فهرست مطالب

Advances in Medical Education & Professionalism - Volume:5 Issue: 1, Jan 2017

Journal of Advances in Medical Education & Professionalism
Volume:5 Issue: 1, Jan 2017

  • تاریخ انتشار: 1395/11/03
  • تعداد عناوین: 7
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  • Naina Kumar, Namit Kant Singh, Samar Rudra, Swanand Pathak Pages 1-5
    Introduction
    Direct Observation of Procedural Skills (DOPS) is a way of evaluating procedural skills through observation in the workplace. The purpose of this study was to assess the role of DOPS in teaching and assessment of postgraduate students and to know the effect of repeated DOPS on improvement of the skills and confidence of the students.
    Methods
    This prospective study was conducted in the Obstetrics and Gynecology department of a rural tertiary centre in Northern India in two phases. All postgraduate students (n=20) were randomly divided year-wise into two groups, using lottery system such that both groups had equal number of first, second and third year students for didactic lecture/simulation teaching using mannequins, with hands-on exposure on Active management of third stage of labor (AMTSL) and Postpartum hemorrhage (PPH) management. In the first phase, Group 1 received simulation teaching using mannequins with hands on for 4 sittings, and Group 2 received didactic lecture on AMTSL. Following the students’ performance of AMTSL steps on delivering women, their competencies were assessed using DOPS structured checklist of ten points on 6 sessions. The students’ performance in six DOPS was compared between the two groups. In the 2nd phase, after flipping of the groups, group one received didactic lecture, and group 2 simulation teaching on PPH management with hands on for 4 sittings, followed by comparison of six DOPS performance in both groups. The data were analyzed by Wilcoxon rank-sum (Mann–Whitney) test using SPSS software, version 20.
    Results
    In both phases, significant difference was observed between the two groups on first DOPS comparison (1st phase: p=0.000; 2nd phase: p=0.002), with simulation group performing better. Comparison of sixth DOPS in the two groups revealed no difference in both phases, but significant difference on first and sixth DOPS comparison in each group (p=0.000).
    Conclusion
    Repeated DOPS results in improved skills and confidence of students in managing real life obstetric emergencies irrespective of the teaching modality.
    Keywords: Direct observation, Procedural skills, Postpartum hemorrhage, Clinical competency
  • Piyali Das, Subhradev Biswas, Ramji Singh, Sanhita Mukherjee, Sharmistha Ghoshal, Debasis Pramanik Pages 6-10
    Introduction
    Early Clinical Exposure has been conceptualized to orient medical students towards actual clinical scenario and help them correlate their theoretical knowledge with real life situations in early years of MBBS courses. In the present study we explored the outcome of early clinical exposure in the context of basic science topics (Physiology) in fresh MBBS entrants and compared their performance with a conventionally taught control group.
    Methods
    One hundred fifty voluntary students of 1st year MBBS (2015-16) batch consisted the sample of this study. They were divided into two groups through the simple random method (using computer generated random number table with roll numbers of the students). They were evaluated by MCQ (Multiple Choice Question) and OSCE (Objective Structured Clinical Examination) before and after being taught a basic Physiology topic (respiratory system) theoretically. The study group underwent clinical exposure before the post-test while the control group did not. Performance of the students was compared between the two groups by unpaired Student’s t-test whereas marks of pre and posttest within the same group were compared by paired student’s t– test. Everywhere p
    Results
    The marks of each group in the pre and post-tests differed significantly (p
    Conclusion
    Early clinical exposure may be an effective technique to supplement the traditional theoretical teaching and improve the performance of fresh medical entrants in Physiology. It has better acceptability by the students and may be considered for inclusion in the existing pre-clinical curriculum with proper allocation of time and manpower.
    Keywords: Early clinical exposure, Undergraduate, Curriculum
  • Shahram Yazdani, Zohreh Khoshgoftar, Soleiman Ahmady, Hassan Rastegarpour, Seyed Abbas Foroutan Pages 11-20
    Introduction
    Over the past few decades, two revolutionary approaches have emerged as a new form of medical education: Electronic Medical Education and Web-based Medical Education. A number of well-known medical institutions, such as Harvard and Johns Hopkins used a wide range of cyberspace capabilities to increase their competitiveness. Researchers have expressed that cyberspace will change health system’s main objective of training physicians and medical education. We conducted this study to identify the health system critical considerations on core issues, involving the development of medical education on cyberspace.
    Methods
    In order to conduct this study, we observed the steps of a critical literature review, combined with the ‘Four-phase method’ adopted by Carnwell and Daly. We focused on particular literature on health and cyber system functions; it was associated with systemic approach.
    Results
    We developed a six-level taxonomy, Cyber level, Governance level, Ministerial level, Organizational level, Program level and Performance level, as a key solution that can be applied for the success of medical education on cyberspace. The results were summarized and appraised in more details.
    Conclusion
    Medical education on cyberspace is a complex interdisciplinary system. It is important that all aspects of the health systems be involved as integral to the development of cyber based medical education; without this convergence, we will be confused by the decisions made by others within the system. Health system should also communicate with those external sectors that are critical to achieving better learning on cyberspace. Integrated planning, governance and management of medical education in cyberspace are pivotal elements for the promotion.
    Keywords: Medical education, Educational technology, Health information technology, Health system
  • Hooman Hosein Nejad, Mehdi Bagherabadi, Alireza Sistani, Helen Dargahi Pages 21-25
    Introduction
    Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents’ teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students’ perception of the residents’ teaching quality.
    Methods
    This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences. In this survey, Emergency Medicine Residents (n=32) participated in an 8-hour workshop. The program evaluation was performed based on Kirkpatrick’s model by evaluation of residents in two aspects: self-assessment and evaluation by interns who were trained by these residents. Content validity of the questionnaires was judged by experts and reliability was carried out by test re-test. The questionnaires were completed before and after the intervention. Paired sample t-test was applied to analyze the effect of RAT curriculum and workshop on the improvement of residents’ teaching skills based on their self-evaluation and Mann– Whitney U test was used to identify significant differences between the two evaluator groups before and after the workshop.
