Strides in Development of Medical Education
Volume:12 Issue: 1, 2015

The concept of active engagement or academic engagement is a certain understanding of the relationship between students and the university. The university is an environment that provides learning opportunities that will lead to student learning. The nature and level of learning depends on the students way of using their environmental resources. Positive engagement and an interactive, supportive academic environment are essential elements in success in the learning process. On the other hand, isolation, alienation, and passiveness of students results in their academic failure. The aim of the present study was to investigate academic engagement of medical students of Kerman University of Medical Sciences, Iran, in 2011-2012. In this study, 2 domains of academic engagement were investigated (active and participatory learning, and level of academic challenge). In this descriptive-analytical, cross-sectional study, all medical students of Kerman University of Medical Sciences were recruited using stratified random sampling method. The data collection tool was the National Survey of Student Engagement (NSSE). In this study, 211 medical students from different academic years with the average age of 22.6 ± 3.1 were enrolled. The mean active engagement score of the students was 98.64 ± 32.33. Active and cooperative learning was at a significant level based on all demographic variables, except employment. The active and cooperative learning of male students differed significantly from that of female students, married students from single students, different academic years, and native from local students. Moreover,, students who were members of one of the academic centers had significantly higher active and participatory learning scores. Mean active and participatory learning, and level of academic challenge were 17.4 ± 5.6 and 21.7 ± 7.1, respectively. Both domains were reported as unsatisfactory among students. The results showed the unsatisfactory academic engagment status of the students of the Kerman University of Medical Sciences. Thus, it is hoped that with future planning to use more modern teaching methods which have a higher level of academic challenges, and active and collaborative learning, and by the appropriate support of the university, university staff, and faculty members, we are able to take steps toward the improvement of academic engagement, and thereby, student success.

Student assessment is one of the most challenging issues of an integrated curriculum. While calculating an overall score is in line with the goals of integrated curriculum, it poses the risk that some students will deliberately leave out the content of some disciplines, based on the fact that they have lower credits in each block exam. In the present study, we describe the experience of Tehran University of Medical Sciences, Iran, where an integrated medical curriculum has been launched since September 2011 as part of curriculum reform initiative. In the first academic year, students passed 4 blocks: Molecule and Cell; Tissue; Development and Function; Cardiovascular Function; Blood circulation; and Blood-Respiratory Function. Each block included anatomy, histology, physiology, and embryology. The overall block score was reported at the end of each block. In addition, a cumulative disciplinary score was calculated at the end of the academic year through the summation of the weighted subscores of each discipline in each block. At the end of the year, the number of students who had failed in histology, anatomy, embryology, and physiology were 15, 17, 44, and 3, respectively. They were required to take a disciplinary examination before the beginning of the next academic year. A comparison of the number of students who failed disciplines with low credits (e.g. histology) with those who failed disciplines with high credits (e.g. physiology) suggests that the former had systematically been ignored by some students. The calculation of a cumulative disciplinary score may reduce the deliberate omission of course content in integrated blocks.

The core of each WBT system is an online software called learning management system (LMS). The existence of such a system in each university is the minimum requirement for the application and development of WBT methods. The present study aimed to investigate the frequency of LMS usage in Iranian medical universities in comparison with the universities of developed countries. This descriptive cross-sectional analysis was performed in 2014. The study population consisted of Iranian medical universities and the universities of 4 developed English-speaking countries, including USA, Canada, Australia, and UK. From among the Iranian universities, a total of 52 universities were selected using the census method. Moreover, 58 universities were randomly selected from among 450 well-known universities of developed countries. The data from LMS of Iranian medical universities were collected through visiting university websites, telephone calls, and in some cases, face-to-face interviews. The data were analyzed by descriptive methods. Of the 52 Iranian universities of medical sciences, 33 universities (63.5%) did not have any LMSs for delivery courses in academic degree programs. Of the 19 universities (36.5%) with LMSs, Moodle, ATutor, Docebo, and native-designed LMSs were found in 11, 4, 1, and 3 universities, respectively. In addition, 16 Iranian universities used open source LMSs and 3 used commercial LMSs. All 58 (100%) universities of developed countries used LMSs for delivery courses in their academic degree programs. Blackboard, Moodle, Canvas, Desire2learn, and Sakai were used in 30, 13, 8, 1, and 1 foreign universities, respectively. Moreover, 2 universities were in transition stage and 3 universities used the Mooc system. Iran universities showed a considerable difference from universities in developed countries in terms of frequency of LMS usage. Educational and IT administrators in Iran should fill this gap, especially at high ranking universities.

