مجله مرکز مطالعات و توسعه آموزش علوم پزشکی یزد
سال یازدهم شماره 1 (بهار 1395)

Education in medicine can face several problems such as facing unknown clinical environment. Medical education has paid attention to early clinical exposure. Early clinical exposure can increase students’ motivation and decrease professional tension. The present study is conducted under the goal of determining one- month course of early clinical exposure to clinical environment effect on medical students’ attitude and function.
The target population of this descriptive study consisted of 70 first year medical students of Shiraz University of Medical Sciences. The participants fulfilled the questionnaires with LIKERT scale scored from 1= very weak to 5= very good after attending early clinical Exposure program. Confidence coefficient derived from the questionnaire was 0. 87 based on Cronbach’s α.
All participants fulfilled the questionnaires with questions related to early clinical exposure program in clinical environment. The results demonstrate that 80% of students considered early clinical exposure effective and suitable. 80% of the mentioned students considered this program presentation was effective on students’ attitudes towards medical profession. Totally, 77.1% of the participants evaluated this program very good and they appraised performing this program on motivating students and enhancing their communication skills and responsibility.
Based on the results of this study, holding short-term course of early clinical exposure as a factor to lead students towards a better function and motivation caused a better learning. So, it is recommended to consider early clinical exposure program as a part of medical students’ educational programs.

Leadership in the area of curriculum development is increasingly important as we look for ways to improve our programmes and practices. In curriculum studies, leadership has received little attention. Considering the lack of an evaluation tool with objective criteria in postgraduate curriculum leadership process, this study aimed to design a specific tool and determine the validity and reliability of the tool.
This study is a methodological research. At first, domains and items of the tool were determined through expert interviews and literature review. Then, using Delphi technique, 54 important criteria were developed. A panel of experts was used to confirm content and face validity. Reliability was determined by a descriptive study in which 30 faculties from two of Isfahan universities and was estimated by internal consistency. The data were analyzed by SPSS software, using Pearson Correlation Coefficient and reliability analysis.
At first, considering the definition of curriculum leadership determined the domains and items of the tool and they were developed primary tool. Expert’s faculties’ views were used in deferent stages of development and psychometry. The tool internal consistency with Cronbach's alpha coefficient times was 96.5. This was determined for each domain separately.
Conclution: Applying this instrument can improve the effectiveness of curriculum leadership. Identifying the characteristics of successful and effective leaders, and utilizing this knowledge in developing and implementing curriculum might help us to have better respond to the changing needs of our students, teachers and schools of tomorrow.

Enhancing the quality and dynamicity of higher education programs requires continuous evaluation of curriculums. Reproductive health PhD program was established in 2006 in Iran while recommending that its curriculum be evaluated by assessing graduates’ performance in workplace and surveying students, faculty members and managers. This study aimed to explore challenges of the curriculum of reproductive health PhD program.
Employing a qualitative content analysis approach and using purposive and sometimes opportunistic sampling, experiences and viewpoints of 33 graduates and students of reproductive health PhD program, educational managers and reproductive health board members about the curriculum of reproductive health PhD program were collected through individual interviews and notes in 2014-15. Data were transcribed and important expressions were coded. Classification of similar codes led to preliminary categories. Five main categories were extracted by further classifications.
The five main categories included inadequacy of course topics and contents, challenges of student education, failure in realizing curriculum goals, long research period, and ambiguity in graduates’ professional status were appeared; each of these included various subcategories.
Results showed that the curriculum of reproductive health PhD program required revisions to meet the program’s mission and designing courses such as sexual health and reinforcing the clinical nature of the program were necessary. Moreover, the results emphasized that the establishment of an independent educational department of reproductive health for managing higher education affairs and greater supervision of the reproductive health board on educational affairs was necessary. Furthermore, reproductive health specialists should be employed in different positions to meet society’s reproductive health needs.

Increasing numbers of medical sciences graduates is counted to be one of the problems in the society, so that there is concerning about their majors and future careers among them. This study was performed with the aim of determining environmental health student's attitude toward their majors and future careers, which was carried out in Yazd University of Medical Sciences in 2015.
This analytical, descriptive study was performed in 2015. The samples were Environmental Health students of Yazd University of Medical Sciences. The sample size was 102. Data were collected using a questionnaire containing 20 questions and analyzed by SPSS software version 21, multiple linear regression test, one-sample t-test and Chi-Square test.
The mean and standard deviation of environmental student's attitude toward their majors and future careers were 3.16 and 0.66, respectively. Attitude scores more than 3 were considered positive and less than 3 were negative. The mean scores of attitude was significantly higher than 3 (P=0.012). In this study, there was a significant relationship between students’ attitude and location status (P=0.003).
According to the obtained results, the students of environment health had a good perspective towards their future careers and majors of study. A proper distribution of human resources, providing financial support of employment, establishing counselling and supporting centers among students for future career is recommended to improve their attitudes.

