فهرست مطالب

Future of Medical Education Journal
Volume:5 Issue: 1, Mar 2015

  • تاریخ انتشار: 1394/02/07
  • تعداد عناوین: 8
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  • Kokab Namakin, Nahid Ghanbarzade, Toba Kazemi, Gholamreza Sharifzadeh, Seyed Alireza Javadinia Pages 44-46
    Background
    Clinical training is an important part of the training courses of medicine during which students learn how to face the patients, diagnose the diseases and treat the patients. Alongside clinical apprenticeship, related theoretical courses are presented so that the most training possible is covered. In the past the theoretical courses of pediatrics ward of Birjand University of Medical Sciences were presented in the afternoons separately from the clinical part. According to the new strategy of clinical deputy of medical school in the case of merging the theoretical courses with clinical apprenticeship, since past year the theoretical courses of pediatrics ward are presented simultaneously with apprenticeship. The purpose of this study was to examine the effect of merging theoretical courses in apprenticeship of pediatrics and gynecology wards on the scores of pre internship of medical students.
    Methods
    This was a retrospective interventional case study and it was conducted after proper coordination and getting the scores of pre internship exam scores, the scores of students having started in 2005 were considered as the control group and the scores of students of 2006 as case group (training of merging of clinical and theoretical courses), and then the two groups were compared. Data was analyzed through SPSS 1 and descriptive statistics and frequency distribution tables and independent t-test were used for analysis (meaningfulness level (p)≥ 0.03).
    Results
    Totally, there were 89 participants in this study. 40 people participated in control group (entrance year of 2005) and 49 (entrance year of 2006) in case group. The mean score of pre internship exam in pediatrics course was higher in the control group but it wasn’t statistically meaningful. On the other hand, the score of the students of the case group in gynecology course was significantly higher than the score of control group (p=0.001).
    Conclusions
    The results showed that in both merged courses the mean score of pre internship exam in case group was higher than control group which implies the necessity of more planning in this case.
    Keywords: Merge of Theoretical, Clinical Courses, Medical Education
  • Seyyed Ali Mard Pages 48-51
    Background
    Longevity of basic medical sciences is a major concern of medical educators and physicians. It has been shown that different learning styles can affect the half-life of the material. This study aimed to evaluate the effect of partially tests during renal physiology course on «the student’s retention of renal physiology knowledge» and «knowledge loss» in pharmacy and medical students.
    Methods
    This case-control study was performed at Jundishapur University of Medical Sciences in the academic year 2012-2013. Study populations were pharmacy students and medical students. The final renal physiology examination was on Jan of 2013 for both groups. Pharmacy students participated in three partial tests during the renal physiology course at first semester of the academic year 2012-2013 while medical students did not participate in these tests. 25 weeks after the final renal physiology examination, the both groups of students were recruited to take a retest. Retention test consisted of 17 multiple-choice questions; each question had one correct answer. Statistical paired- and independent-samples t-tests were used to analysis the results.
    Results
    the mean scores of retention test in medical students was significantly lower than in pharmacy students (P<0. 01). Pharmacy students were answered correctly 66. 4±2. 3% of questions, while the rate was declined to 45. 15±3. 25% in medical students. The rate of «knowledge loss» in medical student was (22. 7±3%) significantly higher than in pharmacy students (10. 86±1. 5%) (P<0. 01).
    Conclusions
    The findings suggest that taking partially tests during physiology course is a highly efficient and an effective strategy to enhance «the retention of renal physiology knowledge» and delay the rate of «knowledge loss».
    Keywords: Partially Tests, Renal Physiology Course, Retention, Medical, Pharmacy Students
  • Atessa Pakfetrat, Hasan Hoseinpour Jajarm, Maryam Basirat, Abbas Javadzade Bolouri, Zahra Delavarian, Mohammad Taghi Shakeri Pages 52-56
    Background
    Medical error is defined as an adverse event caused by medical management, which can be prevented. The aim of this study was to investigate the accuracy of diagnosis of oral and maxillofacial diseases made by health care practitioners.
    Methods
    A descriptive cross sectional study was done between Apr. 2009 and Mar.2010. 372 Patients with oral and maxillofacial lesions who had referred to oral medicine Department of Mashhad dental school or had examined by health care practitioners were examined by two oral medicine specialists and a self established questionnaire was completed. The main aim of this questionnaire was to investigate the accuracy of diagnosis of oral and maxillofacial diseases made by health care practitioners. Histopathologic evaluation was made to achieve a definite diagnosis.
