Journal of Advances in Medical Education & Professionalism
Volume:5 Issue: 3, Jul 2017

As you know, there is increasing attention in social accountability concept for medical and other health professional schools. Despite the uniqueness of the concept of social accountability, it has different definitions in various fields. The World Health Organization (WHO) has described social accountability generally as follows: “the obligation to direct education, research and service activities toward addressing the priority health concerns of community, region, or nation”(1). Applied to health professional schools, the idea of social accountability recognizes it’s prospective for transforming community by acting throughout the educational, research and healthcare delivery, on a mixture of social determinants of health factors and for helping to make a proficient and equitable health system. One of the health professional schools in Shiraz University of Medical Sciences is the School of Rehabilitation Therapy. This school is committed to lead and stimulate positive changes that improve quality of lives through rehabilitation education, research and practice. As part of this commitment, the mission of this school is to teach occupational therapists, physiotherapists and physiotherapy scientists who contribute to wellbeing and welfare of the community. This school is recognized for excellent social accountability. In a qualitative study, we developed the indicators for assessing the concept of social accountability in this school based on the extensive literature review and expert opinions. Finally, 57 indicators were determined for assessing the social accountability and used for assessment of social accountability in this school (2). The results showed that considering the healthcare needs of the community for education and research, provision of interdisciplinary education for students, addition of the idea of social accountability in the accreditation system, teaching professionalism to students before the clinical courses, and cooperation with other stakeholders (including academic health centers, physician communities, and other relevant paramedical schools) were reported as some of the strengths of this school. Some of the weaknesses of this school were lack of continuous evaluation programs for precise analysis of the current needs of the society and lack of correspondence between some of the elective training programs with the accountability approach. What’s more, the willingness of the community to participate in the health programs, lifestyle changes and change in the public approval for services in educational fields are some of the existing trends in this school. It seems necessary that social accountability concept of rehabilitation therapy schools should be further taken into consideration as a means of improving the outcomes of rehabilitation education, research and services. In conclusion, all health professional schools
should contribute to the needs of society by educating their students well in this field. Through accomplishment of these aims, these schools can play the maximum effective role in the health of the community.

Evidence Based Medicine (EBM) has established itself as a strong predictor of future medical practice by medical students. The purpose of this study was to determine the effectiveness of EBM in pre-clinical years and reflect on selfassessment skill of 4th semester medical students regarding the understanding of EBM and its various determinants.
All of the 4th semester (MD4) medical students at the Avalon University of Medical School, Curacao who had completed their EBM curriculum were asked to voluntarily participate in a cross sectional student survey containing qualitative and quantitative questionnaires in a 10-point scale. The students’ responses were analyzed statistically and the results reported.
Twenty-three students participated in the survey. 91% of them reported that EBM had helped them to better understand research process and 95% believed that EBM was necessary to develop clinical skills in the future. 78% of the students agreed that they were provided with enough resources for effective implementation of EBM in the university. All participants (100%) self reported that they could appraise the research articles effectively (mean score 8.26, S.D-1.45).
EBM is an integrative and comprehensive way to successfully adopt concepts of acquired medical knowledge for effective medical practice. Early introduction of EBM in preclinical years proved favorable in students and better equipped them with the ability to critically apprehend and appraise new research and innovations in medicine for optimal learning experience. There is a definitive need for scientific and systematic design of the curriculum for early introduction of EBM in pre-clinical years, best suited for the students. The principles should be directed towards further research for the effective implementation of EBM to enhance clinical skills.

