مجله ایرانی آموزش در علوم پزشکی
سال یازدهم شماره 8 (پیاپی 37، اسفند 1390)

Originality and dynamism of university activities calls for a democratic atmosphere and considered as a supporting principles for faculties. Giving autonomy to universities is a fundamental policy to enhance their responsibility, accountability, and dynamism. Hence, this study is an endeavor to investigate the autonomy and academic freedom situation in university from the viewpoints of faculty members. Study population included 550 faculty members in Shiraz University of Medical Sciences. According to Morgan tables, a sample size of 230 faculties was selected from different schools. Academic freedom, the effect of international policies, and university independence were measured through a researcher-designed questionnaire including 15 close questions in 4 points Likert scale. The score for each item was calculated out of 100. The questionnaire’s validity was verified by experts and the reliability was approved by Cronbach's Alpha (91%). The mean scores for main domains were: university’s autonomy (81.3±21.3), the effect of international policies (76.9±20.5), and academic freedom (73.3±21.6). Among the items, lack of university’s financial independence and its reliance to governmental budget (85.6), the effect of international politics on international academic associations (79.1), the effect of political attitude of university managers on academic atmosphere (76.9), continuous changes of programs after management changes (76.5) were factors which showed the highest mean scores respectively. Regarding the importance of academic freedom and autonomy in accountability and the growth of creativity and innovation in university, this subject should be considered more than ever. Besides, according to strategic management and planning and establishment of monitoring system and systematic accountability could prevent the redundancy resulted from political changes.

Evidence-based learning is an effective educational strategy.Assessment of nursing student’s viewpoints about this new method can be increase its application. This research was conducted to find out student’s experiences toward evidence-based learning in clinical setting. This qualitiative study was performed by grounded theory method in 1388. 18 nursing students were selected.Students were asked to use evidence for problem solving in pediatric internship and report the findings in the end of course. Data was collected by interview and was analyzed using Content analysis methods. Five main themes categorized in this research including experiences of thinking, self efficacy, integrating theory and practice,group intraction and problem solving. In attention to positive experience of evidence-based learning, intergrating of this method in clinical nursing education is recommended.

Educating Patients diagnosed with cancer about their disease and treatment is a vital component of their nursing care. Management of treatment side effects and maintaining the quality of life could be achievable only by adequate and organized self-care education. With regards to the importance of the concept of cost-effectiveness in health care providing system, this study aimed to assess the effects of patient education on the quality of life in patients receiving chemotherapy and also to compare these effects between individual patient education and group education methods. One hundred and two patients with breast, esophagus and stomach cancer referred to Chemotherapy Unit in Omid hospital were randomly assined to two groups: Group teaching and Individual teaching methods. Fifty-one received three individual teaching sessions. Three group teaching sessions were conducted for the other fifty-one patients. All subjects were interviewed by the same interviewer three times (before the first chemotherapy, second and third session) using EORTC QLQ-C30 quality-of-life questionnaire. The mean age of the two groups were 46/6± 3/9 and 48/7±1/32 in the individual and group teaching groups, respectivly. Using repeated measure test, we observed a significant difference in the quality of life scores over time between the two groups (p=0.02, F=3.7). However, this effect was only evident after the third chemotherapy course. Group teaching could maintain quality of life better than individual teaching over time. Health care providers could use these two methods interchangeably according to institute condition and the patient's needs and preferences.

A variety of standard setting methods are used worldwide for medical examination acceptance scores while standards of most exams in our country are pre-determined fixed scores which are set without any scientific methodolgy. The aim of this study is to determine minimum pass level for a pre-internship objective structured clinical examination using Angoff method in Tehran University of Medical Sciences. After designing the questions for examination, a panel of eleven faculty members was formed. These judges were asked to individually estimate the probability that a borderline student would pass each station. The mean of all stations estimated by judges was considered as the standard for the whole exam. This procedure was repeated twice more after sessions of discussion between judges and checking students’ real scores. The individual standard for the whole test was 49.15 while it turned to 49.90 after discussion and finally 51.52 after checking the real scores of students. The change of standard of the whole test after checking real scores was significant compared to individual standard (p=0.02). It showed no significant difference compared to the second standard. The rates of passing students according to the three standards were respectively 67.6%, 64.8% and 58.1% which showed a significant reduction in the third compared to the first one. Angoff method was used in this study to set standard for an OSCE. According to the findings of the study, it seems to be a credible and reliable procedure, especially when group discussion and reality check are used.