    Results
    Only 30/6% of initial diagnoses were consistent with the diagnosis made by oral medicine specialists. Lichen planus and inflammatory hyperplasia have been the most common diseases which health care practitioners did not mention a diagnosis for them.Among the most common misdiagnosis lichen planus and abscess each involved 8 percent of misdiagnosis.
    Conclusions
    Unfortunately in present study there was little compatibility between diagnosis of dentists and practitioners with oral medicine specialist. Sometimes misdiagnosis results in postponing the treatment, patients` suffering and leads to side effects of unnecessary or incorrect treatment. As old people are more susceptible to oral diseases and lesions, there should be a holistic effort to find the cause of present problems and then resolving them through educational promoting and expanding the teamwork among physicians to diagnosis and treatment of the patients.
    Keywords: Accuracy, Education, Oral Medicine, Referral, Specialist
  • Habibeh Ahmadipour, Ameneh Mozafari Pages 58-62
    Background
    Medical graduates should acquire the necessary skills to provide desirable health services. So it is necessary for medical schools to evaluate their students according expected competencies. The aim of present study was to investigate the viewpoints of medical graduates toward their achievement to these expected capabilities.
    Methods
    This research was a cross sectional study carried out in the Kerman medical school, all medical students who had graduated in 2010 and 2011 selected. We analyzed self assessment of graduates'' competencies. The instrument used was a questionnaire including demographic data and 77 competencies in 4 domains: clinical and communication skills, practical procedures, medical ethics and legal responsibility and health informatics. The level of each competency was assessed on a five-point scale. The score of each participant was calculated over ally and for each domain. The score range was from 0 to 100. Data was analyzed by SPSS version 19.
    Results
    Fifty-seven graduates participated in our study. The overall mean and standard deviation of participants'' competency score was 51.25 ± 12.19. There was no difference between males and females. Accurate patient evaluation, performing suture, knowledge about their responsibilities, issuance of medical certificate, familiarity with website had highest scores. Radiography interpreting, measuring Hct, expectations of a physician in Islam and jurisprudence, regulation of sex change, biostatistics had lowest scores.
    Conclusions
    Our study showed that according to graduates self -assessment, they were good in some competencies such as accurate patient evaluation but had undesirable confidence for some important capabilities like radiography request and interpreting. If all of these competencies are essential for graduates, medical schools should make sure that students have acquired all skills before graduation.
    Keywords: Competencies, Graduates, Medicine, Self Assessment
  • Elahe Mohammadi, Mitra Amini, Marzieh Moattari, Neda Moaddab, Arezoo Farajpoor, Mohammad Morad Jafari, Zahra Karimian, Somaye Delavari, Fatemeh Shahidi, Shekoofeh Nikseresht Pages 63-68
    Background
    Mentorship develops a personal relationship in which a more experienced and knowledgeable person helps a less experienced person. In this study we aimed to investigate mentorship status and its impact from viewpoint of clinical professors of Shiraz medical school.
    Methods
    In this cross-sectional study 99 clinical professors of medicine at Shiraz medical school were investigated using simple random sampling. A valid and reliable questionnaire was used to collect the data. The clinical teacher were asked to tell their viewpoint about mentorship in ideal and real situation. A 5 point Likert scale was used for scoring of the questionnaire. Statistical analysis was performed using SPSS 16 software, using t-test, paired t-test, and correlation.
    Results
    Among the various features, from clinical teachers’ viewpoint «being provocative» was the most important feature of an ideal clinical Mentor (mean score: 4. 67, SD: 0. 55). Among the effects of mentorship on personality support of the students, in the ideal case, the effect of «accountability incrassation» had the highest mean score (4. 91), However teachers believed that in real situation, «stress reduction» of students were the most effective role of mentorship in supporting the students (mean score: 2. 76). At career supporting of the students, teachers believed in the ideal state “make motivation towards career«in students had the highest impact (mean score: 4. 58). In the real status,»scientific development «and “professional promoting and career success,» in student had the highest mean score (2. 46).
    Conclusions
    Mentoring is as an important process for the professional development of learners. In today’s situation the most time of mentors are spend of stress reduction of the students, However in ideal situation, positive mentors not only help to shape the professional development of our future physicians by improving the accountability incrassation, they also influence their career choices. To train teachers as a Mentor, we can use short-term courses and workshops and prepare some outlined such as learning and teaching process, adult learning principles, role clarity, setting educational goals, assessment and evaluation of learner and provide feedback.
