مجله ایرانی آموزش در علوم پزشکی
سال دوازدهم شماره 5 (پیاپی 43، امرداد 1391)

The effective relationship of physicians with patients has a significant role in effective treatment, reduces stress and establishes satisfaction in the patient. It was shown that many doctors fail to communicate with patients effectively. The aim of present research was designing, implementing, and evaluating the effect of training on improving the communication skills with patients in medical interns of Arak University of Medical Sciences based on the WHO pattern. This interventional research was done on 74 interns of Arak University of Medical Sciences in 2010. Communication skills of the subjects were directly observed and documented through using a checklist prepared according to basic communication skills developed by WHO. Validity and reliability of the checklist were confirmed. Then through role –playing, the subjects learned how to communicate effectively with patients. After training, their communication skills were checked again.. The data were analyzed using descriptive statistics and t test. The average score on communication skills before training and after it were 2.53±.47 and 3.25±. 34 respectively, which showed a significant difference (P=0.00, t=10.3). The average scores on interpersonal communication skills & skill of obtaining information from & giving information to patients before and after education were 2.62± 0.47& 3.29± 0.37,2.74±0.47 & 3.24±0.3, and 2.42±0.39 & 3.24± 0.3 respectively. The average score on presenting information before and after training were 2.24±0.39 and 3.24 ± 0.3 and on educating patients 2.33 ± 0.52 3.15 ± 0.38, which indicated a significant difference between the scores before and after training(, p = 0/00).There was no significant difference between the scores of males and females(, p = 0/00). Interns’ scores were improved by training, significantly. It is recommended the medical curriculum be revised and some theoretical and practical courses relevant to communication skills accompanied by applying effective methods in teaching communication skills be planned for.

Clinical education is the duty of academic and clinical organizations and its effectiveness is influenced by the interaction of both organizations. Since the commencement of nursing profession, this interaction has experienced different paradigms. This paper is an endeavor for identification and critical analysis of these paradigms as well as the current trends of the interactions between educational and clinical institutions. Exploration of these patterns and their advantages and disadvantages could help the administrators of educational and clinical institutions in designation and choice of appropriate relationship paradigms. For this narrative review, an electronic search within three phases was performed in January 2008 to retrieve studies published from 1990 to 2008 through these databases: ISI Web of Science, Medline, CINAHL, ERIC, and BNI. The key terms were clinical education, clinical practice models, clinical education model, models of shared learning in clinical practice, and partnership between university and clinical institutions. These articles were studied several times to identify and derive the type of communicational paradigm, significant characteristics, manners of communication, advantages, and disadvantages. Four paradigms of communication between educational and clinical institutions in nursing profession were identified. These included service-orientation, organizational independence, shared models of clinical education, and intra-organizational partnership paradigm. A developing trend can be identified which is influenced by factors such as professional progress in nursing and changes in community expectations. The need for professionalism and expanding the body of knowledge in nursing makes it necessary to maintain nursing schools. The trend of communication paradigms is toward the establishment of partnership between these two independent organizations.

A number of studies have been conducted on evidence-based care and factors affecting it; however, this concept has not been explored, in Iran. This study was conducted to investigate the perceptions and experiences of nurses and nurse educators about evidence-based education and factors affecting it. The study was conducted using grounded theory method during 2009-10. The research question was: “which perceptions do the nurses and nurse educators have about the concept of evidence-based education, and what factors do they perceive to affect it?”. The study population was the nurses and nurse educators in kashan university of medical sciences. Purposive sampling and semi-structured interviews were applied to gather the data. In total, four nurse educators and 16 nurses were interviewed. Data analysis was conducted using Strauss method in three levels of open, axial and selective coding. The participants defined evidence-based education as “education based on community and students’ needs and on reliable scientific findings”. According to the participants, textbooks, researches, students’ needs, the science of teaching, the experiences and contextual information of nurse educators are the instances of evidence. They believed that variables of "discipline", "educational content", “teaching methods”, " educators’ knowledge and experiences”, "role models" and " clinical environment" have effects on evidence-based education. According to the participants’ experiences, evidence-based education is based on community and students’ needs and on reliable scientific findings. They believed that several variables affect evidence-based education, but the clinical environment, influences other variables. Improving clinical environment can facilitate evidence-based education in nursing.

Patient rights include the duties that medical team has towards him and the total privileges, abilities or special permissions granted to patients by law. The aim of this study was to assess Qom University of Medical Sciences students’ awareness about patients’ rights. This descriptive and analytical study was performed in 2010. Subjects included 192 medical sciences students (33 medical, 72 nursing, 48 operating room, and 39 anesthesiology students. Data were collected using a questionnaire containing 40 questions in two sections, demographic characteristics and the patient’s bill of Rights. Descriptive statistics and Chi2 test was used for data analysis. The highest knowledge score was about ''the patient's right to know about their treatment'' with 91% of the students showing complete knowledge about it, and the minimum knowledge score was related to ''the patient's right to know about their discharge time''. Only 51% of the students were aware of it. Students’ awareness in most areas of patient bill of rights was not enough, which can eventually impair the observance of patient rights by medical students and patients’ dissatisfaction.