Due to the increasing development of science and technology in today’s world and updates in organizational factors, staff development becomes more essential. An educational program could be considered effective if it could appropriately change in participants’ knowledge and behavior. The aim of this study is to assess the training course of working with ECT (DC Shock device) for nurses based on the Kirkpatrick’s model.

This evaluation study is based on the Kirkpatrick’s model, in which the efficacy of training course of working with ECT to nurses is assessed. A volunteer sample of 160 nurses participated in the project with informed consent. The training course was evaluated concerning four areas including reaction, learning, behavior, and outcome; then the overall efficacy rate of the course was calculated. Data was collected through researcher- made questionnaires whose validity and reliability were confirmed in a pilot study. Data was analyzed by Student t-test.

The mean scores of participants’ reaction(first level in Kirkpatrick model) to the content, instructor and facilities were 4.3±.35, 4.8±.41, and 4.1±.27,out of 5, respectively. The desirability rates (mean scores) for the four levels were: reaction (4.4±.45), learning (4.35±.24), behavior (3.85±.18), and the impact (4.33±.18). The mean of overall desirability rate of this course was 4.16±.41.

The training course of working with ECT for nurses resulted in favorable outcomes in the three evaluated levels of reaction, learning and behavior, and was able to develop efficient changes in the impact level.

B> Medical ethics education is a key subject in medical occupations, as learning ethics is fundamental for their relationship with patients. Teachers are of the most important elements in medical ethics education, because they are one of the most important factors of forming the morality and the professional character in students. The aim of this study is to explain challenges and problems which threaten the medical ethics education. Fourteen medical ethics teachers of universities of medical sciences in Tehran took part in this qualitative content analysis study performed in year 2010. Data was collected through semi-structured interviews and analyzed via content analysis approach (Mayring method). The analysis of participants’ interviews led to the extraction of three themes as follows: 1)professional capability of medical ethics teachers; 2)medical ethics education using active teaching methods; and 3)the gap between teaching in theory and practice. Each of these themes includes several major and minor classifications, each describe a specific aspect of existing challenges in medical ethics teaching related to the teachers. Results indicate that medical educators in general and medical ethics teachers in particular, haven’t been efficient enough in moral development of students. Therefore, short-term professional teaching courses on medical ethics and active teaching methods are suggested to be held for all medical teachers. Besides, all medical teachers are recommended to be obliged to, as behavioral models, facilitate moral and professional development of their students in practice.

This research was performed to determine the University lecturers’ teaching styles at Iran University of Medical Sciences. The study could help introduce the importance of the faculty members’ knowledge on different teaching styles and its promotion and also to focus on the importance of using appropriate teaching styles. In this descriptive cross-sectional study, all non-clinical faculty members at Iran University of Medical Sciences completed a translated and self-administrated teaching style inventory with a four-point Likert scale in the second semester of the academic year 2010. The data was analyzed using descriptive and Chi2 test and according to the questionnaire guidelines. The majority of the faculty members preferred to present concepts as applied and also encouraged deep learning, cooperative learning, and cognitive processing. Also, there was no significant relationship between teaching styles and their school type, teaching experience, and academic rank. According to the results of the study, and faculty preferences on teaching styles, it is recommended that more attention is paid to the teaching-learning interactions, in terms of accommodation of teaching styles to students’ learning styles.

There are various ways such as confidence-based exams to eliminate lucky guesses on a multiple choice question test. In this study the relation between students’ gender and their score on selecting confidence choices in confidence based exams was assessed. This was a descriptive retrospective study. It was done on all of the medical students taking Biochemistry course during 2007-2010 in Kurdistan University of Medical Sciences. Data was extracted from files of end-semester confidence based course exams. Finally, the data were analyzed using SPSS and the specified software for confidence-based exam analysis. Mean of the student's confidence level was higher in female students than male ones. Comparisons of confidence level mean in both genders were different and this difference was significant (p=0.047). Results of this study showed that female students answer to confidence based questions with higher confidence than male ones, and this can be because of the different psychological characteristics of the genders.