Nearly two decades have passed since the establishment of evidence-based medicine (EBM). EBM is of great importance due to its ability to fill the information gap between medical research and clinical practice. The aim of the present study was to evaluate the existing evidence of the application of EBM in published Iranian educational papers.

This is a systematic review of Iranian papers published in both Iranian and international journals. The results were reviewed by two researchers separately to assess the inclusion and exclusion criteria and evaluate the level of evidence. We used the Best Evidence Medical Education (BEME) guideline for conducting the systematic review and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart to present the selection process. In addition, the Medical Education Research Quality Index (MERSQI) was used for the evaluation of the quality of the studies.

EBM was used in 11 fields which can be categorized as the 4 clinical, educational, research, and policy-making groups. The educational group consisted of 3 domains of holding a journal club, case discussions, and teaching and learning. Only 6 studies were found to report the effect of education on the application of evidence-based medicine. The evaluation of their quality showed average quality.

Although there are a limited number of studies on the effect of education on EBM application, they present satisfactory and average quality evidence. Despite the existence of various educational courses on EBM in Iran, no high level and high quality evidence exists to show the effectiveness of education on knowledge, attitude, practice, and behavior of healthcare professionals especially in the long-term. Thus, the designing and performing of high quality research is required in this field.

Classroom management is a key variable in creating a desirable environment for students’ training and learning. Today, equipping professors with managerial skills in planning for professional education, especially medical education, is necessary. Thus, the aim of this research was to investigate classroom management styles of faculty members in Kashan University of Medical Sciences, Iran. This was a descriptive survey. The statistical population consisted of all faculty members of Kashan University of Medical Sciences (n = 182). Through stratified random sampling method, 114 individuals were selected. We used a standard questionnaire to assess classroom management styles. The questionnaire consisted of 25 4-point items and 3 styles of education management (questions 1 to 13), people management (questions 14 to 21), and behavior management (questions 22 to 25) based on 3 approaches (interventional, interactive, non-interventional). The validity of the questionnaire was confirmed using content validity. The reliability of the questionnaire was also confirmed using Cronbach’s alpha coefficient (α = 0.82). Data analysis was performed using descriptive statistics (frequency, percentage, and mean and standard deviation) and analytical statistics (ANOVA and Student’s independent t tests). The mean of each classroom management style was higher than the estimated average (2.5). The highest average was that of education management style (2.75). Based on the obtained means, classroom management (68.28) was an interventional approach. Findings showed that university faculty members, respectively, have the highest regard for education management and people management, and the least regard for behavior management.

Critical thinking skills in students are essential to making better decisions. Obtaining information on the critical thinking skills of students is useful in curriculum planning. Therefore, this study was conducted to evaluate the critical thinking skills of students of the School of Management and Medical Informatics, Tehran University of Medical Sciences, Iran, in 2013.

This was a cross-sectional, analytical study. The study sample consisted of 338 students of the School of Management and Medical Informatics of Tehran University of Medical Sciences in 2013. The data collection tool used was the California Critical Thinking Skills Test-Form B (CCTST-Form B). Data were analyzed using independent t-test and ANOVA in SPSS software.

The mean score of critical thinking among female students was 7.62 ± 4.50 and among male students 7.47 ± 3.69; this difference was not significant. ANOVA showed a significant relationship between critical thinking score and level of education (P = 0.002). The highest mean score of critical thinking (8.98) was observed among M.Sc. students. Moreover, a significant relationship was observed between critical thinking score and field of study (P = 0.001).

The results show that the critical thinking skills of the studied students were poor in all aspects; hence, training students in this respect is essential.

