Strides in Development of Medical Education
Volume:14 Issue: 3, 2017

Empathy is one of the main skills in establishing a relationship between physicians and patients, and in order to increase this sense in students, it is necessary to introduce systematic and active programs into medical education. The aim of this study is to determine the effect of an educational intervention based on a health belief model on empowering the sense of empathy in medical students. This was a quasi-experimental intervention conducted on two groups of 80 medical students involved in the internship program from Tehran University of Medical Sciences in 2015. Sampling was done randomly, and the subjects were randomly assigned to two groups, experimental and control. In the pre-test phase, all students completed a three-dimensional questionnaire including demographic data; a valid, reliable, and standardized Jefferson empathy questionnaire; and a section comprising questions designed by the researcher based on the constructs of the health belief model. Educational intervention was conducted only for the experimental group. To measure the results of educational intervention, the standardized patient questionnaires and the questionnaires completed by the students were used. Data were analyzed by means of frequency, percentage, mean and standard deviation, ANOVA, and independent t-tests. Before the intervention, the two groups were similar and comparable in terms of demographic variables. After the intervention, there was a significant difference in the mean scores of perceived susceptibility (P < 0.001) and perceived severity (P = 0.002) between the two groups. The mean scores of perceived barriers and perceived benefits were significant among the two groups (P < 0.001). In addition, there were significant differences in the constructs of self-efficacy and cues to action three months after intervention (P < 0.001). Training based on the health belief model was effective in empowering the sense of empathy among medical students. Training on empathy skills is recommended in order to increase patient satisfaction, promote health outcomes, and increase job satisfaction among physicians.

Self-assessment of clinical performance in a clinical setting is defined as the process of collecting internal and external data, interpreting the data on personal performance, and comparing them with a set of standards. The current study aimed at analyzing self-assessment of clinical skills among medical interns at Kerman University of Medical Sciences, Kerman, Iran, and determining the relationship between practical skills and theoretical knowledge. The current cross sectional, descriptive, analytical study was conducted in 2014 on a total of 141 interns from Kerman University of Medical Sciences selected via census sampling. Data were collected using a checklist including the main procedural skills of medical students and analyzed using the Mann-Whitney and the Kruskal-Wallis tests with SPSS. The majority of participants were female (n = 79; 56%). The mean score of males` clinical skills was higher than that of females, and the difference was statistically significant (P = 0.001). Analysis of the relationship between internship duration and clinical skill scores showed that the mean score of interns who had completed 6 months of their internship was higher than that of the ones who had not; the difference was statistically significant (P = 0.001). Since the performance of future general practitioners highly depends on their learning and mastery of clinical skills, acquisition of these essential skills during internships is an important objective of medical students. Correct and complete training of clinical skills, especially during internships, is integrated into the medical curriculum, although its implementation requires careful planning and compliance with the medical standards.

Snowball sampling is applied when samples with the target characteristics are not easily accessible. This research describes snowball sampling as a purposeful method of data collection in qualitative research. This paper is a descriptive review of previous research papers. Data were gathered using English keywords, including “review,” “declaration,” “snowball,” and “chain referral,” as well as Persian keywords that are equivalents of the following: “purposeful sampling,” “snowball,” “qualitative research,” and “descriptive review.” The databases included Google Scholar, Scopus, Irandoc, ProQuest, Science Direct, SID, MagIran, Medline, and Cochrane. The search was limited to Persian and English articles written between 2005 and 2013. The preliminary search yielded 433 articles from PubMed, 88 articles from Scopus, 1 article from SID, and 18 articles from MagIran. Among 125 articles, methodological and non-research articles were omitted. Finally, 11 relevant articles, which met the criteria, were selected for review. Different methods of snowball sampling can be applied to facilitate scientific research, provide community-based data, and hold health educational programs. Snowball sampling can be effectively used to analyze vulnerable groups or individuals under special care. In fact, it allows researchers to access susceptible populations. Thus, it is suggested to consider snowball sampling strategies while working with the attendees of educational programs or samples of research studies.

Traditional teaching methods such as lectures alone cannot meet educational needs in the medical sciences. It is necessary to supplement lectures with additional methods in order to prepare the students for problem solving in real situations. The present study aimed at employing the problem-based learning (PBL) method in the theoretical physiology of autonomic nervous system (ANS) course for medical students and comparing the results with the customary method of lectures. In 2014, first-year medical students enrolled in the neurology curricular block at Tehran University of Medical Sciences were randomly assigned to two groups. One group participated in classes with lectures, while the other group was divided into subgroups of 10 for PBL sessions. In the first session of PBL, a scenario pertaining to ANS was presented, and then the students were asked to expand the scenario and discuss it using brainstorming method. The first session was held on introducing a reference for studying. In the second session, students in each group presented the results of their individual studies, and a representative from each group gave a report in line with the educational objectives of the class. Finally, a short-answer final test and survey were administered. Data were analyzed using independent samples t-test and Levene’s test. Based on results, mean scores of students in the PBL group (15.20 ± 3.31) were significantly higher than those of students in the lecture group (12.38 ± 4.49) (P < 0.001). Based on the survey, students preferred PBL to lectures. PBL promotes motivation, self-confidence, and communication skills, all of which contribute to the better learning of the students who attended the theoretical physiology of ANS course.