    Keywords: Mentorship, Mentor, Personality Support, Career Support
  • Zahra Amouzeshi, Mostafa Mohsenizadeh, Ahmad Amouzeshi Pages 68-73
    Background
    Learning the key issues in providing nursing care requires new instructional strategies that prevent superficial learning of students and improve meaningful and high level learning in them. The aim of this study was to determine effect of teaching the nursing process in composing method on nursing students and their clinical learning.
    Methods
    In a quasi-experimental study with two groups, pre-test post-test design, all fifth and Seventh semester nursing students were selected by census method and randomly divided into two control and case groups. Both groups control and case received education using routine and integration method, respectively, for 6 hours. Both groups cared patients a week. Students’ performance was evaluated during the clinical course. Data were collected by nursing process record evaluation form and pre-test post-test, then analyzed with chi-square, Mann-Whitney and T test.
    Results
    Assessment scores in pre and post test scores of two groups showed that composing method in the field of knowledge is more than routine method and the Mann-Whitney test showed statistically significant difference between control and intervention groups (p =0/002). The chi-square test showed not a significant difference between the group and nursing process record (before and after intervention).
    Conclusions
    According to study results and more students participate in education, using a combination of training methods is recommended.
    Keywords: Integrated Method, Nursing Process, Clinical Learning, Nursing Student
  • Lida Jarahi, Seyed Mojtaba Mousavi Bazaz, Majid Reza Erfanian, Leila Shoja Ghaleh Dokhtar Page 72
    Background
    Emphasis on revise and provide new methods of evaluation in medical colleges are widely increasing. Evaluation Methods based on clinical practice and students’ performance appraisement in health care system and in medical student is introduced as an effective method in some studies.
    Methods
    The aim of this study was to consider the usefulness of a new method to evaluate the medical interns’ practice, their satisfaction and their attitude toward evaluation process in community medicine course in Mashhad, Iran. Interns’ practice was evaluated by portfolio during their course, evaluation scores were categorized in four levels: High, good, moderate and less than expected. Intern satisfaction and attitudes was assessed via self-rating questionnaire.
    Results
    Ranking of the scores of interns’ practice appraisement, almost were in moderate to good ranks. Also the majority of interns reported their suitable satisfaction in this study.
    Conclusion
    This study is proposed applying evaluation methods based on students’ performance are as appropriate and practicable method for medical interns.
    Keywords: Satisfaction, Practice Appraisement, Medical Interns, Evaluation
  • Seyed Reza Mousavi, Abbas Ali Zeraati, Mostafa Jafari, Kambiz Akhavan Rezayat, Mohammad Hasan Jokar, Abolghasem Allahyari, Zahra Mirfeizi, Mozhgan Afkhamizadeh, Mahnaz Amini, Parvin Layegh, Elham Galehnavi, Zahra Mozaheb, Nazila Zarghi, Reza Afshari Page 75
    Background
    Morning reports (MRs) are commonly used as an efficient technique in Medical Education. This study was intended to assess the developmental process following Iranian definable standards in the Internal Medicine Department, Imam Reza General Hospital, Mashhad, Iran.
    Methods
    Following an initial one-month assessment through direct observation of morning reports held in Imam Reza Hospital Internal Medicine Department, workshops were run for 6 weeks aiming at rectifying the flaws and reforming the trends practiced contrary to current standards. Checklists were filled by the attending researcher, subsequent to which feedback was given regarding possible flaws and/or challenges to the attending physicians. Reforms as well as alterations were urged to improve the status quo, which were eventually accepted and implemented by the Head of Department. Reassessment was conducted six weeks afterwards, using checklists having been prepared in advance. An equal number of MR Sessions (n=25) was evaluated prior to and following the Reform Scheme.
    Results
    Significant differences can be seen in the level of participation by nephrologists, infectious disease specialists and clinical pharmacologists after the scheme (P<0.001). Better arrangements were made between the coordinator and the resident in charge prior to the MR session, mainly via short text messages (44%). This encompassed the case selection, number of cases to be presented and the chief objective behind these presentations. Of the total of 65 patients presented, 50 (77%) were complicated ones whereas common disorders only reported in 6% of the cases. Presentations became growingly shorter in case of the first cases (P=0.022) while second and third ones took as much time as prior to the Reformation Scheme. There could be seen no considerable improvement in the accuracy of the final diagnoses yet punctuality was reported to have improved significantly as morning reports routinely and regularly commenced at 8 a.m. following alterations(P=0.025). A significant rise in the number of cases presented and discussed in every meeting (p=0.006).
    Conclusions
    Training and feedback seem to have improved the quality of morning reports in different respects, especially when augmented by applying national as well as international standards used in this and other studies.
    Keywords: Morning Report, Teaching Method, Action Research