Strides in Development of Medical Education
Volume:6 Issue: 2, 2010

The importance of dispatching students to foreign countries to continue education is so obvious that even developed countries are not needless of that. Hence, this study was conducted to evaluate the opinion of overseas graduates, who were on a scholarship, about the meaning and concepts of educational achievement and its effective factors. In this qualitative study, 11 faculty members of Kerman University of Medical Sciences who have been graduated from foreign universities participated. They were inquired into their opinions about assessment criteria of educational achievement and its effective factors using an open interview. Among the most important concepts of educational achievement regarding education quantity, attending seminars and conferences can be pointed out. The efficiency of learned materials and learning professional scientific topics are important considering education quality and learning extra topics, respectively. The interviewees also believed that personal factors including personality, family, economic affairs, having professional knowledge in the field of study, necessary skills in the language of the target university and its status especially tutors, topic and field of research were also substantial. Our findings suggest that concepts of academic achievement are vast and one cannot be considered successful assessing only one or some criteria. Hence, duration of study, the amount of scientific products and their quality, the amount of scientific connections and the application of learned topics by the learner are to be noted.

Students’ learning style, as one of the effective factors on learning and academic achievement, is always taken into consideration in a successful educational system. Identifying learners’ learning style would lead to selecting more appropriate teaching methods by teachers and learning styles by learners. Therefore, this study was aimed to identify medical students’ learning style and its relationship with their academic achievement. In this descriptive-analytic study, medical freshmen and fifth-year students of Tehran University of Medical Sciences participated by completing the standard questionnaire of Kolbs. The average of all students’ theoretical and practical exam scores together with the fifth-year students’ OSCE and pre-internship exam scores were considered as indices for academic achievement. The most common learning styles among the freshmen were convergent (50.3%) and assimilation (36.6%) whereas the fifth-year medical students mentioned convergent (69%) and accommodation (16.7%). There was a statistically significant difference between learning styles in both student groups (P=0.0001); convergent and accommodation learning styles were more common among fifth-year students compared with the freshmen while such a result was the inverse for divergent and assimilation learning styles. There was no significant difference between learning style and students’ academic achievement. As convergent learning style was considered to be the dominant one, and simulation, laboratory assignments and problem–based learning are the most suitable learning atmospheres, it is appreciated if educational planners prepare such environments.

In a clinical environment where students learn their profession’s practical skills and become acquainted with their future roles and responsibilities, having a capable and effective clinical instructor is vital to assure an appropriate atmosphere for learning and applying skills and organizing learning in a clinical environment. This study aimed to determine the characteristics of an effective instructor according to nursing & midwifery students and instructor's point of view. In this qualitative phenomenological study, 30 students and 8 instructors of nursing and midwifery in Gorgan University of Medical Sciences were selected using purposive sampling method. Data was collected using semi structured, deep and interactive interviews. They were analyzed using an approach recommended by Collaizi. The analysis of documents revealed three common concepts of characteristics of an effective clinical instructor according to the students and instructor's point of view. They included practical and scientific competencies, educational management competencies and good behavior. Participants also mentioned a variety of issues as inhibitors for effectiveness of an instructor and clinical learning. The most important of them were lack of enough facilities, old educational centers, a paternalistic state created by medical doctors in educational centers, and reluctance of nursing students to their career. Our findings suggest that a systematic and alternative thinking is essential for improvement of a clinical education setting. The enhancement of the instructors’ theoretical and clinical skills should accompany physical, structural and qualitative changes of educational centers.

Evaluation of educational achievement is an important part of an educational process; such an evaluation is possible via holding exams. Multiple Choice Question (MCQ), as an objective testing method, is the most common tool for evaluating students. Hence, this study was conducted to evaluate the exam questions designed by faculty members with emphasis on the MCQ structure in Ahvaz Jundishapur University of Medical Sciences. In this descriptive study, questions designed by 197 non-clinician faculty members were analyzed. Data was collected using a checklist including demographic information, properties of exam questions, and items related to comparing MCQs with design rules of such questions. The results revealed that 8.1% of the questions developed by faculty members were essay, 55.32% and 36.54% were objective and a combination of essay and objective, respectively. Among a total of 5208 evaluated questions, 64.96% contained no structural flaw. The most common flaws included ambiguous or unclear question stems (15.94%), use of negative verb in the stem (12.22%), using “all” or “none” among option (10.85%), and use of blank space in the beginning or middle of the stem (10.41%). Almost 90% of the MCQs were at cognitive level (taxonomy I). Due to the importance of developing standard questions corresponding to guidelines for MCQs in acceptable exams, regular revision of exam questions and further training courses for designing questions is recommended.

