فهرست مطالب

  • Volume:8 Issue: 1, 2020
  • تاریخ انتشار: 1398/10/14
  • تعداد عناوین: 13
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  • ELAHEH MOHAMMADI, HOMAN SHAHSAVARI, AZIM MIRZAZADEH, AMIR ALI SOHRABPOUR, SARA MORTAZ HEJRI * Pages 1-9
    Introduction
    Students observe role models and learn from themin a variety of educational settings. Although it is known thatrole models impact the professional and character developmentof students, some clinical teachers are poor role models. Weconducted a review to summarize the evidence that could helpclinical teachers promote their role modeling.
    Methods
    We performed a review search using specific keywords(curriculum, role model*, faculty development, teach*, program*and education) through electronic databases (PubMed, EMBASE,and ERIC). We obtained 320 qualitative and quantitative studies.Having removed the duplicate references, we read 244 titles andexcluded irrelevant ones. Eighty-two articles were retained andthe abstract of each was read. Finally, 20 articles were included.
    Results
    According to the results of our review, three majorthemes were identified: 1) features of a good role modelcomposed of teaching, clinical, and personal-interpersonal skills,2) self-improvement of role modeling, and 3) faculty developmentprograms.
    Conclusions
    Role models have a profound effect on the attitudesand behaviors of medical students. It is important for clinicalteachers to make an intentional effort to articulate what aspectsthey are modeling. This study can help the faculty members tobe an effective role model. Also, the findings of this review couldform the foundation of a faculty development program in order tofoster role modeling in clinical settings.
    Keywords: Role model, Clinical education, Clinical teacher, Faculty development
  • MIYAKO SHINOHARA, TAKEHIRO NAKAMURA *, NORICHIKA KUNIKATA, HIROSHI OKUDERA, YASUHIRO KURODA Pages 10-17
    Introduction
    The present study aimed to determine the validityand usefulness of scales and training programs for clinical staff toevaluate nerve signs as an initial response to stroke. We developeda stroke workshop, using the analysis, design, development,implementation, and evaluation (ADDIE) model method based oninstructional systems design theory.
    Methods
    The workshop aimed to improve the basic first aidskills of clinical staff for stroke. The participants (n=46) wererandomly assigned to conventional Cincinnati Pre-hospital StrokeScale (CPSS) or modified CPSS groups (simple randomization).Short-term case simulation was conducted immediately after thetraining as well as 6 months later to evaluate the nurses’ skills.We conducted evaluations, using an instructional frameworkthroughout the ADDIE process. We used the Kirkpatrick modelto evaluate the educational effect of up to level 3 in this study.The Wilcoxon signed-rank test was used to analyze differencesbetween the pre-test and post-test groups.
    Results
    The evaluation of the new clinical staff stroke emergencytraining program, either using the conventional CPSS or themodified CPSS, showed that the participants were highly satisfiedand exhibited improved knowledge and skills (conventional CPSS:3.05±0.73 vs 3.64±0.59, P=0.012 and modified CPSS: 2.95±0.97 vs3.61±0.49, P=0.111, before training vs after training, respectively).On the other hand, it was difficult for the participants to evaluateneurologic conditions using the modified CPSS compared withthe conventional CPSS.
    Conclusion
    These results demonstrated that stroke care trainingis effective in reaction, learning, and behavior. The modifiedCPSS could be useful as with the conventional CPSS. In future,evaluation of neurological conditions should be improved.
    Keywords: Workshop, Stroke, Clinical staff, Behavior
  • JAKRIN KEWCHAROEN *, NATTAWAT CHAROENPOONSIRI, SITTINUN THANGJUI, SOWITCHAYA PANTHONG, WASANA HONGKAN Pages 18-24
    Introduction
    Peer-assisted learning has been shown to be aneffective teaching and learning method. However, this techniquehas not been proven in Thai medical school. We aimed to comparethe effectiveness of peer-assisted learning and self-study ininterpreting an electrocardiogram in Thai medical students.
    Methods
    This is a prospective, randomized controlled trial,conducted in Chonburi teaching hospital, a community hospitalaffiliated with Chulalongkorn University. All medical studentsfrom the fourth and fifth years, a total of eighty students, wererandomly assigned to two groups of peer-assisted learning(PAL) and self-study (SS) via stratified randomization doneby computer-generated randomization. The two groups werematched for sex and grade point average. In the PAL group,teaching was performed by the fourth and fifth year medicalstudents. We conducted five weekly study sessions. Differenttopics of electrocardiogram interpretation were assigned to tutorsfor teaching. SS group would separately study the same topic ontheir own. Constructed response questions were used to assessthe students at the beginning as a pre-test and after a five-weeksession as a post-test. Online self-assessment was delivered tostudents one month after the study.