Evidence-based practice (EBP) is the conscientious, explicit and judicious use of the current evidence in clinical decision making. The physiotherapy profession has expressed a commitment to the development and use of evidence. However, very little is known about the extent to which EBP is integrated in physiotherapy curricula in India. The purpose of this study was to describe integration of EBP in Indian physiotherapy programs.
An observational study was conducted where a review of curricula of all Health Science Universities (HSU) in India, offering an undergraduate (UG) and post-graduate (PG) degree program in physical therapy was conducted using a data abstraction sheet. It gathered data on inclusion of research components of EBP in the curricula, content and hours of teaching EBP, and assessment methods. Data were analyzed descriptively.
Curricula of fifteen HSU offering physiotherapy programs were reviewed. Contents relevant to EBP were incorporated from the 2nd yr to final year. Common courses included research methodology (84.61%), research project (69.23%) and clinical management subjects (57.14%). No guidelines were given about adopting EBP in clinical practice. Didactic lectures were the mode of teaching (81.81%). Preferred method for assessing research projects was viva (44.44%). Critical appraisal was least included in the entry level education. Contents relevant to all the five steps of EBP were included in PG curricula.
Though physiotherapy programs are introducing EBP teaching at the entry level, it lacks structured systematic approach and is fragmented. There is inadequate emphasis on clinical oriented teaching of EBP and assessment methods. Moreover, there is adequate coverage of EBP content in PG curricula.

Considering the pervasiveness of social accountable medical education concept around the world and the growing trend of literature in this regard as well as various interpretations made about this concept, we found it necessary to analyze the concept of social accountable medical education.
In this study, the modified version of McKenna’s approach to concept analysis was used to determine the concept, explain structures and substructures and determine the border concepts neighboring and against social accountability in medical education.
By studying the selected sources, the components of the concept were obtained to identify it and express an analytic definition of social accountability in medical education system. Then, a model case with all attributes of the given concept and the contrary and related concepts were mentioned to determine the boundary between the main concept and auxiliary ones.
According to the results of this study in the field of social accountability, the detailed and transparent analytical definition of social accountable medical education can be used in future studies as well as the function and evaluation of medical education system.

There is a growing trend in online education courses in higher education institutes. Previous studies have shown that high levels of self-direction are essential for successful online learning. The present study aims to investigate challenges of and barriers to self-directed virtual-learning among postgraduate students of medical sciences.
23 postgraduate virtual students of medical sciences in Iran, collected through maximum variation purposive sampling and semi-structured interviews, served as the sample of this study. The collected data were analyzed using the inductive content analysis method.
Three themes and six sub-themes were identified as barriers to self-directed learning in virtual education, including cognitive barriers (information overload and lack of focus on learning or mind wondering), communication barriers (inadequate coping skills and inadequate writing skills) and educational environment barriers (heavy workload and role ambiguity).
By the importance of self-direction in online education, the present study results can be used by virtual education planners in the review and design of courses, so as to adequately equip students, obviate barriers to self-directed virtual education, and ultimately train highly self-directed learners in online medical education.

Governments and professional organizations have called for new partnerships between health care providers and academics to improve clinical education for the benefit of both students and patients. To develop a substantive grounded theory on the process of forming academic-service partnerships in implementing clinical education, from the perspective of academic and clinical nursing staff members and managers working in Iranian settings.
The participants included 15 hospital nurses, nurse managers, nurse educators, and educational managers from two central universities and clinical settings from 2009 to 2012. Data were collected through 30 in-depth, semi-structure interviews with the individual participants and then analyzed using the methodology of Strauss and Corbin’s grounded theory.
Utilizing “balancing power” as the core variable enabled us to integrate the concepts concerning the partnership processes between clinical and educational institutes. Three distinct and significant categories emerged to explain the process of partnership: 1) divergence, 2) conflict between educational and caring functions, and 3) creation of balance between educational and caring functions.
In implementing clinical education, partnerships have been formed within a challenging context in Iran. Conflict between clinical and educational functions was the main concern of both sides of the partnership in forming a collaborative relationship, with our findings emphasizing the importance of nursing educators’ role in the establishment of partnership programs.

