Journal of Medical Education
Volume:12 Issue: 1, Feb- May 2008

Background and Available data indicate the quality of doctor-patient communication has a significant impact on patient satisfaction, medical outcomes, medical costs, and the likelihood of a physician experiencing a malpractice claim. Assessment of communication skills is a very important issue. Since a good assessment can show strengths and weaknesses of this process and feedback can improve the behavior, this study was designed to measure communication skill of last year medical students (interns) in Jahrom medical school by an observational checklist. This study is a cross sectional study to access communication skills of interns of Jahrom medical school in southeast Iran, a checklist was designed for this purpose. Checklist completed with direct observation by an educated general practitioner. The researcher observed the interns in Motahari and Peymanie,(2 teaching hospitals of Jahrom medical school).The interns ignored about checklist material to prevent observational bias. Findings were analyzed using SPSS software. 32(55%)of medical interns were female and 26(45%) were male. under category of interview conduction the best results was due to acceptable appearance of interns that 48 interns(82.8%)had acceptable appearance. nearly half of the interns didn’t say hello to patients and great them. none of the interns introduce themselves to patients.. Under category of interview conduction the best results was due to responding properly to patient questions. Under category of interview completion the results showed that the behavior of interns in this part was not acceptable and this part of communication was the worst part. The results of our study reflect that it is necessary to introduce a sustained, coherent and integrated communication skill training program into the medical curriculum.

Background and The quality of educational environment as the spirit of curriculum has frequently been identified as crucial to effective learning. This study measures the educational environment in 4 major clinical wards at university affiliated teaching hospitals by using DREEM (Dundee Ready Education environment measure) model, and explored the opinions of medical staffs.This is a cross sectional study, using DREEM Questionnaire that is modified by national culture in 3 subscales including: perception of learning, perception of course organizers and perception of Atmosphere. Four major wards of General surgery, Pediatrics, Obstetrics- Gynecology and Internal Medicine in 4 different hospitals affiliated to the university was chosen. 53 medical staffs responded the Questionnaire by simple Random Sampling. Data analyzed by SPSS software and tests have done with 5% Alpha error. (Pilot study was done on 10 persons). ‘Total scores of surgical wards (surgery and obstetrics-Gynecology) were significantly lower than non -surgical wards (pediatrics and internal medicine) (PV=0.015).The overall mean score of modified DREEM questionnaire 119/140 (82.8%, 95% CI 78.8% to 88%). The mean score in 3 main subscales showed no significant difference in terms of gender and hospitals. Significant difference was observed in the subscale perception of Atmosphere. Pediatric ward got the best score and internal medical ward got the least score.(PV = 0.027) The overall educational environment score of major clinical wards for undergraduate is excellent. Internal medicine ward got the least score in all three subscales that needs serious reform in teaching- learning activities. A curricular change seems mandatory.

Students have individual learning style preferences including visual (V; learning from graphs, charts, and flow diagrams), auditory (A; learning from speech), read-write(R; learning from reading and writing), and kinesthetic (K; learning from touch, hearing, smell, taste, and sight). These preferences can be assessed using the VARK questionnaire. We aimed to assess different learning styles of medical students in our collage. This study was conducted to describe learning styles of 214 Medical and Midwifery students in Mashhad University of medical sciences. By using the English version of the VARK questionnaire, we measured the difference in learning styles of medical students and midwifery students and compared with 57336 global general students who completed the test in VARK website up to Sep 2007. The dominant learning preference of our students was Aural preference (30.8%) followed by Read/Write (20.6%), while (7.5%) were in Kinesthetic and (5.6%) were Visual learners; still most of the students (35.5%) represented a multimodal learning preference. No significant difference was found between males and females. The general pattern between medical student and Midwifery student is the same. There was a significant relation between Internship Entrance Exam score and the learning styles of medical student and who were more Read/Write got higher scores. Knowing that our students have different preferred learning modes will help medical instructors in our faculty develop appropriate learning approaches and explore opportunities so that they will be able to make the educational experience more productive.

Background One of the prominent sources of needs assessment is a survey of complaints and medical errors. This study aimed at determining the number and reasons of patients’ complaints against physicians during five years in Fars province, Iran. After required correspondence and coordination with the head of Fars Medical Council, a questionnaire was prepared. As suggested by the head of medical council and also due to the secrecy of the data, two employees of medical council cooperated in collecting the data. Then the collected data were categorized and analyzed, using SPSS statistical package. The results revealed that 368 complaints have been made during five years against public hospitals, private hospitals, private offices and clinics, respectively. Most of these complaints have been made against dentists, gynecologists, ophthalmologists, orthopedists and general surgeons respectively. Based on the content analysis of the complaints, 33 cases (9%) have been related to death, 56 cases (15%) disability and 50% misunderstanding and lack of good relationship. In 95cases (26%), the physicians have been faulty from which 59 cases (16%) have been settled by arbitration. In 177cases (48%), physicians have not been faulty. Some cases have been closed due to the passage of time and request for stopping the claims. The results of this study indicate that the majority of the complaints have been made due to a lack of proper relationship between physicians and patients, mostly related to behavioral problems. Considering the fact that one’s behavior reveals his/her attitude, there is a severe deficiency in medical education with regard to affective and attitudes domain of objectives. To solve this problem, the experts, specialists and ethics experts’ contribution is called for so that by establishing a medical curriculum committee, this aspect of medical education can be integrated in the program.