    Results
    Mean pre-test and post-test score was put into theanalysis and compared across groups using t-test. No significantdifference in pre-test score was observed between the two groupsin the same academic year. There was a significant differencebetween the mean post-test score between the fourth year PALand SS groups. Also, the mean difference score in the fourth yearPAL group was higher than the fourth year SS group. However, inthe fifth year group, there was no significant difference betweenthe PAL and SS groups in the mean post-test score and meandifference score.
    Conclusion
    In conclusion, peer-assisted learning is an interestingmethod to improve understanding and interpreting skills of basicECG better than self-study in the early clinical year medicalstudents.
    Keywords: Peer group, Electrocardiography, Self-assessment
  • LUCRECIA M. BURGOS *, ALBERTO ALVES DE LIMA, JOSEFINA PARODI, JUAN PABLO COSTABEL, MARÍA NIEVES GANIELE, MARÍA DOLORES ARCEO, EDUARDO DURANTE, RICARDO GELPI Pages 25-31
    Introduction
    The multiple mini-interview (MMI) model can beuseful to evaluate non-cognitive domains and guide the selectionprocess in medical residency programs. The aim of this study wasto evaluate the reliability and acceptability of the MMI model forthe selection of residents in a cardiology residency program.
    Methods
    We conducted an observational and prospectivestudy. It was performed in a tertiary-care center specialized incardiology and included candidates for the cardiology residencyprogram in March 2018. Ten stations were developed to evaluatedifferent non-cognitive domains. Reliability was evaluated by thegeneralizability G coefficient. Candidates and interviewers weresurveyed to evaluate the acceptability of the MMI model.
    Results
    Nine faculty members were trained and 22 candidateswere evaluated. The G study showed a relative G coefficientbetween 0.56 and 0.73, according to the design. 91% of thecandidates stated that they preferred MMI over other types ofinterviews as a selection method for admission to the residencyprogram, and all the interviewers considered they had enoughtime to evaluate the candidates and their strengths as futureresidents.
    Conclusion
    The MMI is a reliable model to evaluate candidatesfor a residency program in cardiology with high acceptabilityamong residents and observers.
    Keywords: Medical education, Cardiology, Internship, residency
  • SOLEIMAN AHMADY, NASRIN KHAJEALI, ZOHREHSADAT MIRMOGHTADAIE * Pages 32-41
    Introduction
    Capability is built upon knowledge and wisdom,and scientific progress and development is associated withwealth production, national and international authority, andindependence. To promote scientific development, as a prerequisiteto the country’s progress in other areas, there is a need for strategicplanning and creating scientific capacities. Today’s world is facinga rapid growth and development in science and technology, anduniversities and higher education centers have an important rolein the society’s development and progress in the areas of humanresources training, science and technology production, andsolving different problems. Considering the Iran’s health scientificroad map and communication of innovation and reform plans, andsince universities are required to identify the areas of authority,this study was conducted to determine the challenges of scientificauthority promotion and proper courses of action.
    Methods
    In this study, content analysis was used as a qualitativeresearch method. The triangulation method was applied for datacollection. Purposive sampling was done to select the participantsfor focused group discussion and data collection continued untildata saturation was achieved. The participants were 19 highereducation experts and MOHME policymakers. The ATLAS.tisoftware version 5.2 was used for analysis of data.
    Results
    The results of the analysis of transcripts obtained fromFGD with higher education experts and MOHME policymakersshowed 4 themes, 10 categories and 43 sub-categories. The resultingthemes included: “Experienced perceptions of scientific authority”,“Requirements of scientific authority”, “Challenges of scientificauthority”, and “Strategies for promoting scientific authority”.
    Conclusion
    Universities and governmental sectors do notrepresent all the capacities, and there are much more capacitiesthat can be exploited with participation of different sectorsand institutions, especially inter-sectoral and inter-universitycollaborations. Many advances in new sciences have occurredin interdisciplinary majors, and these collaborations help to takesolid steps towards scientific authority.
    Keywords: Scientific, Qualitative research, Medical Sciences
  • FATEMEH KESHMIRI, SHERVIN FARAHMAND, FATEMEH BAHRAMNEZHAD, HOOMAN HOSSEIN, NEJAD NEDAEI * Pages 42-49
    Introduction

