Journal of Advances in Medical Education & Professionalism
Volume:1 Issue: 3, Jul 2013

The purpose of this study was to improve communication skills and knowledge of bioethics of last year medical students doing clerkship and to evaluate the effectiveness of using workshops for this purpose from students’ point of view, in order to continue such programs in future. After Ethical approval for the study a two-day workshop on teaching effective communication skills and principles of medical ethics was planned and conducted by the department of Medical Education through multidisciplinary faculty of Foundation University Medical College, Pakistan. A total of 102 last year medical students participated in this workshop. The students were divided into 8 groups each containing 12 students. A team of pre trained facilitators for each group conducted the group activities. Teaching strategies including interactive discussions on basic principles of doctor-patient relationship, power point presentations, day to day case scenarios, video clips and presentations involving students in role plays were used. Pre and post workshop self evaluation proformas about knowledge and skills of communication and medical ethics were rated (0=none, 1=below average, 2=average, 3=above average, 4=very good, 5=excellent) by the students. 89 out of 102 participants returned the proformas. A significant percentage of students (%82) showed improvement in their knowledge and skills of appreciating bioethical issues like valid informed consent, patient confidentiality, end of life issues and breaking bad news by rating as “very good” after participation in the workshop. More than %70 students recommended this activity for other students. Teaching through interactive workshops was found to be an effective method as reflected by students’ feedback. Therefore, the program will be continued in future.

Hospital managers, as one of the most important health care workers, are the subject of continuous education. In some countries around the world, health management education is an important part of health reforms. The aim of present research is to perform evidence-based studies based on assessing hospital managers’ needs. Therefore, it should be considered that educational need assessment regarding hospital managers is essential in today’s health care management. A total of 26 hospital managers were surveyed using a data gathering form (questionnaire) including 59 open questions designed in order to obtain data in 3 different areas. These included managers’ insight towards job duties and the capabilities required to fulfill their duty along with educational needs determined by managers. The next step involved presenting standard description of job duties to hospitals managers and asking them to document their educational needs regarding capabilities required to fulfill their duties. The standard description of job duties originated from ISO 9001 certified hospitals. For each manager, a score ranging from 0 to 19 was attained. For each correct matched statement, a positive point was considered and in the case of unmatched statements, managers received no points. Out of 26 participating managers, only 20 did state the educational needs of hospitals managers. In describing job duties of hospital managers, the mean scores regarding hospital managers of public sector was 10.27 while it was 8 with private hospital managers. The findings of our study indicate that hospital managers as the leaders of the most sophisticated health care facilities delivering expensive complicated services need proper training regarding job competency. Therefore, it seems that continuous need assessment in this area should be carried out.

Although logbook is a useful tool in learning and assessment of the student, its use in the education of undergraduate dentistry students is not well-established. The present study was conducted to assess the effect of logbook as a study guide and an effective method for assessment of the students in the fixed prosthesis course. This quasi-experimental study was performed in Shiraz Dental School. The subjects of this study consisted of 60 students categorized into two experimental and control groups. In the control group, the students underwent the current format of Fixed Prosthesis curriculum. In the experimental group, the intervention was carried out using the Logbook. Pre and post tests were done using MCQ. The instructors and students had to evaluate the students’ daily activities. The data were analyzed using SPSS software. T-test, Paired T-test and Mann Whitney test were used for statistical analysis. The logbooks were effective in cognitive and psychomotor domain (knowledge and practice) of dental education and the mean difference between the two groups was significant (P<0.01). The use of logbook provided a more objective evaluation and led to further student satisfaction. Logbook is a useful tool for teaching and learning as an interactive study guide and assessment tool. Using logbook in dentistry education necessitates more studies to be conducted in this regard and also the revision of dental curricula.

Objective Structured Clinical Examination (OSCE) is one of the most appropriate methods for assessment of clinical skills.Validity and reliability assurance is a mandatory factor for any assessment tool. In Shiraz University of Medical Sciences, medical students’ clinical competences are evaluated by a pre-internship OSCE. This study is designed to examine the validity and reliability of this exam. Validity is the extent to which the test measures what it intends to measure. Reliability refers to the accuracy of measurement and the consistency of test results. Content validity was evaluated by expert opinion about blueprinting and station checklists. To determine the construct validity, station scores correlation with the total OSCE score and inter station correlations were calculated. The inter examiner reliability was assessed by coefficient of correlation. Content validity was established by alignment between the curriculum and the blueprint using expert opinion. Correlation of the station scores with the total OSCE score were positive and statistically significant in all stations except the 16th station (suturing). Inter examiner reliability coefficients of correlations ranged 0.33 – 0.99, with an average of 0.83. Our findings support the assumption that the pre-internship OSCE is valid, reliable and suitable to assess students’ clinical competence. Validity and reliability studies should be performed for all new assessment tools, particularly in high-stakes assessments.