Although the majority of student assessments in medical sciences relates to their clinical competencies, adopting an assessment method which fulfills students’ satisfaction has always been a great challenge. In recent years logbooks have been used in the clinical evaluation of midwifery students in Mashhad University of Medical Sciences. So, the present study determines student's satisfaction with this approach. This descriptive, cross-sectional study was conducted on all 34 eligible midwifery students in school of nursing and midwifery of Mashhad University of Medical Sciences. Data gathering tool was a researcher–constructed questionnaire with confirmed validity and reliability. The questionnaire included 23 items covering nine domains and used Likert scale. Data were analyzed through descriptive statistical indices as well as T test, correlation and multiple regression analysis. The mean score for student's satisfaction with logbook was 62.7 ±15.5 (of 100). The lowest satisfaction score was related to the domain of "interest in logbook method" (57.8 ±24.5) and the highest one was "conformity to educational goals" (71.1 ±14.9) (of 100). Most of the students agreed that logbook is fair (55.9%), objective (64.7%) and in conformity with educational goals (61.8%). However, only 44.1% of them were interested in using this method. Overall, 38.3% of the students were satisfied with logbook and 26.5% were dissatisfied and the rest were in between. Most of the students were satisfied with logbook, but less than half of them were interested in utilizing it. This could be due to insufficient ability of logbook in assessment and promoting of clinical skills from the student's view point. Thus, we may improve the student's satisfaction level by revising logbook and combining it with some other methods of clinical evaluation in order to cover its weak aspects according to student's views.

Despite numerous benefits of physical activity during pregnancy, it's not common in women, probably due to knowledge deficiency. This study aimed to assess the effect of Trance Theoretical Model (TTM) on physical activity in pregnant women. In a quasi-experimental study, 100 women referred to Dehaghan health centers in year 2010 were randomly assigned to control and experiment groups. Intervention included training about physical activity, benefits and perceived barriers during pregnancy, in the form of discussion, lecture and showing films during five one hour sessions. The data gathering tool was a researcher made questionnaire based on the standard questionnaire for physical activities during pregnancy and TTM. The samples in both groups answered the questions before and after the intervention. Data analysis was done using descriptive indices and inferential statistical tests (Chi2 and t test). After the intervention, the experiment group showed a significant progress in preparation stages for physical activity, as the ratio of women in the preparation stage raised from 6% to 26% (P<0.001). Mean scores of perceived benefits of physical activity was significantly increased from 76.8±10.88 to 84.7±1.09 after training (P<0.001). Also the performance score of experiment group improved significantly (P<0.001) from. 21±.14 to 2.6±1.2. These results support the application of TTM for physical activity intervention and indicate that the procedure was very effective in improving attitude and encouraging women to exercise more during pregnancy.

Considering the effect of the attributional pattern on the individual's behavior and feelings, nursing instructors should alter undesirable attributions that make students irresponsible toward learning activities. The current study was aimed to investigate the effect of attribution training on the attributional pattern among nursing students of Islamic Azad University-Birjand Branch in the academic year 2009-2010. In this quasi-experimental study, 187 nursing students in Birjand branch of Islamic Azad University were randomly assigned to control (n=93) and experimental (n=94) groups. At the beginning, using Julian Rotter’s locus of control Scale, participant's attributional patterns were evaluated. The experimental group received an attribution training program. Then, at the end of study, the student's attributional patterns were again reassessed. Data were analyzed using independent T, paired T, and McNemar's tests. At the beginning of study, the mean attribution score showed an external locus of control pattern in both groups. At the end of the intervention, the mean attribution score of experimental group had decreased significantly (from 9.88±1.89 to 8.76±1.93), which indicated acquisition of an internal locus of control pattern among the experimental group. There was not significant change in the mean attribution score in the control group. There was a significant difference between the mean of score changes in the two groups. That is, the experimental group acquired a more internal locus of control pattern than the control group. It seems that attributional training could be considered for nursing students at the beginning of their admission to the university.

Lifelong learning is a process in which individuals develop their knowledge, skills, and interest through learning opportunities in their life. This paper aimed to determine the required competencies for training medical students to acquire lifelong learning. In this qualitative study, purposeful sampling method and open-ended semi-structured interview were employed for data gathering. A population of 21 experts and teachers were interviewed. Data was analyzed using content analysis based on Krippendorff's approach. Member check and external observer methods were used for data credibility and authentication. Based on the results of the study, 5 themes were emerged: “Knowledge and attitude towards dynamicity of science and medical sciences”, “Self directed learning”, “Evidence based medicine skill”, “Communication skills”, “Integrative and inter-professional learning skills”. With regard to the functionality and necessity of life-long learning in medical profession, curriculum developers could enjoy the outcome of the study to review the curriculum and equip their students with essential qualifications and finally train lifelong learners in medicine.