    This study aimed to explore the challenges ofprofessional identity formation at clinical education environmentsfrom the faculty members’ viewpoints.

    Methods

    This is a qualitative study. The population consistedof clinical faculty members of Tehran University of MedicalSciences. In this study, 39 faculty members participated inan in-depth semi-structured interview. To analyze the data,conventional content analysis approach was used. Open codingwas extracted from the participants’ statements that representedtheir experiences. Then, based on their similarities, the codeswere classified. Subcategories were emerged and after arranging,they were classified into categories based on their relationships.

    Results

    Instability of professional commitment, patientcenterednessas the missing loop care and treatment, andinappropriate conductive context were explored as the challengesof professional identity in clinical educational environment.

    Conclusion

    According to the results of the study, the formationof professional identity among the providers is not an easy taskbecause many factors affect the formation of professional identity.Therefore, a comprehensive shift towards forming the professionalidentity at individual and organizational level should be planned.

    Keywords: professionalism, Qualitative research, education, Environment
  • ADILSON JOSE MANUEL DE OLIVEIRA *, MÁRIO FRESTA Pages 50-52
    Introduction
    Angola has about 28 million inhabitants andapproximately 0.21 physicians/1,000 population. There is onlyone specialist in some medical fields in the whole country whilethere is not even one specialist in some other fields. The objectiveof this study is to investigate the significance of the CooperationProgram for Foreign Doctors (Brazil) and its impact on theprovision of specialized medical care in Angola, showing theevolution of the different specialties as well as the emergence ofsome specialties in Angola.
    Methods
    A retrospective study was performed, identifying theAngolan doctors trained in Brazil by the Cooperation Programfor Foreign Doctors. The number and specialty of the trainedphysicians were obtained from the database of the program, andthe number of doctors in each specialty in Angola was obtainedby consulting the registry of doctors of the various specialistcolleges in Angola.
    Results
    From February 2011 to March 2019, 111 physicians weretrained in 32 specialties; there was a greater increase of 50% ormore in 6 specialties, with emphasis on geriatrics, haematology,nuclear medicine, surgical oncology and sleep medicine that hadno specialists.
    Conclusion
    The lack of specialist doctors is a very commonproblem in low-income countries; on the other hand, highincomecountries are already beginning to limit training in somespecialties due to lack of labour market. The Angolan cooperationmodel could be adopted by several countries to promote aqualitative overall growth in health care.
    Keywords: Medical education, Public Health, Training
  • GERALD P. ROSEN *, S. HOWARD WITTELS, ITALIA SMITH, OMAR VISWANATH Pages 53-54
  • SOLEIMAN AHMADY, NASRIN KHAJEALI*, FARSHAD SHARIFI, ZOHRE SADAT MIRMOGHTADAEI Pages 74-85
    Introduction

    Identifying the learners’ problems early enough and providing advice from the beginning is definitely an important investment in the training and progress of future practitioners. The current review aimed at examining factors related to academic failure of the preclinical medical students.