Problem-based learning (PBL) as a learning style has gained a special position amongst different levels of education systems, and many different approaches, such as tutor education, proper scenario presentation, etc., are used to increase its efficiency. However, the role of homogeneous groups to facilitate team working has never been studied. The purpose of this study is to examine the effect of selective group allocation in PBL efficiency. In this semi-experimental double-blinded study, 40 students of medicine during their externship in the radiology department were divided into two equivalent groups based on their grade average points. The same topics and the same instructors were chosen for both groups. In the control group, the students were randomly divided into four subgroups each with five members. The subgroups in the study group, on the other hand, were homogenized based on their grade average points. The students’ rate of learning of the theoretical topics and their performance in reporting and interpreting the stereotypes in radiology were measured at the beginning and at the end of the study in both groups by two questionnaires with Alpha Krunback of 0.87 and 0.85. All students were male with the mean age of 23.7 years ± 1.19. Age, grade point average of the students in the last semester and the mean of their pre and post-test scores in both groups showed a normal pattern of distribution (p>0.05). The learning and performance scores in each group at the beginning and at the end of the course showed a statistically significant difference with a p value of 0.011 and 0.03, respectively. Homogenizing the PBL groups with allocation of more competent student in each group plays a complementary tutor role and boosts the level of learning by enhancing group dynamicity.

Job stress is one of the main factors in decreasing productivity in organizations and the leading cause of psychosomatic disorders in personnel. Since job stress of nurses working in Intensive Care Units (ICUs) is considered as an important segment in health and medical systems, it significantly affects the quality of care and the nurse’s quality of life. To this end, the purpose of this research is to examine the effects of teaching stress management skills on the quality of life of the nurses working at ICU of the hospitals affiliated to Shiraz University of Medical Sciences. The subjects of the study consisted of 60 ICU nurses with the average stress score in Osipow job stress exam working at the hospitals affiliated to Shiraz University of Medical Sciences. The subjects were randomly assigned to two groups (30 in the case and 30 in the control group). The intervention was performed as a teaching stress management workshop for eight hours throughout two-days (four hours per day), and the nurses were followed up for two months. The data were collected through a two part questionnaire including demographic characteristics and WHO Quality of life BREF and were analyzed in SPSS software using paired t test, and t-test. The findings showed that the nurses of both the case and control groups were homogeneous considering the demographic data such as age, sex, marital status, number of children, shift position, job satisfaction, number of working hours per week, work experience and the amount of income. Moreover, there was no significant difference between the mean score of the life quality before the intervention in both groups. But after the intervention, a significant increase was revealed in the mean score of the life quality of the case group as compared to that of the control group (P<0.0001). The findings revealed the efficacy of the stress management workshop in improving the life quality of ICU nurses. During one and two months after the intervention, the mean score of the quality of life had a significance increase compared to the stage before the intervention.

Implementation of professional standards as well as evaluation and assessments of providers has an important role in health promotion of each society. The purpose of this study was to assess the midwives working at midwifery offices as to performance of professional standards and effectiveness of continuous evaluation and education on them. This is an interventional study in which all of midwifery offices (110) were evaluated. The study was done in three stages using standard checklist observation and interview in each step. Based on detected errors, appropriate education was done and their performance was reevaluated in the next step of supervision. Finally total scores in each step as well as scores in different subjects were compared among three evaluated stages. Overall mean score of faults at midwifery offices decreased from step 1 to step 3 in the following fields: environmental health and infection control (P<0.0002), personal and patient care (P=0.0005), individual health (P=0.003) and adherence to laws and rules (P<0.0001). Continuous evaluation is essential for assessing the effectiveness and improvement of our educational program. With continuous evaluation, correction of observed defects will be done at an early stage by appropriate intervention and education. So our medical and health programs will attain the planned goals.

Dear editor Clinical environments encounter is an important part of studying medicine (1). Patient contact as an integral part of medical education occurs in various formats in the clinical settings (2, 3). During clinical training, medical students may experience high levels of stress, and some may not deal with it well. The abruptness of students’ transition to the clinical setting generated positive and negative emotions. Due to being a novice, they did not receive adequate training on how to get emotionally prepared for meeting seriously ill people. In such circumstances, the shortage of training will have predictably crucial consequences. Early clinical contact has been suggested to reduce these stresses and help the students adapt effectively to changes in the hospital climate (2). Patient contact creates an environment where each student appreciates cultural diversity and reinforces the development of clinical professional interpersonal skills through social, emotional and cognitive experiences (4, 5). It encourages validating of the relationship between patients and doctors and allows students to experience a more personal relationship with patients and nurture the ability to empathize with them, providing considerable benefits for trainees and patients. In this way, the social emotions that students experience when empathizing with a patient represent a uniquely human achievement. By internalizing their subjective interpretations of patient’s beliefs and feelings, the student’s body, brain and mind come together to produce cognition and emotion.