Measuring the quality of life among menopause women is one of the efficiency proofs in health education; hence, this study was conducted to determine the effect of structured educational program by support group on quality of life among menopause women.

In a single blind field study from August to December 2011 in Saadatmandy health care center of Robat Karim town, 110 menopause women meeting inclusion criteria were selected through convenience sampling method. After taking the consent form, they were randomly allocated to either of the control or support group (55 subjects in each group). The support group was divided into 6 groups (5 groups of 9 and a group of 10 subjects). The educational program was performed in predetermined days of the week and for 10 consecutive sessions of 120 minutes.The scores for quality of life level achieved before the educational program and a month after that were compared using Menopause specific quality of life questionnaire (MENQOL). No intervention was done in control group.

The execution of structured educational program by support group in intervention group indicated a statistically significant difference in quality of life level among menopause women (reduction of symptoms from 153.76±38.61 to 113.31±24.35, P<0.001). No significant change was found in quality of life scores achieved by control group.

Structured educational program by support group could be used as an appropriate strategy which helps menopause women to promote their health and encounter with menopause symptoms in a healthier manner and in conclusion promote their quality of life. This educational program could be applied in health intervention and health care programs in our country.

The rapid expansion of e-learning elucidates the necessity of paying attention to this phenomenon by all educational centres especially medicals. Considering the importance of this subject and regarding the commencement of new courses in our country as well as the establishment of higher education disciplines, this paper aimed to review the structured analysis of requirements, challenges, problems, and barriers in the application of e-learning in education and thus provide a model and guide for choosing, designing, and implementing an electronic course.

Theoretically viewing, this is a review study. Researcher selected and studied total 100 articles (literature review and original research articles published from 2003 and afterwards) out of 4700 Articles found from databases of ERIC, ACM, GUIDE Association, Digital Learning, OECDT, and Becta, using search engines of Google and Yahoo. The keywords used in this search were “requirements, challenges and e-learning”. Then the findings were combined with results of an experimental study by the researcher extracted from a satisfaction questionnaire, and finally analyzed.

After discussion and summing up the reports and opinions of experts regarding the requirements and challenges of setting up an e-learning system, main factors and infrastructures were summarized in the following domains: 1) IT, 2) human resources, 3) pedagogical, 4) cultural, social and values, 5) economic, 6) management, and 7) administrative and supportive. Then a fundamental approach for the stages of analysis, design, implementation, and evaluation of an electronic course was proposed.

The spectrum of requirements and challenges of e-learning in our country is so extensive, as it includes: changes in traditional perspectives to creation of cultural, communicative, and hardware infrastructures, formal and public policymaking, legislation and creating legal platforms in education systems, creation of an e-learning management system, development of the fields for content production based on international standards, and privatization for the production of local e-content. Presentiation of an executive model considering the above-mentioned findings could help the managers and decision makers for a successful implementation and further efficacy of this approach.

Alteration and adjustment of nursing care system in 21st century depends on its success in designing the nursing pedagogical models. This study was conducted in order to identify and explain the challenges in postgraduate (MSc) levels in nursing and to represent appropriate solutions. This qualitative study was conducted in Tabriz University of Medical Sciences in two phases. The existing challaenges were identified through "Focus Group Discussion" method in phase one and for the second, "Delphi Technique" was utilized to prove the challenges and represent the solutions. Sixteen MSc students participated in phase one and thirty panel members including nursing managers of teaching hospitals, faculty members and executive staff of nursing school, and eight MSc students and PhD candidates attended in phase two. FGD data analysis was done through content analysis by conventional approach. For phase two through Delphi Technique, consensus has been gained on final options after three rounds. This study identified post graduate (MSc level) challenges including 1)Cultural and professional identity, 2)Work atmosphere and 3)Imbalance between theory, research and clinical practice. The most important solutions to these challenges were respectively as follows: “to adopt strategies to improve the nursing image”, “to specify determined positions for postgraduates of MSc and to define their duties”, and “to specialize nursing education in MSc degree and upper levels as well as representing new disciplines such as intensive nursing and cardiovascular nursing”. Challenges identified through FGD, were proved via Delphi Technique. The offered solutions were also supported by review of literature. The information derived from this study could be used as a base for further investigations in the application of these solutions.