karami Robati Page 11
    Background

    Dissertations or theses are valuable sources of information, which play an important role in scientific development because of their specific nature and characteristics.

    Objectives

    The aim of this study was to investigate the status of medical students and residents' dissertations in terms of contribution to scientific development in Kerman University of Medical Sciences.

    Methods

    This cross-sectional, analytical study examined the status of medical students and residents' dissertations, submitted to the Medical Faculty of Kerman University of Medical Sciences during 2012 - 2015. First, the research deputy of Kerman University of Medical Sciences provided the dissertation information. Then, the information was analyzed in terms of study design, study type, extraction of Persian and English articles, publication in domestic and international journals, and indexing in reputable scientific databases in two groups of medical students and residents' dissertations. SPSS was used for all statistical analyses.

    Results

    In total, 643 dissertations were studied, including 342 (53%) residents and 301 (47%) medical students' thesis. Overall, 267 (41.5%) dissertations were published as articles in domestic and international journals. The findings showed that 13.4% of articles were indexed in the Scopus database. The mean scores of medical students and residents' dissertations were 19.22 ± 0.70 and 19.15 ± 0.85, respectively.

    Conclusions

    Despite the large number of medical students and residents' dissertations submitted to Kerman University of Medical Sciences, a limited number of dissertations were published as scientific and research papers, and the number of articles indexed in international journals was insignificant. Thesis writing is generally a unique opportunity for students to learn research skills and methods. In addition, publication of thesis findings in domestic and international databases can lead to scientific development.

    Keywords: Dissertation, Residents, Medical Students, Kerman University of Medical Sciences
  • Niloofar Shadman, Maryam Raoof, Sara Amanpour*, Mahsa Mahdian, Jahangir Haghani, Molouk Torabi Parizi Page 12
    Background

    Dental students are exposed to various stressors that are related to treatment procedures, training, and administrative challenges in the college.

    Objectives

    The aim of this study was to assess the stress, anxiety, and depression levels of dental students and their relationships with demographic factors.

    Methods

    This was a descriptive-analytical cross-sectional study on 297 dental students enrolled at the Kerman University of Medical Science in 2015 - 2016. The stress, anxiety, and depression levels were measured using the depression anxiety stress scale-21 (DASS-21). Data on demographic characteristics were also obtained. The statistical analysis was carried out by SPSS (version 11.0) using the chi-squared test. P < 0.05 was set as the level of significance.

    Results

    The mean age of the participants was 23.80 ± 1.2 years; 58.9% were female, 88.9% were married, and 33.7% were dormitory students. Free education was provided for 64% of the students while the others were charged a tuition fee. The prevalence rates of moderate to extremely severe levels of stress, anxiety, and depression were 39.7%, 39.4%, and 35.7%, respectively. Stress, anxiety, and depression were not significantly associated with the year of academic study, gender, marital status, and place of residence (P > 0.05). The students with higher scores in the entrance exam who were free of charge presented significantly higher levels of severe-to-extremely severe stress and depression (P = 0.003 and P = 0.033, respectively) than students who were charged tuition fees.

    Conclusions

    Based on the findings of the present study, the high prevalence of depression, anxiety, and stress among dental students in Kerman is alarming. This emphasizes the need for interventions, with the development of appropriate support services for this group. However, further studies should be conducted to find major sources of depression, anxiety, and stress.

    Keywords: Depression, Anxiety, Stress, Dental students
  • Yusuff Adebayo Adebisi *, Omotayo Carolyn Olaoye, Aniekan Micheal Ekpenyong, Aishat Jumoke Alaran, Don Eliseo Lucero, Prisno III Page 13
  • Azim Mirzazadeh, Amirhosein Jahanshir, Sepand Riazi* Page 14
    Background and Objectives

    The development of a course plan is an essential activity before presenting each course, which enables effective education by mapping the road ahead. For this reason, the study of the status of course plans at universities is of particular importance, such that access to the documentations in this regard can lead to the discovery of the uncertainties of the status quo.

    Methods

    This was a survey study performed in two stages. In the first stage, data about the current status of course plans was collected through a researcher-made questionnaire. Then, quantitative data were analyzed using descriptive statistics in SPSS software. Secondly, the content of the course plans was examined. The data was collected using a researcher-made checklist based on review of the related texts.