One of the ways to assess professors is through evaluation by students. This is one of the most challenging methods, with many people for and against it. The present study aimed to weigh existing evaluation criteria in the form of students’ evaluation of professors at Shiraz University of Medical Sciences. The present descriptive-analytical cross-sectional study was conducted with 240 students of Shiraz University of Medical Sciences in 2016 - 17. Data were collected using a six-criterion questionnaire. Questionnaires were distributed among students by the researcher through the schools’ education units and then collected. Data were statistically analyzed using SPSS. Weighing criteria were done by Shannon’s entropy method in Excel. Of the six evaluation criteria, “Attracting students’ attention” weighed the most (0.2087 out of 1), followed by “Use of interactive and new teaching methods” (0.2049), “Ability to make the subject understood and motivate” (0.1728), “Punctuality” (0.1727), “Proper communication” (0.1546), and “Proper planning” (0.0863). Attention to basic criteria in students’ evaluation of professors is highly important, and this kind of evaluation is only useful when evaluation questionnaires are reviewed by students and include important points and become a part of an extensive and systematic evaluation program for the progress of faculty members.

Clinical education is a major component of nursing programs, and nurses’ failure to acquire the necessary clinical skills during their studies compromises the provision of high - quality nursing services in their occupational future. The present study was conducted to design and determine the psychometric properties of the clinical skills questionnaire for operating room nursing students. The present methodological research designed and determined the psychometric properties of the questionnaire in four steps, including defining the concept of clinical skill in nursing students using a book and literature review, designing the questionnaire’s items using the available resources in Iran and other countries, assessing face and content validity of the questionnaire by 10 university students and experts, and examining the internal consistency of the questionnaire using Cronbach’s alpha. The final version of the clinical skills questionnaire, which included 38 items, generated four subscales, including responsibilities of scrub nurse, responsibilities of circulating nurse, recovery room care of patients, and sterilization and infection control. In terms of psychometric properties, we observed a content validity ratio of 0.90, a content validity index of 0.95, and internal consistency showing a Cronbach’s alpha of 0.86.The findings confirmed the validity and reliability of the clinical skills questionnaire for operating room nursing students. The 38 - item questionnaire has appropriate psychometric properties and can be used in Iran’s educational and health systems by educational caregivers. Other validity indices, including construct validity, are recommended to be measured to determine the validity of the questionnaire subscales.

Teaching clinical skills to students who provide health services is of great importance. Many universities use questionnaires to make qualitative assessments about the teaching of these skills based on the students’ point of view. In many cases, the learning environment affects teaching; however, this issue is not often taken into account while designing questionnaires. In addition, it is necessary to specialize the questionnaires because the clinical trainings of different medical groups differ from each other. The aims of this study were 1, to develop a questionnaire that could be used for quality assessment of clinical education provided by faculty members of rehabilitation school and 2, to evaluate the validity and reliability of such a questionnaire. Based on the clinical education curriculums of the departments of rehabilitation school, a questionnaire consisting of two sections assessing teaching quality (24 items) and learning environment (7 items) was designed. Face and content validity of the questionnaire was approved during several feedback stages based on the opinions of the faculty members. In addition, the reliability of the questionnaire was evaluated by administering it to 25 undergraduate students during a given time interval. Using Cronbach’s alpha, the internal consistency values of the questionnaire for teaching quality and learning environment components were found to be 0.94 and 0.73, respectively. The results of the test-retest reliability were as follows: intraclass correlation coefficient (ICC) of 0.95 and 0.96; Pearson correlation coefficient of r = 0.92 and r = 0.93, and paired t-test of P > 0.05. Both the teaching quality and learning environment sections in the designed questionnaire were found to be valid and reliable. The results showed that the questionnaire could be used to assess the quality of clinical education provided by faculty members in rehabilitation schools.

Cheating is a common phenomenon that can undermine the credibility of university tests and certificates. Cheating is a more sensitive issue among medical students. The present study was conducted to investigate the performance and attitude of undergraduate students of Golestan University of Medical Sciences in Iran towards cheating, as well asthe factors that influence cheating. The present descriptive analytical and cross-sectional study was conducted in 2014 on 524 female and male undergraduate students of Golestan University of Medical Sciences. Convenience sampling was used to select the participants. The data were collected using a valid and reliable 64-item questionnaire on performance and attitude towards cheating with a Cronbach’s alpha of 0.88. The obtained data were then analyzed using descriptive tests and the χ2 test. P < 0.05 was set as the level of statistical significance. Demographically, women made up 58% of the study population. In terms of ethnicity, 68.5% of the population wereFars, 24.6% Turkmen, and the rest were other ethnicities. A total of 70.6% of students had negative attitudes towards cheating. In terms of performance, 57.1% of students admitted to cheating. Significant relationships were observed between the attitude and performance of students (P = 0.001). The relationship between gender and occupational status, and attitude and performance was also found to be statistically significant (P < 0.050). Male and employed students had more positive attitudes towards cheating and actually did it more frequently than their female counterparts. The majority of nursing students were against cheating in terms of attitude and performance. Nevertheless, to better understand this behavior and develop coping strategies, further studies should be conducted on the phenomenon of cheating in other academic activities among medical students.