مجله مرکز مطالعات و توسعه آموزش علوم پزشکی یزد
سال هشتم شماره 4 (زمستان 1392)

Clinical instruction is known as the essence of education in medical sciences, while feedback delivery is a core responsibility of clinical instructors. This study aims to compare the nursing student's satisfaction and reactions to oral versus written feedback during clinical education. This is a single blinde, randomized controlled trial. A purposive sample of last semester-nursing students (n=44) was selected and randomly assigned into one of verbal or written feedback groups. Each instructor (n=3) was scheduled to teach two groups, and deliver either verbal or written feedback. Instructors were well attuned to feedback delivery sessions they would hold during their instructional tasks. Instructors were asked to give necessary feedback to the students and document the details of their reaction using the checklists designed for this purpose during the instruction period, daily and during the nine days of instruction. At the end of each instruction period, a questionnaire designed to measure the satisfaction level of feedback delivery sessions was filled out by students. The study did not show difference of satisfaction level between the oral and written feedback groups. The relationship between student's reactions and feedback type at the confidence level of 90% was significant, so that students who received oral feedback showed more severe reactions as compared to written feedback group. Students, satisfaction level in both groups was the same. There is no difference in student's satisfaction between verbal versus written feedback groups. But the number of severe negative reactions in verbal feedback group was significantly higher and this is congruent with previous studies.

Training evaluation is an integral part of the education systems which helps managers making better decisions about curriculums. This study aims to investigate effectiveness of a workshop on evaluating health promotion programs which was held for health staffs of Shahid Sadoughi University of Medical Sciences. In this quasi experimental study a workshop on “Evaluating Health Promotion Programs” was evaluated based on Kirkpatrick's model. Data were collected through a self administered researcher designed questionnaire. Data were analyzed by appropriate statistical methods using SPSS V.19. Mean satisfaction of teaching method and workshop conditions were 38.97±7.89 and 45.67±5.62 respectively. Increasing knowledge had positive correlation with participant's satisfaction of teaching method (r=0.684, P=0.007). Participant's evaluation score about attending in the workshop (18.47±2.67) were positively correlated to workshop Environmental and Managerial conditions (r=0.545, P=0.019). 89.5 % of participants reported that they are willing to evaluate their health promotion programs in the future. For such workshops, teacher's selection teaching methods and workshop conditions should be considered. When using Kirkpatrick model, not only the descriptive results should be reported, but also it is important to report other analytical findings in order to achieve better results.

Physicians have a fundamental role in the health system. Therefore, investigation of different medical education approaches would have a major impact on improving the quality of education. The aim of this study was investigating the performance of community-based education center of Kermanshah from the viewpoint of medical interns. In this cross sectional analytic study, medical interns who were trained in community-oriented education center (n=175) over one month were enrolled and completed the researcher built questionnaire. Alpha reliability was 0.88 and its content validity was confirmed by the approval of five faculty members who were expert in the field of education. Data was analyzed by SPSS software and using of descriptive statistics, ANOVA and Friedman tests. Based on the viewpoint of our participants, community oriented education were desirable compare to education in hospital in terms of quality of education (42/4%), experienced of practical tips (48/3%), observing different cases (57/2%), preventive medicine education (55/6%)and time for communicating about patient (74%). Among reasons of difference between training in the COME center compare to teaching hospitals, "possibility of learning of practical tips" was considered more important than other reasons (P<0.05). In this study, most participants have evaluated the training performance of the COME center as good and also more useful compared to training in teaching hospitals. Reinforcing of COME centers could be a priority in making future educational policies.

