مجله ایرانی آموزش در علوم پزشکی
پیاپی 9 (بهار و تابستان 1382)

Despite growing evidence in the field of undergraduate medical education, there is not much data on resident training. Case presentation is a useful tool for scientific clinical education which along with evidence based medicine will become an interactive training method. So, the goal of this study was to compare traditional educational methods with hard talk and their role in learning process, based on resident's viewpoints. In a pre-experimental study, special monthly case discussion sessions (named "Hard talks on gastroenterology") were designed for internal medicine residents of Shaheed Beheshti University of Medical Sciences. Then the data were collected using an attitude measurement questionnaire. Each educational case was started with a title followed by history, physical examination data, as well as paraclinical lab results, respectively. The scenario ended with a definite clinical question about next needed test, diagnosis or treatment. After the sixth session, questionnaires were distributed non-randomly among 50 participants and 31 questionnaires were completed. The data were analyzed by SPSS 11 using frequency distribution and Kruskal Wallis. Residents were more positive toward Hard talks. They evaluated the possibility of challenge with speakers 54.8%, learning the presented subject during the session 80.6%, the compatibility of the subject with resident's real needs 77.4%, the possibility of using the attending physician experiences 77.2%, volume of knowledge transfer in a session 67.7%. The participants considered the Hard talks better than traditional methods. In general, this study showed a relatively successful experience in resident training. Due to the lack of new methodologies in resident education this can be used as a guide for designing new interventions in the field.

Dissertation is one of the important and valuable information resources especially in libraries. In fact, dissertation reflects the accepted university pattern for research presentation. Evaluation of dissertation subjects during a special period presents the university research strategy. This study was performed to determine the structure and charachteristics of postgraduate dissertations of Isfahan University of Medical Sciences. All postgraduate dissertations of IUMS during 1989-1999 were evaluated using a checklist for their structure (i.e. introduction, methods, results, discussion) and type of study (Basic, Applied, Experimental-Devolopment), Experimental, Quasi experimental and Observational. 83.9% of dissertations were for either MD, pharm D or DD 8.9% for PhD, 6.3% for MS and 0.9% for Medical specialty degree. The results showed that 96.6% of these dissertations were applied and 34% basic- applied and, their distribution varied among different schools (School of Dentistry had the most applied dissertations). 47.7% of dissertations were descriptive, 22% descriptive-analytical, 0.6% analytical, 0.6% quasi-experimental and 26% experimental research. There was a great variaton in dissertation structure among different schools. The results of this study indicated the importance of shifting thesis subjects to basic and analytical researches. Also, it could be used as a guide for planning dissertation subjects. Structural differences of thesis among different schools reveal the need for designing an “acceptable unique pattern of thesis writing” in the whole university.

To improve the quality of dissertations (as a mandatory course) in general medicine (MD) program, it is useful to know the viewpoints of supervisors about different issues and problems in their supervision process, i.e. the objectives of the course, facilitation methods for learning, problems of the practical phase, and their ideas about the course efficacy. This study explores supervisor's views concerning the thesis process and its related problems in Isfahan University of Medical Sciences. 106 supervisors from Medical School participated in this cross sectional descriptive study. A self-administered questionnaire, which proved to be valid and reliable was used for data collection. The questionnaires were completed individually in the participant's office or School. SPSS software was used for data analysis. Results were analyzed according to the frequency distribution of variables and compared by t- test and ANOVA. According to the supervisors, the most important problems were allocating appropriate budget, approving the research proposal by the department and school councils, instructing students about literature review and article writing, and not being informed about national research priorities. They considered "learning research methodology" as the main objective of dissertation. Most of them agreed on it as a necessary course for MD program, but believed that students usually faced shortage of time. They claimed that offering thesis as an elective course would improve the quality of the projects. Dissertations in general medicine program are facing some problems. It seems that shortage of time brings about limitations in doing and supervising the projects. It is recommended to revise the approval process of thesis proposals. Moreover, involving students in the preplanned researches, improving the supervisors knowledge in research methodology and statistical analysis, announcing research priorities, and revising the course plan may improve the quality of dissertations.

One of the most important principles of educationg concepts and establishing skills in nursing students is the use of proper gool-based educational methods. Special attention has to be paid to medication administration skills, in order to provide patients’ health. Identifying the best educational ways for administrating medication by nursing students can solve some of the existing educational problems. This experimental study was conducted to compare the impact of traditional and multimedia independent teaching method on cognitive knowledge and psychomotor skills of first year nursing students. In an experimental study 80 first year nursing students participated and were randomly divided into experimental and control groups. The control group was taught by the traditional method and the experimental group by multimedia independent teaching method. The initial and retention of cognitive knowledge and psychomotor skills were measured by a post-test and standard checklist right after the instruction and one month later. Also, the students’ opinion on applied strategies was asked by a separate questionnaire. The results were analyzed by descriptive statistics and using t-test and Chi2. Based on the results no significant difference in administrating medication skills was observed between the case and experimental groups in the first stage. But there was a significant difference in initial cognitive knowledge between the two groups. Analysis of data indicated that neither cognitive nor psychomotor skills were statistically different one month after the education. Both methods, however, were found to be effective. Most participants preferred multimedia teaching method to traditional method. Although there was no difference in psychomotor skills of the two groups, due to the students’ emphasis on multimedia independent teaching, it is recommended to use this method in nursing education.

