فهرست مطالب

Journal of Medical Education
Volume:6 Issue: 3, Agu 2004

  • تاریخ انتشار: 1383/05/11
  • تعداد عناوین: 8
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  • Page 1
    Purpose
    "Introduction to Clinical Medicine" in Isfahan University of Medical Sciences and Health Services is an initiative in which general practitioners work as instructors and have the opportunity to experience teaching in addition to clinical practice. Since teaching, affects both teacher and students, this study aims to assess the influence of teaching clinical skills on the instructors'' psychological, social and professional behaviour.
    Methods
    This was performed as a qualitative study. The research population consisted of instructors of “Introduction to Clinical Medicine” who were all general practitioners and acted as facilitator in small groups working on physical examination and case discussion. The data collecting tool was a semi-structured interviewwhich was recorded on the tape. Then, the interviews were transcribed and confirmed by interviewees at the end. 10 instructors were interviewed. The data were analysed according to Colaizzi model.
    Results
    After coding the data to 38 main subjects, they were classified into three main categories including professional, psychological and social effects. The influence of teaching on professional performance included performing a thorough and correct physical examination, taking a detailed and correct history, increasing decisionmaking ability and increasing professional knowledge. Some of the psychological effects were increasing selfconfidence, job satisfaction and morale. The social effects of teaching were increasing social contacts, having a relationship with an academic environment and having a respectful job.
    Conclusion
    Considering the positive effects of teaching on instructors, teaching clinical skills by general practitioners can increase general practitioners knowledge and clinical skills and improve their morale. It is recommended to train general practitioners both for teaching skills and clinical skills and consider this, as an opportunity for physicians’ continuing education.
  • Page 2
    Background
    A major metacognitive learning strategy that appears to improve students learning experience is concept mapping.
    Purpose
    To determine the effects of teaching by concept mapping method on meaningful learning of a group of bachelor degree program nursing students.
    Methods
    Students studied in fourth year of Nursing, Bachelor’s Program, in two nursing faculties located in Tehran were selected by simple sampling method and randomly assigned into intervention and control groups. The selected materials were taught by concept mapping strategy for the intervention group while in the control group traditional lecturing method was used. A teacher-made, criterion referenced test was used as instrument to evaluate meaningful learning of participants in two groups.
    Results
    Based on intended criteria 230 fourth year students wereincluded.25 students were excluded due to lack of one or more including criteria. The remaining students were divided randomly into two intervention (106 students)and control (99 students) groups. The study was conducted during a 5-week period. The results showed that there was a significant statistical difference between the mean scores of retention test of learning in the case (72.40 %) and control (53.30 %) groups (P<0.005). T-test also revealed that there was a significant statistical difference between the mean scores of cumulative post-test for the case group (73.29 %) and the mean scores of cumulative posttest for the control group (68.69 %).
    Conclusion
    Based on our findings it can be concluded that teaching by concept mapping strategy has significant effects on meaningful learning and retention of the students. By addressing these issues it is suggested that more nurse educators would attempt to use the concept mapping strategy in the promotion of meaningful learning.
  • Page 3
    Background
    Documentation of medical data in patient records is needed to improve the quality of healthcare and medical knowledge progress. Documentation of patient history, clinical problems, treatment, and follow-up care are needed to improve practice and research.
    Objective
    To determine documentation of patient records at the internal medicine ward of Imam Khomeini Hospital, Tabriz, Iran.
    Method
    The study was descriptive and 100 patient records were selected through random sampling. Records were related to the patients who had been discharged from the general internal ward during April to June 2000. Data was collected using the questionnaire including 30 closed questions, and 5 open ones. The results were reported in ratios (%) averages and standard deviation. T-test was used to examine the association of length of stay and records data adequacy scores. Data was analysed by the SPSS software.
    Results
    Completeness of the patient records was moderately acceptable (68.7%). The difference between performance of residents, interns and students in documentation of primary diagnoses and differential diagnoses was significant (P<0.001) and performance of residents was more efficient (59.6%), (69.7%). Of the records, 22.2% were without summary sheet.
    Conclusion
    Patient records had many deficiencies. Instructions for documentation are necessary. Regular monitoring and evaluation by the attending physicians and writing skills education could be effective in accurate documentation.
