فهرست مطالب

Advances in Medical Education & Professionalism - Volume:4 Issue: 2, Apr 2016

Journal of Advances in Medical Education & Professionalism
Volume:4 Issue: 2, Apr 2016

  • تاریخ انتشار: 1395/01/29
  • تعداد عناوین: 8
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  • Shahram Yazdani, Fakhrolsadat Hosseini, Soleiman Ahmady Pages 45-53
    Introduction
    Systems-Based Practice (SBP) is one of the six competencies introduced by the ACGME for physicians to provide high quality of care and also the most challenging of them in performance, training, and evaluation of medical students. This concept analysis clarifies the concept of SBP by identifying its components to make it possible to differentiate it from other similar concepts. For proper training of SBP and to ensure these competencies in physicians, it is necessary to have an operational definition, and SBP’s components must be precisely defined in order to provide valid and reliable assessment tools.
    Methods
    Walker & Avant’s approach to concept analysis was performed in eight stages: choosing a concept, determining the purpose of analysis, identifying all uses of the concept, defining attributes, identifying a model case, identifying borderline, related, and contrary cases, identifying antecedents and consequences, and defining empirical referents.
    Results
    Based on the analysis undertaken, the attributes of SBP includes knowledge of the system, balanced decision between patients’ need and system goals, effective role playing in interprofessional health care team, system level of health advocacy, and acting for system improvement. System thinking and a functional system are antecedents and system goals are consequences. A case model, as well as border, and contrary cases of SBP, has been introduced.
    Conclusion
    The identification of SBP attributes in this study contributes to the body of knowledge in SBP and reduces the ambiguity of this concept to make it possible for applying it in training of different medical specialties. Also, it would be possible to develop and use more precise tools to evaluate SBP competency by using empirical referents of the analysis.
    Keywords: Accreditation, Medical education, Competency, based education
  • Seyed Aliakbar Faghihi, Hamid Reza Khankeh, Seyed Jalil Hosseini, Seyed Kamran Soltani Arabshahi, Zahra Faghih, Sagar V. Parikh, Mandana Shirazi Pages 54-63
    Introduction
    Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners.
    Methods
    Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general.
    Results
    The participants’ experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers’ use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME.
    Conclusion
    Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME.
    Keywords: Continuing medical education, General practitioners, Qualitative study
  • Alireza Esteghamati, Hamidreza Baradaran, Alireza Monajemi, Hamid Reza Khankeh, Mehrnaz Geranmayeh Pages 64-71
    Introduction
    In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students’ knowledge, attitudes, and practice; therefore, it should be properly planned. Due to the extensiveness of the clinical environment and its importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents’ learning by improving their learning environment. Therefore, our qualitative content analysis study, aimed to examine the experiences and perspectives of internal and surgical residents and their attending physicians about learning in clinical settings.
    Methods
    This qualitative content analysis study was conducted through purposeful sampling. Semi-structured interviews were conducted with 15 internal and surgical residents and 15 of their attending physicians at educational hospitals of Tehran University of Medical Sciences.
    Results
    The main categories explored in this study were hidden curriculum, learning resources, and learning conditions. In the context of clinical environment and under its individual culture, residents learn professionalism and learn to improve their communication skills with patients and colleagues. Because of clinical obligations such as priority of treating the patients for education or workload of the attending physicians, residents acquire most of their practical knowledge from colleagues, fellows, or follow-up patients in different learning conditions (such as: educational rounds, morning reports and outpatient clinics). They see some of their attending physicians as role models.
    Conclusion
    Changing cultural and contextual factors is of prime importance to promote a learning-oriented environment in a clinical setting. The present findings will help curriculum planners and attending physicians to improve residents’ learning by means of appropriate workplace planning and by considering the components involved in clinical learning.
    Keywords: Learning, Teaching hospitals, Workplace, Curriculum, Medical students
  • Zahra Jouhari, Fariba Haghani, Tahereh Changiz Pages 72-79
    Introduction
    Research on medical students shows that adopting self-regulation of effort, time, and study strategies can positively influence academic achievement. The purpose of the current study was to assess learning and study strategies in medical students.
    Methods
    This cross-sectional study was carried out in 2014-2015 at Isfahan University of Medical Sciences. The sample size was determined 360 students based on the results of a pilot study on 30 members of the study population. Medical students in the first to fourth year of their studies were selected through simple sampling randomly. A valid and reliable Persian translation of Learning and Study Strategies Inventory (LASSI) questionnaire was completed by the students. It measures three latent factors of selfregulated learning: Skill, Will, and Self-Regulation. It consists of 80 questions in ten different scales (each scale including eight questions and a variable score of 8-40). Data were analyzed using t-test, correlation analysis, and ANOVA.
    Results
    Considering the ten LASSI scales, the highest mean score belonged to test strategies (28.67±4.44), and the lowest mean to self-testing (21.91±4.91). The results showed significant statistical differences between male and female students in selecting the main idea, attitude, and self-testing. ANOVA and post hoc Tukey tests showed a significant difference between the mean scores of different areas of LASSI among students with different grade point average (GPA) in the university. In all areas except the study aids, the mean scores of students with GPA higher than 17.5 were significantly higher than those of students with GPA lower than 14.5.
    Conclusion