The clinical competencies of a physician is usually judged based on his(her) communication skills. Teaching communication skills is one of the important subjects in medical education, whereas it has not been considered in medical education curriculum of the country. Due to the involvement of the faculty members in medical education system, their viewpoints concerning educational matters is of special importance. This study was performed to determine the faculty member's viewpoints in regard to teaching communication skills to medical students. In this descriptive-analytic study 142 faculty members from 17 departments in Medical School of Isfahan were selected by simple random sampling method The data collection tool was a questionnaire consisted of three parts: demographic, attitude and open questions. The validity of the questionnaire was confirmed by experts and its reliability by split-half method. The data were analyzed according to the frequency distribution and the mean of the scores, and compared by t-test, Mann Whitny, Kruskal Wallis, ANOVA and Tokey. 85% of the faculty members had a very positive attitude toward teaching communication skills to medical students. There was no difference in the attitude according to the sex of the faculty members. The younger faculties, aged between 30 and 40 years with 5 to 10 years of teaching experience, had a better attitude compared to other groups. The specialty field had no role in their attitude toward the subject. The views of all the faculty members about teaching communication skills regardless of their sex, age, specialty field and teaching experience was positive. Thus, teaching these skills to students as one of the formal subjects seems necessary.

One of the main missions of universities is to train skillful manpower for the society. The higher education institutions try to find out what their graduates will face in the society and if they have a chance to use their specialty. This research was performed to determine the job future of the graduates in Semnan. In a cross-sectional study, all nursing graduates (B.S.) who had been graduated during 1992-1999 were studied (N=174). 93 persons participated in the survey by completing a questionnaire containing 10 questions. The data were analyzed by SPSS software. Frequency distribution, standard deviation and the mean of all questions were calculated and also Chi2 test was used. 60.22% of the participants were female. 30.12% of them were hired as permanent employees. Most of them worked at the hospitals and 43.1% were employed in non-nursing positions. Only 17.2% were employed within less than 6 months and the rest were unemployed in a period of 6 months to 3 years after graduation. Also, 17.2% were unemployed at the time of this study. Most of them (60.21%) had not entered postgraduate studies and 2.61% had continued their studies for non-nursing majors. 6.45% had changed their major of study and also their jobs. 80.64% of the participants did not have any contacts with their schools. And only 17.2% were employed in hospitals affiliated to Semnan University of Medical Sciences. Chi2 – test showed a significant relationship between gender and the period of unemployment. The results revealed the long period of unemployment of nursing graduates, the undetermined hiring situation and employment in fields other than nursing. It is recommended to consider society's needs and student's interests at the time of admission to the university and take some measures concerning employment problems.

Introductio:Learning clinical skills at the bedside is one of the best educational methods which mainly depends on clinical instructors’ characteristics. It seems that teaching by qualified and competent instructors can enable students to reach their maximum capability. This research was designed to study the effect of teaching on knowledge, attitude and practice of nursing and midwifery instructors concerning effective behaviors at clinical teaching. This was a quasi-experimental research which studied all nursing and midwifery instructors (N=25) at Tabriz University. The research was designed as one group and two stages which assessed knowledge, attitude and practice of instructors before and two months after running the educational program (two days workshop). The data collecting tool was a questionnaire including four sections. The scientific validity of the questionnaire was confirmed by content validity and its reliability was evaluation by split-half method. In addition to instructors, the forth section of the questionnaire concerning performance, was also completed by the students who were under the supervision of trained instructors before and two months after the workshop. The results were analyzed by SPSS 9 software and using paired t-test, relative frequency, mean and standard deviation. According to the results, participation of instructors in educational workshops had a positive effect on increasing knowledge and improving their attitude toward clinical teaching behaviors. Moreover, according to the viewpoints of instructors and students, their performance scores increased after education. But, no significant difference between the mean of performance score of instructors before and after workshop was observed. Based on student's viewpoints, instructor's performance in assessing students showed a significant difference. Considering the positive effects of education on knowledge and attitude of the instructors, providing education and an appropriate background in clinical environment for employing effective behaviors seems necessary. The results of this research can be used in designing a valid evaluation tool for assessing the effectiveness of clinical education and the educational performance of clinical instructors

Need Assessment is an inseparable element of educational planning and optimization of human resources. Identifying educational needs can increase the efficacy of educational plans. The goal of this research was to investigate the characteristics of an appropriate need assessment model and also determine the most applicable need assessment models according to the viewpoints of health directors and experts in Isfahan University of Medical Sciences and Health services. In this descriptive-qualitative research 32 health directors and their assistants and 31 staff experts of Health Networks in Isfahan were studied. The data were collected through a questionnaire whose validity was confirmed by content validity and its reliability by test-re-test. Then the data were analyzed by SPSS software using frequency distribution and Ch2 test. The proper patterns for need assessment of the understudy population have the following characteristics: They define need as the distance between existing and desired situation, consider society, goals and its values as need assessment sources, use direct observation and questionnaire as need assessment tools, recognize need in municipality, consider the participation rate of the population as the criterion for determination of the model, apply need assessment timing in several steps, gather people representatives at special places as the most suitable location, use Delphi method as the most suitable executive method, apply purpose axis patterns and compositional patterns as the most applicable models. Educational need assessment is the first and most essential step in educational planning for medical education, and health and therapeutic system. Determining the needs based on precise patterns and techniques can increase the effectiveness and quality of planning in this system. It is recommended to train health directors and experts regarding suitable need assessment models.