    Results
    The results indicated that residents’ attitude towards their teaching ability was improved significantly after participating in the workshop (p
    Conclusion
    On the whole, the educational workshop for Residents as Teacher for emergency medicine residents resulted in favorable outcomes in the second evaluated level of Kirkpatrick’s model, i.e. it showed measurable positive changes in the self-assessments of medical residents about different aspects of teaching ability and performance. However, implementing training sessions for resident physicians, although effective in improving their confidence and self-assessment of their teaching skills, seems to cause no positive change in the third evaluated level of Kirkpatrick’s model, i.e. the residents’ behaviors, and it does not seem to raise students’ satisfaction or meet their expectations.
    Keywords: Resident as teacher, Curriculum, Emergency medicine
  • Mahmud Chaghari, Mohsen Saffari, Abbas Ebadi, Ahmad Ameryoun Pages 26-32
    Introduction
    In-service training of nurses plays an indispensable role in improving the quality of inpatient care. Need to enhance the effectiveness of in-service training of nurses is an inevitable requirement. This study attempted to design a new optimal model for in-service training of nurses.
    Methods
    This qualitative study was conducted in two stages during 2015-2016. In the first stage, the Grounded Theory was adopted to explore the process of training 35 participating nurses. The sampling was initially purposeful and then theoretically based on emerging concept. Data were collected through interview, observation and field notes. Moreover, the data were analyzed through Corbin-Strauss method and the data were coded through MAXQDA-10. In the second stage, the findings were employed through Walker and Avant’s strategy for theory construction so as to design an optimal model for in-service training of nursing staff.
    Results
    In the first stage, there were five major themes including unsuccessful mandatory education, empowering education, organizational challenges of education, poor educational management, and educational-occupational resiliency. Empowering education was the core variable derived from the research, based on which a grounded theory was proposed. The new empowering education model was composed of self-directed learning and practical learning. There are several strategies to achieve empowering education, including the fostering of searching skills, clinical performance monitoring, motivational factors, participation in the design and implementation, and problem-solving approach.
    Conclusion
    Empowering education is a new model for in-service training of nurses, which matches the training programs with andragogical needs and desirability of learning among the staff. Owing to its practical nature, the empowering education can facilitate occupational tasks and achieving greater mastery of professional skills among the nurses.
    Keywords: Grounded theory, Model, Nurse, Training
  • Fatemeh Shirazi, Farkhondeh Sharif, Zahra Molazem, Mahboobeh Alborzi Pages 33-41
    Introduction
    Working in the complex and ever changing healthcare settings forces the nurses and nursing students to be equipped with lifelong learning skills. One of the lifelong learning skills is self-directed learning. This study aimed to explore the M.Sc. nursing students’ self-directed learning activities.
    Methods
    A qualitative design using conventional content analysis approach was used in this study. Semi-structured interviews were conducted with twelve Iranian M.Sc. nursing students who were selected using purposive sampling.
    Results
    Data analysis indicated that the M.Sc. nursing students performed different activities in their self-directed learning. These activities were categorized into four main themes and ten subthemes. The main themes were “sensory perceptions”, “knowledge construction”, “problem-centered orientation”, and “interaction with others”.
    Conclusion
    According to the findings, the M.Sc. nursing students performed different intellectual and experiential self-directed activities for promoting their learning. Besides, the students’ perseverance and inquisitiveness played an important role in their self-directed learning in the challenging clinical environments.
    Keywords: Self, directed learning, Qualitative study, Nursing student
  • Leila Bazrafkan, Ali Asghar Hayat, Karim Abbasi, Aghdas Bazrafkan, Azadah Rohalamini, Mozhgan Fardid Pages 42-48
    Introduction
    The information literacy status and the use of information technology among students in the globalization age of course plans are very momentous. This study aimed to evaluate the information literacy status and use of information technology among medical students of Shiraz University of Medical Sciences in 2013.
    Methods
    This was a descriptive-analytical study with crosssectional method. The study population consisted of all medical students (physiopathology, externship and internship) studying at Shiraz University of Medical Sciences. The sample size (n=310) was selected by systematic random sampling. The tool of data gathering was LASSI questionnaire (assigned by America research association) with 48 closed items in five-point LIKERT scale. The questionnaire included two distinct parts of demographic questions and the information literacy skills based on the standards of information literacy capacities for academic education. The content validity was acquired by professors’ and experts’ comments. The reliability was also calculated by Cronbach’s alpha (0.85). Data were analyzed in both descriptive (frequency- mean) and analytical level (t-test, analysis of variance) using SPSS 14 software.
    Results
    60.3% of the participants were females, and the remaining (29.7%) were males. The mean score of information literacy and its five subgroups among the students weren’t at a desirable level. The mean scores of information literacy for educational grades from the highest to lowest belonged to the internship, physiopathology and externship. The results showed that the highest average was related to the effective access ability to information among interns (9.27±3.57) and the lowest one was related to the ability of understanding legal and economical cases related with using information among externs (3.11±1.32). The results of ANOVA showed that there wasn’t a significant difference between educational grades and information literacy. Finally, the result of independent t-test did not show a significant difference between the two genders in information literacy.
    Conclusion
    Regarding the importance of information literacy for medical students and undesirable status of information literacy among students, the current educational plans will need to be revised.
    Keywords: Medical students, Information literacy, Technology, Medical informatics