    Methods

    The study was carried out as a systematic search of publications in the following databases published from January 1987 to January 2018: PubMed, Web of Knowledge, Educational Resources, Information Center and Scopus. No language limitation was set for searching the resources. As a comprehensive search, the following keywords were used for the abstract, title and keyword sections: academic performance, academic failure, academic achievement, drop out, academic engagement, learning disorder, medical student, struggle student and problem learner. A valid tool (STROBE) was used to determine the quality of the articles.

    Results

    Most articles discussed personal causes, 7 discussed learning style, 7 discussed personality traits, 6 discussed motivational strategies and self-efficacy, 4 discussed quality of sleep, 4 discussed the effect of stress, 9 discussed demographic factors, 3 discussed physical activity, 1 discussed coping strategies, 2 discussed class attendance and 4 discussed study strategy. Twenty-five articles described instructional design cause, 3 described teaching strategies, 2 described course assessments, 1 described the course structure, 3 described critical thinking, 3 described blended learning, 13 described predictive courses, 14 described admission tests, 1 described the learning environment, 2 described curriculum planning and 3 described the pre-matriculation program.

    Conclusion

    Medical teachers often do not know which students are problem learners or what causes academic failure. The goal of this systematic review was to determine the origin of problems in learning to identify problem learners. The results indicates that managers, policymakers, instructors and counselors can monitor student academic achievement by careful planning of instructional design, attention to an educational environment, use of active teaching methods, continuous assessment of students and consideration of personal factors.

    Keywords: Academic failure, Medical student, Medical education
  • RITA REZAEE, MAHMOUDREZA PEYRAVI, MILAD AHMADI MARZALEH*, AMIR KHORRAM, MANESH Pages 95-102
    Introduction

    Early education and training are mandatory to raise the knowledge and awareness of the healthcare staff. Iran is a disaster prone area with a high number of emergencies. This study aimed to assess the need for disaster and emergency management education for Iranian medical students.

    Methods

    Using two-round Delphi technique in 2017, 15 experts within the field of disaster and emergency management were asked for their opinions concerning the education required for Iranian medical students. Highly important educational domains and their sub-domains selected with an agreement of above 7080% were prioritized by AHP technique.

    Results

    Of 41 identified and prioritized educational subjects, four main groups were obtained: 1) crisis and disaster primary concepts, 2) disease control skills, 3) management skills, and 4) medical care skills. The medical care skills had the highest priority (with a weight of 0.546), compared to other areas after the final analysis.

    Conclusion

    Different areas of competency are needed to raise awareness and preparedness in medical students in combating crisis and disasters. We propose a curriculum for Iranian medical students and suggest it to be used for other professionals, who are involved in the process of disaster management.

    Keywords: Disasters, Crisis, Medical students, Education, Interdisciplinary, Awareness
  • SATEESH BABU ARJA*, SIREESHA BALA ARJA, SAMIR FATTEH Pages 111-117
    Introduction

    There are two popular methods of clinical skills teaching. One is Peyton’s method, and the other one is Robert Gagne’s method. A hybrid model which is a combination of both teaching methods is developed and implemented at Avalon University School of Medicine in Clinical Skills. The aim of the study was to evaluate the hybrid model of clinical skills teaching.

    Methods

    This is a quasi-experimental study where a control group with a sample size of 26 was compared with two study groups; one group included 24 participants, and as the other one consisting of 16 subjects selected without randomization. All students in the class were included in the study, except for those withdrew voluntarily. The quantitative data were gathered in the form of a questionnaire on the Likert scale which was collected as the end of course evaluations. The quantitative data for the responses on the Likert scale was analyzed for descriptive statistics: Mean, Median, and Mode. The quantitative data also included the students’ performance on assessments of clinical skills which was analyzed using ANOVA test. The qualitative data were gathered in the form of open-ended questions in the end of course evaluations. The qualitative data were also collected from the faculty members who were the examiners for the clinical skills course as the feedback taken from them.