To assess the characteristics of a good teacher, one must inquire the teachers’ opinion in addition to the students’. Hence, this study was aimed to determine the characteristics of effective teachers and pertinent effective educational factors according to the teachers and students’ point of view in schools of nursing in Kerman University of Medical Sciences. In this descriptive-comparative study, 358 students and 89 teachers from Kerman, Bam, Zarand, and Jiroft schools of nursing participated. Data was collected using a researcher-made questionnaire which covered five domains. The results showed that according to the students’ point of view, interpersonal communication, teaching skill, personal characteristics, evaluation skill, and educational rules were priorities in order of importance whereas teachers gave priority to teaching skill, educational rules, evaluation skill, personal characteristics, and interpersonal communication. The importance of interpersonal communication and personal characteristics according to the students’ opinion was significantly higher than what teachers believed (P=0.0001 and P=0.04 respectively). However, the importance of teaching skill and educational rules was significantly higher in teachers’ opinion when compared to the students’ (P=0.0001 in both cases). Lack of enough time to study was the most important effective factor in teachers’ efficacy regarding the opinion of both teachers and students. Despite the significant difference between the teachers and the students’ point of view, it is suggested to consider improvement of communication skills together with modern teaching methods in teachers’ empowerment programs. Educational managers should also direct their programs to gain a better background for studying, learning and efficacy with a decrease in working hours.

An appropriate relationship between a physician and a patient will lead to earning patients’ trust, prevention of frequent referrals to multiple physicians and patients’ bewilderment, and lastly, it results in saving time and money. Hence, this study was conducted to determine the dominant model of relationship between physicians and patients according to patients’ opinion.

In this cross-sectional study, 305 patients who, for the first time, referred to the physicians of the clinic of Isfahan Shahid Beheshti Hospital for their recent illness were recruited. Data was collected using a researcher-made questionnaire including 10 general and 19 attitude-assessing questions. The questionnaire’s reliability and validity were already confirmed.

The dominant models of relationship between patients and physicians were guidance-cooperation (86.5%), active-passive (11.1%), and mutual participation (2.4%), in order of frequency. There was no significant difference between the relationship model and the patients’ educational or social class. Guidance-cooperation and active-passive models were significantly more frequent in older and younger individuals, respectively (P=0.047).

According to mutual participation model (the most effective model of relationship between physicians and patients) and considering its low frequency in our study, we can conclude that enhancing patients’ awareness about their health status, and encouraging them to participate in the treatment process (which results in increasing both sides’ responsibility for a common goal) would improve the relationship between physicians and patients. Having earned both physicians and patients’ trust, all mentioned issues would finally facilitate health access.

Evaluating research indicators amongst clinical and basic science faculty members reveals that such indicators are lower in clinical faculty members. Hence, we decided to assess the effect of providing education-research services, by founding a clinical research development center, on the research performance of clinical faculty members of Kerman University of Medical Sciences. In this intervention field study, 66 faculty members of Afzalipour teaching hospital and 45 ones in Shafa teaching hospital were recruited as cases and controls respectively. After founding the research center in cases’ work place, education-research services were provided for two years. The research activities of cases and controls were compared two years before and two years after founding the center. 39 and 33 percent increase were observed in the cases’ total and per capita number of published articles respectively; similar indicators showed 21% and 21.6% decrease in the controls accordingly. The differences between two groups regarding both indicators were significant (P<0.01). Indicator of tutoring in dissertations and the total number and per capita number of presenting abstracts in the congresses showed a higher increase among cases.An increase in the total number and per capita number of accepted research proposals was 76% and 68% in cases and 120% and 122% in controls, respectively. Founding a clinical research center and providing education-research services in clinical faculty members’ workplace has positively influenced their performance and promoted their research indicators. Hence, establishing similar centers in other teaching hospitals is recommended.

Evidences reveal that continuing education courses for employees have not really influenced the improvement of clinical skills and patient care. This implies the need to alter educational methods of such courses. Hence, this study was conducted to assess the effect of integrated teaching on learning clinical skills among rural trained birth attendants participating in a continuing midwifery education course.