Educational-research environment and social factors of internal factors of universityinfluencingtheacademicself-efficacyresearchstudents.The purpose of this study was to investigate the role of educational - research environment andsocial factor on the research self-efficacy of students of Mashhad University of Medical sciences. This is across sectional analytic study. Subjects were all of students of Faculties of Nursing and Midwifery, Pharmacy, Dentistry and Medicine. One hundred and eighty five students participated in this study who were selected according to the stratified sampling method. In this study, three questionnaires were used to collect information:1) educational - research environment, 2) social factor of university and 3) research self-efficacy. There was a significant positive relationship between educational - research environment, social factors of university and its components, with research self-efficacy of students (P<0.01). Research self-efficacy is predictable through educational- research environment, social factors of university and its components. The resultsshowedthat the situationis notdesirable for conducting research.Also in terms ofthe total scale of research, self –efficacy, there was no significantdifferencebetweenmale and female students (P= 0.54).Multivariateanalysis showed that between male andfemale students, research self-efficacyOnly in sub- component of self-efficacy in skills P<0.01. The research self-efficacy status of students is not suitable, thus, according to the results of this research to improve the educational -research environment andsocial factors of internal factors to enhance ' self-study of students is suggested.

Students need acquiring self-directed learning readiness in order to enable to keep up to date their knowledge and professional competence after leaving the university. The aim of this study was to determine the capacity of current medical education system to create self-directed learning readiness for students. In this cross-sectional study، self-directed learning readiness of 473 students of Rafsanjan University of Medical Sciences was surveyed by Fisher’s questionnaire. The total score above 105 indicated high، 60-105 moderate and less than 60 low level of self-directed learning readiness. Data was analyzed using SPSS software، correlation and simultaneous multiple regressions analysis was used. The mean and standard deviation of student’s self-directed learning readiness score was 17. 17 ±55. 83 with a minimum of 40 and maximum of 137. About 11% of students were in low، 80. 1% in the moderate and 8. 9% were in high level. There was no statistically significant correlation among students'' self directed learning readiness score and demographic characteristics and academic achievement. Medical universities should lead students toward acquiring self directed learning readiness by student-centered approaches.

Teaching and learning are the most important factors affecting education. Different style of teaching have been used in different countries. This study aimed to compare the effect of lecture-based method versus group discussion method on the perception of achievement and satisfaction of pre-university students in Neka and Behshahr during 2010-2011 semesters. This was a quasi-experimental study. A questionnaire was developed to pre-test and post-test the perception of satisfaction and achievements of the participants in lecture-based teaching arm (n=138) and group discussion teaching arm (n=144). Overall، 282 participants were randomly selected from the pre-university students studying in Neka and Behshahr. To assess validity and reliability of the questionnaires، test retest method and Cronbach alfa was measured (α=0. 75) There was a significant difference between the two methods. It was found that students were more satisfied with the lecture-based teaching method and their achievements were higher. Given the current university entrance exam is centralized and that there is limited infrastructure for group based learning is available، students perceived the lecture based method more satisfying. Concerning the content of the text books and existing evaluation system in pre-university level، it is suggested that policy makers consider the underlying causes of this preference which should be، according to the literature، the other way around.

Multiple choice questions (MCQs) are widely used to assess medical residents. The study aims to analyse MCQ exams of medical residents administered at Kermanshah University of Medical Sciences during 2008-2012. Data of this retrospective study were extracted from 63 MCQ exams including 9600 tests. Quantity related variables included; discrimination index، difficulty level، reliability of test index (KR20). Quality related variables included; proportion of questions without structural defect and proportion of taxonomy 1، 2 and 3 questions. Data were collected using MCQs from question bank and analyzed by SPSS V. 16 software. Over the specified five years، the average difficulty level was %0. 62، the average discrimination index was 0. 27 and the average of reliability coefficient (KR20) in total exams was 0. 88. The average of questions in Taxonomy 1 over the specified years was 33. 5% and questions with taxonomy 2 and 3 were66. 5%. The average of questions without structural defect was 62. 6% which fell in the unacceptable range. A significant difference was observed in reliability coefficient (KR20) - (P=0. 017)، difficulty level (P=0. 001)، taxonomy 1 (P=0. 001) and Taxonomy 2 and 3 (P=0. 006). According to findings of this study، taxonomy 2 and 3 were decreased and taxonomy 1 was increased over the specified five years. We recommend the specialist board members and the Deputy for Education of the Ministry of Health to consider the results of this study and react to them by improving MCQ quality of future exams.