    Results

    There was a significant improvement in the feedback of students (end of course evaluations) after implementing the hybrid model of clinical skills teaching which was shown by increased Mean, Median, Mode for the most pointers on the Likert scale. Also, there was a notable improvement in the performance of students with a significant p-value (p<0.05) on ANOVA test.

    Conclusion

    The hybrid model is very effective in teaching clinical skills. This teaching method can be evaluated by replicating this study at larger institutions with more number of students.

    Keywords: Clinical skills, Teaching, Learning, Assessment, Feedback, Evaluation
  • SASAN DABIRI, AEEN MOHAMMADI*, RITA MOJTAHEDZADEH Pages 131-137
    Introduction

    In the test-enhanced spaced learning, educational contents are presented in small packages of well-developed test questions with a defined frequency to the learners. It is not clear that applying this educational style might have a positive impact on the summative assessment. Therefore, in this study we assessed the effect of the test-enhanced spaced learning on the otolaryngology board and annual examinations of residency training.

    Methods

    In a quasi-experimental study with consecutive sampling, all forty-four residents of otolaryngology in four levels of training in 2016 at Tehran University of Medical Sciences (TUMS) received daily-standardized multiple-choice questions with a twice-repeated frequency of 10 days. Individual feedback according to one’s response to each test was provided. The results of national board and annual exam were compared with the same results of all residents of other universities and previous year TUMS’ residents for whom spaced learning were not applied and they were considered as the control groups. The board exam had two parts, multiple-choice questions, and computer-based clinical examination. The annual exam format was multiple-choice questions. The total score for each one was 150. Student’s t-test and Mann-Whitney U test were used for comparative analyses.

    Results

    The mean of the board exam results showed statistically significant improvement compared to other medical schools (113.6±10.7 vs. 102.9±13.4 in multiple-choice questions, p=0.048, 118.7±12.5 vs. 54.1±60.0 in the computer-based clinical examination, p<0.001), while similar comparison results in the previous year did not show any significant difference.

    Conclusion

    Spaced learning with testing effect may be useful in the clinical education setting to improve the learning outcomes.

    Keywords: Learning, Cognition, Internship, Residency, Otolaryngology
  • SHILPA PATRICK, KIRTI VISHWAKARMA, VISHAL P GIRI, DEBRANJAN DATTA, PRIYANKA KUMAWAT, PREETI SINGH, PRITHPAL S MATREJA* Pages 181-185
    Introduction

    Pharmacology is perceived as a volatile subject as it’s difficult to recall and recite the core of the subject. Enriching the learning environment through incorporation of a variety of teaching and learning strategies and methods yields enhanced learning. Crossword puzzles provide expansion of vocabulary, stimulate thinking capacity, boost confidence, and fasten up the learning capacity; hence, the present study was conducted to investigate the usefulness of crossword puzzle as an innovative self-learning tool in pharmacology.

    Methods

    This prospective study was conducted among 5th semester students of the second professional MBBS course. A total of 139 students participated in this study and were evaluated with formative examination and feedback questionnaire. Permission was taken from Institutional Ethics Committee for the study. A crossword puzzle consisting of 32 questions on endocrine pharmacology was prepared and divided into two sections: the across section had 17 questions and the down section contained 15 questions. The data were analyzed, using Graph Pad Software and presented as percentage of the responses.

    Results

    On average, out of 32 questions, one mark each, the students scored 52.69% and all students responded correctly on questions on the topic of hormonal contraceptives. 75.5% of the students had an enjoyable experience and the majority of them agreed that it helped them enhance their knowledge of drugs, remember diseases and drug names, and overall learning about the topic. They were also of the opinion that this should be inculcated in pharmacology curriculum.

    Conclusion

    Incorporation of crossword puzzles, as an adjunct tool, was useful as majority of the students reported that this improved their attitude of learning, thereby improving their performance.
    *

    Keywords: Endocrine system, Pharmacology, Self-learning, Lectures, Feedback