Anxiety is a feeling of apprehension caused by the feeling of being at risk and can affect the performance of an individual. Today, exam anxiety is increasingly observed among educated people and this situation causes a loss of concentration. Faith increases confidence and patience and strength to deal with problems. The aim of this study was to assess the effect of recitation of the Quran on exam anxiety in nursing and emergency medicine students. This was a quasi-experimental study performed on nursing and emergency medicine students of Borujen School of Medical Emergency Nursing, Iran. The purposive sampling method was used in the present study and all students participated in this study. The courses presented during one semester for each field of study were randomly divided into two groups. An audio of Maryam Surah, verses 1 to 26, were played for one group before the midterm exams and the other group before the end of term exams for 5 minutes. Data collection was performed using a demographic questionnaire and Spielberger’s State-Trait Anxiety Inventory (STAI) before all exams. Data analysis was performed using descriptive and analytic statistics (such as independent t-test and paired t-test) in SPSS software. The results of this study showed that the mean levels of apparent anxiety in nursing students during exams without Quran recitation was 48.73 ± 13.52 and during exams with Quran recitation was 44.72 ± 15.26. The average level of hidden anxiety during exams without Quran recitation was 43.33 ± 9.61 and in exams with Quran recitation was 41.36 ± 11.99. A statistically significant difference was observed among these averages (P < 0.05). The mean levels of apparent anxiety in emergency medicine students during exams without Quran recitation was 41 ± 12.98 and during exams with Quran recitation was 39.11 ± 11.82. The average level of hidden anxiety during exams without Quran recitation was 41.33 ± 8.78 and during exams with Quran recitation was 38.46 ± 11.01. A statistically significant difference was observed among these averages (P < 0.05). The results showed that the sound of the Quran before exams can reduce student's anxiety levels. Therefore, it is recommended that managers and policy makers consider the results of this study, and play audios of the Quran before exams in order to reduce stress but also take steps to promote familiarity with the Quran.

Hidden curriculum is a relatively new and very enlightening concept raised by curriculum experts in recent years. The aim of the present study was to investigate the hidden curriculum of the doctoral degree and hidden factors of choosing a supervisor. This was a qualitative research performed using the phenomenological method. The study data were collected through semi-structured interviews. In this study, all doctoral graduates who had passed the research period (n = 45) were selected using purposive sampling method. For data analysis, the Strauss and Corbin (1997) method was used (open coding and axial coding). In this study, 230 themes were obtained and divided into 5 main categories (negligence of main tasks, lack of social and economic justice, inequality of universities, lack of communication across borders, and lack of equal facilities) and several subcategories. The results showed that numerous factors can affect the academic process in universities during this period. Therefore, more contemplation is necessary during this period.

Medication errors is one of the most common medical errors, a universal problem, and serious threat to patient safety and in some cases can result in patient death. Therefore, understanding the different aspects of this problem can provide an opportunity to prevent and minimize this issue. The purpose of this study was to explore medication errors among nursing students in Kerman city, Iran. In this descriptive cross-sectional study, all nursing students in their 7th and 8th term (n = 90) were recruited using census method in 2012-2013. The data collection tool was a researcher-made questionnaire including questions related to demographic data and medication errors. The validity and reliability of the questionnaire were approved. Data were analyzed using descriptive statistics and chi-square test in SPSS software. The results showed that 84.4% of students were female, and 66.3% of students had witnessed or discovered medication errors by other students. In addition, 66.97% (n = 60) of the students confirmed their medication errors (total of 101 errors). Based on this, the average of medication errors of the whole sample was 1.12. The highest rate of error was related to intravenous injection (68.3%) and the lowest to subcutaneous injection (1.8%). The most prevalent types of medication errors were wrong dose (41.7%) and infusion rate (46.7%). There were no statistically significant relationships between medication errors and gender, age, marital status, and work experience (P > 0.05). This study showed that the incidence rate of medication errors among nursing students is high. Therefore, this issue necessitates additional attention from the education system in order to provide patients with safe care services which is their inalienable right and obtain their satisfaction.