In this experimental study, 63 participants of a continuing education course were randomly divided into two groups of integrated education and conventional one. Data was collected using a questionnaire and Objective Structured Clinical Examination (OSCE). After pre- test, an 8 hour specific educational program for each group about midwifery emergencies was conducted for two days. The participants’ skills were evaluated instantly and one month after the course by OSCE.

The pre-test mean score was not significantly different between two groups, but the mean scores of integrated method were significantly higher than conventional one regarding post-test (60.09 versus 48.23) and consistency test (51.16 versus 40.55)(P=0.0001 in both cases). The skill score difference between pre-test and post-test and the same difference in consistency test in integrated teaching was significantly higher than conventional method (P=0.0001 in both cases).

Our findings suggest that consistency in learning and a higher level of skills was observed in the integrated method. Hence, it is proposed to apply such methods in continuing education workshop to teach clinical skills.

AIDS is not only a health problem but also a socio-cultural challenge leading to economic problems. Since appropriate health behavior is the result of adequate knowledge and attitude, this study was performed on couples, referring to Kerman pre-marriage counseling center, to determine their knowledge and attitude towards AIDS and its related factors. In this cross-sectional study, 1020 couples participated. Data was collected using a questionnaire concerning demographic information, and including 22 questions about knowledge and 10 items about attitude. According to our findings, the couples’ knowledge level was excellent in 40.1%, good in 37.4%, moderate in 20% and poor in 2.6%. The attitude was excellent in 58.4%, good in 33.5%, moderate in 7.1% and poor in 1.1%. There was a significant relationships between knowledge and attitude with age, educational status and career using Chi-square test (P=0.0001 in all cases) in a way that those with higher educational levels, in age group between 16 to 35 years old and employees had better knowledge and more positive attitude. There was also a significant relationship between attitude and sex (P=0.0001); male participants showed more positive attitude compared with women. Among sources of knowledge, radio and TV were the most frequently mentioned ones (59.9%). Our results suggest that TV and radio are the most frequent information resources so improving their related educational programs according to addressed group is necessary. More attention to health education in schools accompanied with cooperation and supervision of health sector is recommended.

Nowadays, immigration of health care graduates is one of the most important challenges for which health care policy makers should try to find a solution. Hence, this study was conducted to determine the most significant contributors to immigration of graduates to foreign countries.

In this cross-sectional study conducted on the students of Iran University of Medical sciences, 407 students were selected using stratified sampling method. Data was collected using a questionnaire; its validity was already confirmed by experts and its internal consistency reliability was calculated by Chronbach’s alpha (r=0.89).

According to the study samples’ point of view, the highest scores were given to economic factors with the mean score (±SD) of 4.31 (±0.3) out of 5, while official and educational factors (X=4.29, SD=0.5), professional factors (X=4.04, SD=0.7), globalization (X=3.45, SD=0.68), social factors (X=3.33, SD=0.77), and cultural factors (X =3.26, SD=1.1) were in the next steps.

Our results suggest that policymakers should consider significant factors such as economic and educational ones to maintain expert health care workforce. In planning such strategies, one must focus on expanding educational and career opportunities. It is also recommended that Iranian health policymakers notice issues like oversaturation of job market in some especial fields.

The importance of considering general trainings of students and gaining updated knowledge together with curriculum overload and large volume of lessons especially in medicine necessitate presenting most of the students’ educational needs in form of short term courses. Hence, this study aimed to assess the participants’ point of view about the first national interdisciplinary summer school regarding achievement of educational objectives in Shiraz. In overall, 63 students from 13 universities of medical sciences participated in this course. The topics were divided into four major groups including medical education, medical ethics, management, ingenuity and creativity with their subgroups. They were discussed in 83 issues during 100 working hours using lectures and other active educational methods. According to the students’ point of view, the highest educational efficiency belonged to medical education and then, to ingenuity and creativity. More than 90% of executers mentioned that achieving educational objectives in each subgroup was very good or excellent. According to the evaluation, the mean score (±SD) of the program’s executers and lecturers was 18.97(±1.18) out of 20. Considering the effectiveness of this program, continuing such a program, allocating resources, and developing them should be noticed in all universities.