    Results

    In total, 99 (92.52%) of the 107 academic departments completed the questionnaire. Of the 6926 responded units, 2251 units (32.5%) had a course plan. Of the 173 disciplines, 15 (8.7%) had provided a course plan on the faculty website. Of the 99 departments, 39 (39.4%) had a defined plan for course design and 34 (34.3%) departments had a monitoring committee. Qualitative analysis of course plans showed that 45.3% had an acceptable status, 6.2% were somewhat acceptable, 10.4% were incomplete and 38.1% were unacceptable. The general characteristics of the course (96.1%), the general description of the course (45.6%), the general objectives (87.0%), the specific goals (63.2%), and the introduction of resources (45.9%) had a “complete” and “fairly complete” status respectively and had the highest scores in course design. Also, students’ role and tasks components-role dimensions (66.4%), student’s assessment at the end of the course- summative evaluation (56.0%) and course timetable (51.8%) respectively, had the “incomplete” and “non-observance” status more than other components, and did not have a proper situation in course design.

    Conclusions

    The results of this study lead to the recognition of the current status of course plan in Tehran University of Medical Sciences and can be considered in future decisions.

    Keywords: Design, Course Plan, Survey, Documentations, Decision-Making
  • Farangis Shoghi Shafagh Aria, Parvin Samadi *, Shahram Yazdani Page 15
    Background

    The development of professionalism is one of the fundamental goals of educational systems, especially in medical sciences. Medical students, in addition to acquiring clinical knowledge and skills, should somehow benefit from moral values and professionalism in order to practice in a professional manner. The development of professional ethics is heavily influenced by the hidden curriculum affected by changes in the educational system. The health reform plan is launched in Iran in recent years.

    Objectives

    The current study aimed at qualitatively explaining the effects of changes to the educational system on the development of the professionalism in medical residents.

    Methods

    The current qualitative study was performed by the content analysis method. A total of 26 interviews were conducted with 12 prominent professors of medical education, 13 third-year internal medicine residents, as well as a focus group including 10 residents. The purposive sampling method with maximum diversity was used in the current study and continued until data saturation. Data were analyzed using the content analysis method. The Lincoln and Guba criteria were used to increase the credibility of the findings.

    Results

    The most important finding of the current study was the challenge of developing professionalism due to environmental changes. The main theme included the challenges of professionalism development in the existing educational system, changes related to the sociocultural environment of the community, changes related to health reform plan, and the shift from training to health services and promtion of faculty member.

    Conclusions

    Changes and interventions in the health care services sector, such as the health reform plan, greatly affect the development of professionalism in medical residents. The plans that affect the health system, a special attention should be paid to the education section and the educational documents should be prepared initially and implemented simultaneously.

    Keywords: Education, Medicine, Hidden Curriculum, Residents
  • Ali Akbar Rohani, Reyhaneh Ebrahimi, Habibeh Ahmadipour * Page 16
    Background

    The patient-centered approach improves the quality of health care. Promoting this approach will increase the patients’ satisfaction and improve interpersonal skills among health care providers.

    Objectives

    The aim of the current study was to compare the viewpoints of interns toward the patient-centered approach in the beginning and the end of the internship at the Kerman University of Medical Sciences (KUMS).

    Methods

    This longitudinal study was carried out at KUMS between March 2017 and July 2018. All medical students who had passed the internship entrance exam were selected through a census. The Persian version of the patient-practitioner orientation scale (PPOS) was completed at the start and the end of the internship. This instrument has 18 items in two 9-item subscales: sharing and caring. The minimum and maximum scores were 1 to 6, respectively. The higher the score, the more the patient-centered orientation. The data were analyzed by SPSS using independent and paired t-tests, ANOVA, and multiple linear regression.

    Results

    The mean scores of PPOS were 3.92 ± 0.42 and 3.86 ± 0.37 at the beginning and the end of the internship, respectively. This difference was not statistically significant. The mean score of the caring subscale significantly increased during internship but no significant change was found in the mean score of the sharing subscale.

    Conclusions

    The results of our study showed that the patient-centered attitude toward patient caring improved during the internship in the majority of interns but no significant improvement was found in terms of patient sharing. Significant progress can be made in the quality of physician-patient communication and patient satisfaction if necessary training programs are run on patient-centeredness.

    Keywords: Medical Student, Patient-Centeredness, Attitude, Internship
  • Reza Dehnavieh, Ali Akbar Haghdoost, Somayeh Noorihekmat, Sara Poursheikhali, Ali Masoud, Reza Sheikhzadeh, Somayeh Borhani, Fatemeh Shiri, Atousa Poursheikhali* Page 17
  • Fatemeh Zeynab Kiani, Ali Ahmadi * Page 18

    Context: Communication, as an essential human skill, is one of the most influential factors in the performance of healthcare workers. In fact, the establishment of effective communication with the recipients of healthcare services and patients can increase their satisfaction and quality of life. Due to the paucity of comprehensive research in this area, the present study aimed to investigate the barriers and facilitating factors concerning communication among healthcare workers.
    Evidence Acquisition: This systematic review was conducted by searching PubMed, Scopus, Web of Science, MagIran, Iranmedex, Google Scholar, and SID databases, using the following keywords: “communication”, “communication barrier”, “communication facilitator”, “health system”, “nurse”, “physician”, “faculty member”, “teacher”, “student”, “health manager”, and “patient”. All searches were conducted within a 10-year period from 2008 to 2018.