Studies show that metacognitive awareness is necessary for students’ academic achievement. Some factors affect the development of this awareness. The aim of this study is to assess the effect of teaching metacognitive strategies on metacognitive awareness of students of school of health in Kermanshah University of Medical Sciences. This quasi-experimental study was performed on case and control groups and evaluated them by post-test. Study population included 300 students of school of health at Kermanshah University of Medical Sciences in 2011. A sample of 70 students (35 in experiment and 35 in control group) were selected by systematic randomization. Experiment group received education on metacognitive strategies while control group did not. Then, metacognitive awareness of both groups was evaluated by standard questionnaire of Metacognitive Awareness Inventory (MAI). Data was analyzed using t-test. Findings showed that the mean score of students in experiment group (209.06±24.01) was significantly higher than that of control group (173.03±18.01) and (p=.001). This difference was significant considering the two factors of metacognitive knowledge and regulation (p=.001). Moreover, the mean score of male students regarding metacognitive knowledge and regulation was significantly more than mean score of female students. However this difference was not significant among students of different disciplines. With regard to the positive impact of teaching metacognitive strategies on metacognitive knowledge and its significance in academic achievement, it is recommended to provide students with education of metacognitive strategies.

There are few studies that compare electronic learning in continuing medical education using instructional material developed based on scientific principles of instructional and motivational designs. Therefore, this study was performed in Kermanshah University of Medical Science in 2011 in order to compare physicians’ learning and motivation in these two instructional approaches.

In this quasi-experimental study 60 general physicians and medical residents were selected by convenience sampling method. E-learning content development in control group (n=30) was based on instructional design models and in the experimental group (n=30) was based on the integration of instructional design and motivational design models by Macromedia Flash software. In this study, three questionnaires of demographic information (with 8 items), learning outcomes (with 20 questions) and motivation level (with 48 items) were used. The data were collected by pretest and posttest both containing similar questions and the physician’ motivation questionnaire. Statistical analysis was performed by Levene’s test, independent and paired sample T tests and chi square test.

Based on the findings, there was no significant difference between pretest scores of the two groups (11.37±1.19 vs. 11.73±0.69) but there was a significant difference between posttest learning scores (15.63±1.38 vs. 17.53±0.94); and motivation of physicians (143.83±5.45 vs. 160.63±22.41) in both groups (p<.05).

The physicians’ learning and motivation were different in these two instructional methods; therefore, it is recommended that instructional and motivational design be used in future electronic continuing medical education programs

The rapid development of science and technology has endowed a fresh significance to continuing education as its necessity has become undeniable. Considering the significance of keeping physicians’ knowledge up-to-date and their limited free time to participate in their classes on the other hand, e-learning could be a useful option to train these people. The main objective of this study is to identify main factors which deter these physicians to participate in e-learning courses of continuing medical education in Mashhad University of Medical Sciences. This descriptive cross-sectional study was performed during summer 2011 in Mashhad University of Medical Sciences. Study population included 378 physicians subject to continuing medical education which were selected through stratified sampling method. Data gathering tool was a reliable and valid questionnaire made by researcher. Descriptive and inferential statistics were used for data analysis. Considering the weighted mean achieved, contextual issues (2.71±.63) showed the highest and personal issues (2.15±.70) and attitudinal issues (1.98±.64)(out of 4) showed the lowest deterrence rate respectively. Personal concerns of individuals formerly participated in e-learning courses were lower than that of individuals who didn’t participate beforehand (p<0.01, F=6.51). The scores attributed to each of these three fields of personal, contextual, and attitudinal problems to attend e-learning courses were higher for men compared to woman (f=86.1, p<0.01). Contextual problems were the most important deterring factor among community of continuing medical education to participate in e-learning courses.

Evaluation of educational objectives achievement is one of the most important jobs by medical universities. Therefore the aim of this study is to evaluate educational goal achievements of operative dentistry department from the viewpoints of general dentists graduated from dental school of Hamadan University of Medical Sciences during 2004-2009 years. Also their viewpoints about preclinical and clinical courses were surveyed.

In this descriptive cross-sectional study, a questionnaire was sent to all dentists graduated during the years 2004 to 2009 from dental school of Hamadan University of Medical Sciences. This researcher made questionnaire encompassed multiple choice questions to evaluate theoretical knowledge of graduates and opinion poll about preclinical and clinical courses. Data was analyzed using Fisher's exact test.

Achievement of general goals was desirable in 16.3%, almost desirable in 83%, and poor in 0.7% of dentists. The impact of preclinical courses on operative skills of dentists was considered desirable by 16.72%, and almost desirable by 83.2 percent. The effect of clinical courses on operative skills of dentistry was considered desirable by 21.94% of graduates, almost desirable by 61.87%, and poor in 16.18% of them. Achievement of educational objectives of operative dentistry showed a significant correlation with sex, age, admission allotment, marital status, interest, and graduation year (p<.05).

This study showed that the educational objective achievement of operative dentistry department of dental school of Hamedan University of Medical Sciences enjoys a good status.