    The results showed that students need help and consultation in most areas of learning and study strategies. Using 10 areas of LASSI can determine the strengths and weaknesses of students in various areas. Knowing their own limitations, students will be able to improve their study habits. Hence, it is suggested to evaluate the students when enrolling at universities and design educational programs based on the students’ characteristics.
    Keywords: Learning, Medical student, Assessment
  • Zohreh Badiyepeymaie Jahromi, Leili Mosalanejad, Rita Rezaee Pages 80-87
    Introduction
    In this study, the authors aimed to examine the effects of cooperative learning methods using Web Quest and team-based learning on students’ self-direction, self-regulation, and academic achievement.
    Methods
    This is a comparative study of students taking a course in mental health and psychiatric disorders. In two consecutive years, a group of students were trained using the Web Quest approach as a teaching strategy (n=38), while the other group was taught using team-based learning (n=39). Data gathering was based on Guglielmino’s self-directed learning readiness scale (SDLRS) and Buford’s self-regulation questionnaire. The data were analyzed by descriptive test using M (IQR), Wilcoxon signed-rank test, and the Mann–Whitney U-test in SPSS software, version 13. p
    Results
    The results of the Mann–Whitney U test showed that the participants’ self- directed (self-management) and self-regulated learning differed between the two groups (p=0.04 and p=0.01, respectively). Wilcoxon test revealed that self-directed learning indices (self-control and self-management) were differed between the two strategies before and after the intervention. However, the scores related to learning (students’ final scores) were higher in the WebQuest approach than in team-based learning.
    Conclusion
    By employing modern educational approaches, students are not only more successful in their studies but also acquire the necessary professional skills for future performance. Further research to compare the effects of new methods of teaching is required.
    Keywords: Clinical, Nursing, Training, Students learning, Internet, Problem, based learning
  • Mohammadreza Dehghani, Shirin Ghanavati, Behrouz Soltani, Nader Aghakhani, Sezaneh Haghpanah Pages 88-92
    Introduction
    Obtaining clinical competency in clinical education is one of the problems in nursing and use of the new methods of clinical training is very important. Clinical supervision is one of the methods used as a mechanism to promote knowledge and skill for promoting professional performance in nursing students. This study is carried out to determine the impact of clinical supervision on field training of nursing students at Urmia University of Medical Sciences.
    Methods
    In the present experimental study, 32 nursing students were enrolled in the study based on census and randomly assigned into two groups of experimental and control by block randomization. Clinical supervision was used in the experimental group and the control group received routine clinical trainings in the field. The students’ clinical skills were assessed using a researcher-made checklist, the validity of which was confirmed through content validity method by 13 faculty members and its reliability was approved by test-retest method on 20 nursing students in the form of a pilot study and through Cronbach’s alpha (87%). Data were analyzed using SPSS, version 14.
    Results
    There was a significant difference between the experimental and control groups in clinical skills such as recognition and administration of medication, team participation, patients and their relatives’ education, considering the safety, infection prevention and nursing process (p
    Conclusion
    The study demonstrated that in clinical supervision process, students have a better communication and cooperation with their instructor and with each other and their confidence and understanding and the amount of learning in practical skills was enhanced more than routine clinical training. The implementation of this clinical training method for students of nursing and other fields of medical sciences is recommendable.
    Keywords: Clinical, Nursing, Training, Students
  • Kamyar Iravani, Mitra Amini, Aida Doostkam, Mahnaz Dehbozorgian Pages 93-96
    Introduction
    The script concordance test (SCT) is one the best tools used to evaluate clinical reasoning in ill-defined clinical situations. The aim of this study was to demonstrate SCT application in otolaryngology residency training.
    Methods
    A 20 item otolaryngology SCT containing 60 questions was administered to 26 otolaryngology residents. The test was prepared by two otolaryngologists familiar to medical education. These questions have been validated by otolaryngology experts. The panel consisted of 9 academic staff in the field of otolaryngology. Pearson correlation test was used to assess the reliability of the test.
    Results
    The obtained mean scores were 68.4±5.8 (out of 100) for residents and 78.2±6.4 (out of 100) for experts. There was a significant difference between the two scores (p
    Conclusion
    The SCT is a reliable tool to evaluate clinical reasoning in otolaryngology residents. It should be included in otolaryngology residency training.
    Keywords: Training, Otolaryngology, Validity, Reliability
  • Sanjay Zodpey, Anjali Sharma, Quazi Syed Zahiruddin, Abhay Gaidhane, Sunanda Shrikhande Pages 97-101
    Introduction
    India has the highest number of medical colleges in the world and subsequently the higher number of medical teachers. There is a dire need of adopting a systematic approach to faculty development to enhance quality education to meet health challenges for 21st Century. This manuscript provides a landscape of faculty development programs in India, identifying gaps and opportunities for reforms in faculty development.
    Methods
    Conventionally, FDPs are organized by medical colleges and universities through Basic Courses and Advanced Courses focusing on pedagogy. Medical Council of India is facilitating FDPs through 18 selected regional centers to enable medical teachers to avail modern education technology for teaching from July 2009. Foundation for Advancement of International Medical Education and Research has three Regional Institutes in India.
    Results
    Recommendations include the need for formulating a national strategy for faculty development to not only enhance the quantity of medical teachers but also the quality of medical education; providing support for Departments of Medical Education/Regional Centers in terms of finance and staffing and incorporation of teaching skills in postgraduate training.
    Conclusion
    Distance learning courses focusing on educational leadership and pedagogy for medical teachers can be an option to reach a wider audience. FDPs can be an asset in recruiting and retaining teachers as they offer valued professional development opportunities.
    Keywords: Faculty, Development, Pedagogy, Medical education