  • Page 4
    Background
    The demand for nuclear medicine procedures is growing in recent years but training of medical students in this subject is not appropriately developed. There is no well defined program for training medical students in the field of nuclear medicine.
    Purpose
    To evaluate the knowledge of the general practitioners from clinical applications of nuclear medicine.
    Methods
    One hundred and six general practitioners (58 male and 48 female) participated in an exam with 14 multiple questions (Four question on general nuclear medicine and 10 questions on clinical applications of nuclearmedicine). Also their idea was asked regarding training in nuclear medicine. Validity of questions was confirmed by nuclear medicine specialists and consensus of four reference text books(3-5). Minimum score was 0 and maximum score was 14. Correct answering of less than 50% of questions were considered as poor, 50-70% were intermediateand >70% as good.
    Results
    Of all participants, 95% were under 40 years old, 92% graduated in the last 10 years and 52% were trained in Mashad universities. The study showed that 32% of participants have poor results and only 12% of participants had good results. About 62% of participants correctly answered to less than 58% of questions. Overallmean score was 7.53􀁲 2.72. Doctors graduated from Tabriz universities had significantly higher scores than graduates from other universities. Sixty nine percent of participants had no training in nuclear medicine at all and the rest had a variety of 3-15 hours of training. About 90% of participants needed more information in nuclear medicineas they checked in the questionnaire.
    Conclusion
    Our study showed that knowledge of general practitioners in the field of nuclear medicine is poor and they need to improve their knowledge.
  • Page 5
    Background
    Effective clinical teaching is a major objective in general practitioner’s education at medical schools.
    Purpose
    To identify the sources of clinical skills learning that medical student experience
    Methods
    In this cross sectional study, interns of Tehran medical university who spent at least 12 months of their internship answered a questionnaire on the sources of clinical skills training. Chi2 test was used to examine theassociation of source of learning and students,’ specification such as sex, score of pre –internship exam, and marital status.
    Results
    All 250 interns who were eligible participated. Over all 46.60% interns learned their clinical skills from residents or clinical teachers, 29.61% observed others performing the procedures, 16.25 learned the skills from hospital staff or nurses, 7.54% practiced their knowledge when confronted to an emergency situation
    Conclusion
    Our results warrant a more attentive approach to clinical skills (specially procedural skills) training
  • Page 6
    Background
    Interns’ attitude has strong association with their experience and judgment. It is actually one of the effective factors influencing the development and modification of medical education.
    Purpose
    The present study was carried out in order to compare the attitude of interns before and after the training course of social medicine.
    Methods
    In this quasi-experimental study data was gathered by using a questionnaire with internal consistency coefficient of 0.86% and 0.89% respectively before and after the course. Interns were selected via conveniencesampling. Interns filled out pretest (before taking the course) and post test (after taking the course) questionnaires and the results were compared and analyzed through parametric and nonparametric tests.
    Results
    A total of100 students participated in the study. There was significant difference in mean of attitude score between pretest and post test results (P<0.05). In order to compare the rank of each attitude item in the two stages, ‘Sign test” was used. All 27 items showed significant difference (P<0.05). No significant difference was observed between two sexes in both pre and post tests.
    Conclusion
    According to the results of the present study, researchers found out that social medicine training courses had considerable effects on interns’ attitude and could cause alterations in their attitude toward social medicine objectives.
  • Page 7
    Graduate Medical Education is one of the stage of the continuum of medical education in Iran. At present, near 5500 residents are being trained in 24 specialties and 21 subspecialties in 26 Universities of Medical Sciences. Based on a special Act of National Parliament in 1973, the Iranian Council for Graduate Medical Education is responsible forsupervision on the quality of Graduate Medical Education. Despite significant activities in this field during last three decades, there has been no integrated effort for evaluation and accreditation of specialty education units, yet. In this regard, the Secretary of the Council appointed a committee for preliminary studies and presentation of newapproaches. In this article, the authors first describe the details of the activities of this committee. Thereafter, challenges of Graduate Medical Education and relevant supervisory bodies have been discussed. In the end, activities for the establishment of new accreditation system of Graduate Medical Education in Iran have been described.