The main mission of military medicine in the world is to support the health and treatment of the military in relation to issues, risks, injuries and diseases that arise due to the specific occupational conditions. The current study was carried out with the aim of determining the required skills of military physicians to define and determine the required training modules.
The study was a qualitative research. Semi-structured interviews were used to collect the data and qualitative content analysis was used to analyze the data. The study population included all the professors and experts in the field of military medicine and medical sciences at the medical universities of Tehran. Snowball sampling technique was used to sample the study participants.
Based on the results, the required skills of military physicians in 5 categories and 29 sub- categories were identified; then based on the identified skills, 60 training modules at two introductory and advanced levels were determined including 39 introductory levels and 21 advanced levels.
We can conclude that some of the important skills that military physicians need and can achieved through training have not been provided in any educational program and to achieve such skills and capabilities, other programs should be developed and modular training can be one of them

In recent years curriculum reform and integration was done in many medical schools. The integrated curriculum is a popular concept all over the world. In Shiraz medical school, the reform was initiated by stablishing the horizontal basic science integration model and Early Clinical Exposure (ECE) for undergraduate medical education. The purpose of this study was to provide the required data for the program evaluation of this curriculum for undergraduate medical students, using CIPP program evaluation model.
This study is an analytic descriptive and triangulation mixed method study which was carried out in Shiraz Medical School in 2012, based on the views of professors of basic sciences courses and first and second year medical students. The study evaluated the quality of the relationship between basic sciences and clinical courses and the method of presenting such courses based on the Context, Input, Process and Product (CIPP) model. The tools for collecting data, both quantitatively and qualitatively, were some questionnaires, content analysis of portfolios, semistructured interview and brain storming sessions. For quantitative data analysis, SPSS software, version 14, was used.
In the context evaluation by modified DREEM questionnaire, 77.75%of the students believed that this educational system encourages them to actively participate in classes. Course schedule and atmosphere of class were reported suitable by 87.81% and 83.86% of students. In input domain that was measured by a researcher made questionnaire, the facilities for education were acceptable except for shortage of cadavers. In process evaluation, the quality of integrated modules presentation and Early Clinical Exposure (ECE) was good from the students’ viewpoint. In product evaluation, students’ brain storming, students’ portfolio and semi-structured interview with faculties were done, showing some positive aspects of integration and some areas that need improvement.
The main advantage of assessing an educational program based on CIPP evaluation model is that the context, input, process and product of the program are viewed and evaluated systematically. This will help the educational authorities to make proper decisions based on the weaknesses and strengths of the program on its continuation, cessation and revision. Based on the results of this study, the integrated basic sciences course for undergraduate medical students in Shiraz Medical School is at a desirable level. However, attempts to improve or reform some sections and continual evaluation of the program and its accreditation seem to be necessary.

Gender equality amongst healthcare professionals is no doubt paramount to allow both equal opportunity and provision of good quality healthcare. The General Medical Council encourages that all colleagues should be treated fairly, but studies have previously demonstrated gender bias against female medical students (1). Whether this might have any impact on the students’ decision-making process and career pathways has yet to be explored. We aimed to evaluate whether doctors gave students gender-specific advice and the extent to which this advice influenced the students. Furthermore, we explored whether students felt their gender affected their career choices. We carried out a cross-sectional national study of British clinical medical students. A standardised questionnaire was completed by 94 students (54.3% female). The response rate was 88.7%.
Results showed that 43.6% (n=41) of students received career advice based purely on their gender, and 63.4% (n=26) of these said that this would influence their career choices. Importantly, 82.9% (n=34) of the students who received gender-specific advice were female.
Additionally, 41.2% (n=21) of females felt their gender would restrict their career choices compared with only 11.6% (n=5) of males (p=0.00142). 37.3% (n=19) of females thought their gender would unfairly disadvantage their career progression compared to 4.65% (n=2) of males (p=0.00016).
Our results highlighted that doctors gave more gender-specific advice to females compared to males, and that this advice significantly impacts students’ decision making process. Furthermore, females disproportionately felt their careers would be disadvantaged and restricted compared with males. This shows an enormous disparity between male and female attitudes towards medical careers.
This can have both long and short-term effects on training, career choices and patient interaction. Further research investigating why females feel their gender will restrict their careers, and why doctors give gender-specific advice, particularly targeted at females must be undertaken to identify the root cause of the problem.
We therefore advocate that medical schools: 1) promote gender equality through seminars, talks and increase accessibility to good female role models; and 2) train clinical teachers to impart generic career advice as opposed to genderspecific career advice.