Equity in education is meant providing equal educational opportunities for students that often included the equality in professor's behaviors with their students. This form of justice can improve student's performance. So, considering the importance of educational equity and the its special position in medical education, this study was performed to investigate the situation of educational justice from the perspective of paramedical students in Kermanshah Faculty of Paramedical Sciences.
In this analytical cross-sectional study, which was performed by stratified sampling method in 2014, the required information was collected by educational justice questionnaire. The reliability and validity of this questionnaire was confirmed. Then, the data were analyzed using SPSS software (version 21) and Kruskal–Wallis test.
The average score of education justice was 53/48 ± 15/24. A significant relationship was found between the average scores of students educational justice with gender and their field of study (P The research findings showed that the student's demographic characteristics are the influencing factors on the situation of education justice in Kermanshah Faculty of Paramedical Sciences. Therefore, the need to creating equal opportunities in education in a way that all students have access to the same facilities in the same environment, must be considered through the university and especially the professors.

Using the adequate and standardized educational facilities and spaces can ensure effective educational program. The purpose of the current study was developing basic educational standards for master's degree program in 'nursing neonatal intensive care'.
This study is a descriptive study used Delphi approach to conduct with the participation of 40 experts in nursing neonatal intensive care from all over Iran in 2014. The study population consisted of neonatologists and medical professionals, administrators of educational department, faculties of pediatrics department, head nurses of neonatal intensive care unit, students and graduates of course in nursing neonatal intensive care were selected purposively. Firstly, the educational standards (24 items) were gathered with extensive review and secondly, experts commented to questionnaire in three rounds. The first and second rounds were performed in a meeting with participation of 20 experts from Mashhad University of Medical Sciences and the third round was performance through sending emails to 40 experts from all over Iran.
In the third round, 10 basic education standards for students of master's degree program in 'nursing neonatal intensive care' unit have been agreed. The standards included theoretical training classes, equipped center for clinical skills, educational workshops, evidence-based learning environment, sufficient number of beds for neonatal intensive care unit, specialized books/ study hall school and hospital, wireless Internet, shared databases, and research approved process.
These findings can be used to evaluate the educational resources in schools, which had courses of sciences degrees and it can be a good pattern for the standardization of other majors.

Researches show that medical professionalism is threatened and it is needed a proper educational intervention. Hidden curriculum plays a very important role of transmission of professional values. Most of expert curriculum planners found that the effects of the hidden curriculum of education from the educational dimensions, in particular, in transmission of values and norms is far more powerful than the obvious curriculum.
In this qualitative content analysis, 15 students individually and 9 students in one group were selected in Bushehr University of Medical Sciences and semistructures interview was done. Participants of this study were medical students, nursing and midwifery students, operating room and anesthesia students in Bushehr University of Medical Sciences. Data were analyzed by using content analysis in seven steps. The accuracy of data was confirmed from various methods.
After coding and categorizing the obtained data, the students mentioned to the three main themes as the hidden curriculum role in transition of professional characteristic. These three main roles were "communication", "principles, laws and regulations" and "supportive atmosphere".
Inappropriate organizational structure in the health system created some serious obstacles in the paths of professionalism. Based on the findings, some factors were considered as facilitating professionalism. They included having a good relationship, having encouragement and support system, and having the rules facilitate professionalism and organizations as well as organizational and managerial failures of Ministry of Health, educational system and lack of attention to the hidden curriculum in the transfer of professionalism were considered as inhibitors.

In clinical education, it is essential to prevent patients from injuries by using the new educational approaches. Therefore, the students must be ready before involving in any procedures. This study aimed to determine the effect of education in simulated environment and instructional videos on the skills of the episiotomy among midwifery students.
In this interventional study, at the beginning of the sixth term, all of the midwifery students, 30 students, were divided randomly into 3 groups. The education was taken place in simulated environment and using educational films without intervention. The training was performed on training mannequin. The film was prepared from this training and presented to each of the students in film group. A practical test done and the results recorded in check list. The data were analyzed by SPSS software.
The mean scores of students in performing an episiotomy based on all of the cases in 3 groups was statistically significant difference (p The educational film, which was designed, based on the scientific principles can be effective in gaining skills as a self-taught. Therefore, using the mentioned methods is recommended in clinical education planning.