    Results

    According to our literature review, 44 articles (38 quantitative and 6 qualitative) met the inclusion criteria. In these studies, “pleasant greetings” and “tidy appearance” were the most important factors facilitating the patient-physician relationship, “teacher’s modesty”, “patience”, and “respect for students” were the main factors facilitating the teacher-student relationship, and finally, “responsibility”, “empathy”, and “companionship” were identified as the most significant factors in the patient-health care worker relationship. On the other hand, the most important barriers to communication in the clinical setting were “poor introduction of the healthcare provider to patients”, “high workload and fatigue”, and “lack of training on the principles of communication skills and environmental factors”.

    Conclusions

    Based on the findings, identifying the facilitating factors and barriers to communication is the most important step in the management of health services. Communication skills training can have a beneficial effect on the health education programs for the healthcare staff. In addition, it can improve the efficacy of health services.

    Keywords: Communication Facilitator, Communication Barrier, Health Care, Systematic Review, Iran
  • Mohammad Reza Mahmoodi * Page 19
    Objectives

    The purpose of this study was to evaluate the improvement of students’ ability to answer consecutive patient management problem (PMP) and modified essay question (MEQ) exams, to assess its relationship with academic progress, and to determine whether consecutive PMP-MEQ exams can improve the students’ clinical reasoning skills by improving the test scores.

    Methods

    This descriptive, analytical, cross-sectional study consisted of 67 third-year nutrition students in three consecutive years, who were asked to prepare for a multiple-choice question (MCQ) test and consecutive PMP-MEQ exams. The students were required to answer PMP-MEQ exam, which comprised of two queries of five-choice question (PMP) and three short-answer questions (MEQ). Repeated measures ANOVA, independent t-test, paired t-test, and Pearson’s correlation test were used for statistical analysis.

    Results

    The mean difference in PMP scores was significant between the three periods (P = 0.0001). However, the difference in the mean score of PMP exam between students with grade point average (GPA) ≥ 16 and GPA < 16 was not significant, except for PMP3 (P = 0.001). An increase was observed in the scores of students in both groups by continuous PMP examination. The significant mean difference in PMP3 exam showed that improvement of students with GPA ≥ 16 was greater than that of students with GPA < 16 (P = 0.001). The difference in the mean scores of MCQ and PMP exams was significant, except for the third PMP exam in students with GPA ≥ 16 (P = 0.143).

    Conclusions

    Use of PMP-MEQ exams in reasoning-based clinical education can be a suitable approach for clinical evaluation of undergraduate students. Also, continuous PMP-MEQ examination can improve the clinical reasoning of students, mainly those with GPA ≥ 16.

    Keywords: Clinical Reasoning, Continuous Assessment, Modified Essay Question, Patient Management Problem
  • Zahra Babadi Akashe, BiBi Eshrat Zamani *, Ali Kheradmand Page 20
    Background

    E-book is one of the forms of network publishing that has attracted extensive attention.

    Objectives

    The purpose of this study was to investigate the factors affecting the acceptance of e-books among students of less-privileged areas such as Shahrekord.

    Methods

    In this descriptive, analytical study, 371 students of Shahrekord University were selected through simple random sampling. The research instrument was a researcher-made questionnaire consisting of 48 questions that was designed with the help of research literature related to the technology acceptance model and interviews with five educational technology experts. Data were analyzed using ANOVA, Independent t-test, multiple regression and Pearson correlation tests.

    Results

    Cultural factors had a significant impact on users’ attitudes and their use of e-books. A significant relationship was observed between the components of usefulness, ease of use, perceived enjoyment, cultural influences and attitude with the acceptance of e-books (P < 0.001). Also, the best predictors of acceptance and use of e-books were the components of perceived enjoyment, barriers, cultural influences, and attitudes.

    Conclusions

    The results regarding the identification of the factors affecting the acceptance of e-books can be used in virtual, non-formal and distance learning centers to design primary and supplementary educational resources. Design engineers and e-book providers can also use the findings of the current research to improve and promote electronic products.

    Keywords: University, E-Book, Technology Acceptance Model, Students