Journal club is one of the classical methods of medical education dating back to 100 years ago. This method can be used for teaching critical evaluation, evidence-based medicine, research design, statistics, and educational concepts to medical residents. The purpose of this study was to investigate the anesthesiology residents’ attitude toward a new method of presenting journal club (with the presence of specialists in community medicine and/or statistics). This was a cross-sectional, interventional study performed in the adult intensive care unit of Namazi Hospital, Shiraz, Iran. From among 50 faculty members and second year anesthesiology residents participating in the journal club through both the new and traditional methods, 36 returned their viewpoints. A questionnaire with 19 items was designed by the researcher with the collaboration of the Medical Education Development Office and the Anesthesiology Department of Shiraz University of Medical Sciences, Iran. The validity of the questionnaire was confirmed by educational experts and its reliability was reported as over 90% using Cronbach's alpha coefficient. The intervention group (journal club sessions with the presence of community medicine or statistics professionals) scored significantly higher than the control group on all items of the questionnaire. The participants in the experimental group reported that the most important effects of the new approach was their better understanding of statistical terms and research methodology, a positive attitude toward the usefulness of interdisciplinary communication, article reviews and the application of results in clinical practice, development of article assessment skills, creating motivation for further research, causing desire to participate in other journal clubs, and recommending colleagues to participate in such clubs. Moreover, Spearman's rank correlation coefficient showed that with the increase in the number of journal club sessions participated in, the rate of knowledge and desire to participate in more sessions also increased. Participants admitted that they had improved academically and were generally satisfied with this new approach. Regarding the generalizability and implementation in other training centers, this new approach can be exploited in other departments of specialized medical fields. In case of achieving valid and reliable results, the approach can be proposed as a national model.

One method of evaluation with the intent to select and modify teaching methods in universities is the evaluation of student's opinions. Team teaching by faculty members is a routine method of education in universities. The present study evaluated student's satisfaction with team teaching in Babol University of Medical Sciences, Iran, during the first and second semesters of 2011-2012.

In the present descriptive, analytical study, 461 students of Babol University of Medical Sciences who had experienced team teaching were randomly selected. The participants completed a questionnaire the reliability and validity of which had been previously approved. The questionnaire contained 19 questions, based on the 5-point Likert scale ("very high", "high", "moderate", "low", and "very low"). The resulting data were analyzed using SPSS software and compared using t-test and ANOVA.

The results showed that 8.2% of students partly opposed and 0.4% of them absolutely approved the use of team teaching method. The highest frequency of answers (56.9%) were assigned in the "moderate" level. Nearly 34.5% of students approved the use of this method. Students of dentistry and laboratory sciences showed the highest and lowest tendency toward this method, respectively. Higher year students showed less tendency toward team teaching method. There were no significant differences between boy's and girl's answers in respect to this method.

It seems that Babol University of Medical Sciences students did not significantly oppose the use of team teaching method. Nevertheless, in order to correct the existing small problems, it is essential to revise the implementation technique of this teaching method.

Learning theories focus on individuals’ way of learning. Cognitive learning theory emphasizes the importance of the internal process of the learner and includes several known prospects such as Gestalt, data processing or information processing, meaningful learning, concept mapping, exploration methods, self-efficacy, and self-regulation. Each of these perspectives emphasizes a specific aspect of cognition. Limited information exists on the processes and approaches used by nursing students in learning. The present research was conducted in order to determine the role of cognitive theory in nursing education.

In this study, library and search databases [Medline, Google Scholar, Scientific information database (SID), and Magiran] were search using the keywords learning theory, cognitive theory, and nursing education. All literature published from 2000 to 2013 were selected. Subsequently, each approach to this theory in nursing education was studied.

The key principles of Gestalt in connection with the care and education of patients, include mental organization towards simplicity, balance and discipline guided by the patient's desire, and a simple and clear description of the illness. Application of information processing theory in nursing education consists of compliance of occupation with mindset, and acceptance of and respect for different ways of thinking among people working in the health care environment. Concept mapping is a metacognitive strategy for training nursing students on learning methods and exploration method is the factor which increases the confidence of nurses. Self-efficacy emphasizes the importance of acquisition and application of knowledge, and development and improvement of scientific and professional skills. Moreover, nursing students with greater achievements are learners who show self-regulation.

In the 21st century, nursing has undergone numerous changes and nurses are forced to deal with patients with a wider range of pathologies, and chronic and underlying diseases. For satisfactory performance in such an educational environment, nurses require cognitive and metacognitive skills. Educational applications of social cognitive learning theory in nursing include model orientation, teaching new behaviors and skills, encouraging previously learned behaviors directly and indirectly, teaching of the prevention of chronic diseases, increasing patients’ independence and effectiveness. This study provided valuable knowledge on cognitive theory in nursing education. Thus, the introduction, application, and study of this theory in nursing education are recommended.