Background and Internship, undergraduate clerkships, is the last stage of training for medical students in Iran during which they work as medical doctors under supervision of academic staff for 1.5 years. We assessed the validity of students’ scores in internship in one of the paramount medical universities in Iran. In an historical cohort study, we collected the medical students’ scores in four consecutive cohorts based on their entrance year to the medical school. We checked the validity of these scores and their internal consistencies by computing the Cronbach’s alpha, and also using the discrimination index. The Cronbach’s alpha of scores in the internship courses was lower than that in the other courses (0.72). In addition, the internship courses had the lowest discrimination index. Overall, female and younger students were more successful in their studies. Although internship is one of the most important parts of medical education, it seems that the validity of students’ scores during this phase was lower than that of other courses. These findings necessitate more work to document the predictive validity of internship evaluations by correlating them with future clinical performance.

Background and Cardiopulmonary resuscitation (CPR) training for undergraduate medical students has been noted to be poor in the past. Attempts have been made The aim of this study is to determine effect of CPR training in the anesthetic ward to improve knowledge and practice undergraduate medical student of CPR. A 12 month Educational experimental study with self control was done on all undergraduate medical student (n=30) at the medical university of Ardabil in 2006-2007. During I month of program all this students have undergone CPR training including basic life support (BLS), advanced cardiac life support (ACLS) and practical skills. Data were collected via questionnaire, demographic, pre/post knowledge and practice. After training the acceptable score (good and very good) about knowledge of BLS, ACLS and practical skill significantly increased %6.7 to %50 (p=0.0001), %13.3 to %53.4 (p=0.001) and %3.3 to %100 (p=0.001) respectively. A significant relationship between knowledge of ACLS and practical skills was shown (p=0.005). The CPR training course in anesthetic ward leads to a significant increased in skills and knowledge. Adding this course to undergraduate curriculum of medical students especially in operatically wards (e.g. Anesthetic ward) is essential.

Background and More attention to clinical skill training is essential for better medical education. In this study, the sources students used for learning these skills are investigated In this cross-sectional study all medical students who at least passed 6 month of their clinical rotations and all interns participated. A questionnaire was used to collect the data which includes items on demographic data and items about the setting and sources of learning procedural skills. The questionnaires were developed based on a review of clinical skill training in Shahid Beheshti Tabriz, Tehran, Isfahan, and Kerman Universities of Medical Sciences. The questionnaire was examined for content validity by a panel of experts including 6 faculty members. For assessing the reliability of the questionnaire, a test-retest procedure on 10 students was conducted with an r = 0.85.To analyse the data we used SPSS ver. 16 and to examine the significance of findings we used a t-test and chi-square test. In this study 90 medical students and interns participated of all participants, 49 were interns; 45.6% were male. The interns were more likely to learn the more common procedures including intravenous blood sampling intramuscular injection, subcutaneous injection, urinary catheter placement, naso gastric tube placement, wound dressing and care, stitching, splinting from hospital staff and 25% of interns had no learning source for more advanced procedure such as intubation and CPR while only 20% of them learned these skills from specialist. It seems that more faculty members involvement with students’ skill training and promoting more effective use of skill labs potential can improve the clinical skill training of medical graduates.

Background and roles and tasks of intended graduates direct medical eductionist for developing the right curriculum. In Iran there has been no systematic study on defining GPs roles. This study is an attempt to systematically clarify the roles of GPs in Iran. In this questionnaire – based survey the directors of Education development centers, deans of medical schools, and directors of research of University of Medical Sciences Participated. The subjects were selected through stratified sampling procedure. A questionnaire was developed which covered the goals and functions of health system as mentioned in World Health Report 2000. For content validity a panel of experts including health care professionals, biostatisticians, and psychometrist evaluated the questionnaire. For the reliability of the questionnaire a pilot study was carried out. Chronbach’s ás were calculated as 0.91 for current state, 0.92 for ideal state and 0.89 for both part as a whole.The final revision of the questionnaire included 15 roles in current and ideal states. The respondent should score each role in both states in a range of 0-100. Of 91 subjects who received the questionnaire, 71 (78%) completed and returned it. Of all subjects 16% were female and 84 were male. All subjects were faculty members. The subjects believe that in the current state “health care provision” (78.3±24.1) “health center administration” (42.3±21.4), and “leading clinical services and coordinating patients care” (29.4±22.6) are more evident while “fund holding” is rather non-existence (1.7±4.6). They believed that in an ideal national health system physicians should play most of these roles in various extents. The participants believed that GPs should play other roles beyond the clinical care provision to enable health system respond to community needs and expectations. The graduate medical degree should be reformed if the gradates are going to play these new roles.