Journal of Medical Education
Volume:23 Issue: 1, Dec 2024

Context: 

Objective structured clinical examination (OSCE) is one of the student assessment methods currently used in both undergraduate and postgraduate medical education. This paper reviews evidence related to key factors influenced by the number and duration of OSCE stations. The aim of our study was to broaden current knowledge of the effective components of OSCE design. Although many OSCE designers have doubts about the optimal number and duration of OSCE stations, this issue has not been adequately addressed so far.

The search was conducted through the databases of ScienceDirect, Eric, PubMed, Scopus, Ovid, and Google Scholar. English language papers, including original and review articles, without a time limit until 2022, were included. This review was conducted on papers selected using the keywords: Objective structured clinical examination, OSCE, duration of station, number of stations, utility, validity, reliability, cost, budget, finance, skill, competency.

The findings have been validated by scrutinizing OSCE-related skills, reliability, validity, and cost evaluations incorporating OSCE design. These results revealed that key factors to consider in OSCE design include skills, reliability, validity, and cost.

Our findings could have a profound impact on the design of OSCE structures in medical education worldwide.

Project management skills are increasingly vital in today's complex global landscape. However, graduates often lack practical skills, leading to project failures. This study evaluates the effectiveness of modular project management courses in enhancing graduates' skills.

This study aimed to design, implement, and evaluate a modular project management course that integrates theoretical knowledge with practical skills, using instructional models like ASSURE and Kirkpatrick's evaluation framework.

The study employed a descriptive-analytical approach, targeting university faculty, administrative staff, and graduate students. The course included interactive lectures, simulations, and group workshops. The evaluation utilized semi-structured interviews and pre-and post-tests to assess participant satisfaction and knowledge acquisition. Data were analyzed using qualitative and quantitative content analysis.

A total of 150 participants completed the course. Analysis revealed that 85% expressed satisfaction, and pre-and post-test results indicated a significant increase in knowledge (P < 0.001). Qualitative feedback highlighted strengths in hands-on applications and instructor quality while suggesting enhancements in interactivity.

Modular project management courses effectively enhance practical skills and knowledge retention among graduates. Continuous evaluation and adaptation are necessary to ensure alignment with professional competencies.

This review aims to investigate the impact of economic sanctions, as a form of economic crisis, on medical education.

This research is a review of studies published between 1995 and 2023. A search was conducted in electronic sources, databases, and information repositories. The initial search yielded 313 articles. In the first screening, which involved examining the titles, 173 unrelated articles were removed, leaving 158 articles for the abstract screening stage. During this stage, 95 unrelated articles were excluded, and after accessing and reviewing the full text of the remaining 63 articles, 35 were deemed eligible for review.

Economic sanctions are defined as restrictions imposed by one country on the international trade and investment of another to force a policy change. Academic and research systems are often overlooked areas that are severely impacted by sanctions. In Sudan, for example, sanctions led foreign organizations to refrain from cooperating with academics in the country, particularly regarding the publication of articles. Importantly, the negative effects of economic sanctions on education cannot be easily remedied, even long after the sanctions are lifted.

The effects of sanctions on education and health have been proven in many countries, including Sudan, Haiti, Zimbabwe, and Iraq. There is an urgent need to specifically focus on the consequences of sanctions on medical education above all other aspects.

This research aims to study the attitude of Shahid Beheshti University of Medical Sciences towards the necessity of implementing interprofessional education (IPE) in 2022. Professors’ research was applied in terms of purpose and descriptive in terms of type.

Considering that the target population is around 2500 people, using Sullivan's formula with a 5% margin of error and a 95% confidence level, the predicted total sample size was 333 people. Sampling was done using cluster and random methods. The study tool included a demographic information questionnaire and a professor attitude questionnaire towards IPE. Data were collected using a standard questionnaire. Out of a total of 330 people selected in the sampling, 138 people completed the questionnaire on Porsline software platform, and 180 completed the questionnaire by visiting in the Porsline. A total of 318 questionnaires were collected. For data analysis, the questionnaire data was entered into SPSS software.

The results of descriptive statistics showed that out of 318 professors, 113 have clinical medicine specialties, 26 have medical and health education specialties, 47 have nursing specialties, 72 have basic medical science specialties, 45 have health specialties, and 15 have health specialties. They managed healthcare services. Most of the professors had clinical medical specialties. But in terms of age, the dispersion of people is more, 40.3% of them who are 50 - 60 years old constitute their dominant population. Also, the results of inferential statistics showed that the attitude questions have a significance coefficient of less than 0.05%, which indicates the significant positive attitude of professors in IPE.

Research has shown that professors of Shahid Beheshti University of Medical Sciences, on the whole, have a positive attitude towards IPE. The positive effect of IPE in improving the attitude of students towards learning and the need for interprofessional cooperation in the health system indicates the availability and essential and motivational background ideal attitude for the integration of IPE in health sciences. For this purpose, managers should aim to plan and implement IPE in the country’s health education system in order to employ capable and talented workforces to respond to the health and hygiene needs of the current and future generations.

Nursing informatics in educational activities can serve as a strategy to bridge the gap between clinical practice and nursing education programs.

This study aimed to assess the informatics competency of nursing faculty members and its application in educating nursing students at Abadan Nursing Faculty.

This descriptive-analytical research was conducted in 2023 at Abadan Nursing Faculty. The sample consisted of 73 faculty members from the nursing, operating room, and anesthesia departments, who were included in the study through census sampling. Data collection was performed using the standardized Nursing Informatics Competency Assessment Tool (NICAT) and an electronic teaching aids checklist. Data were analyzed using SPSS version 18, with independent t -tests, one-way analysis of variance (ANOVA), and Pearson’s correlation at a significance level of P < 0.05.

The mean score of faculty members’ nursing informatics competency at the Nursing Faculty was 110 out of a maximum of 150, placing it within the proficient range. The highest score for nursing informatics competency was related to the informatics literacy dimension (47.65), while the lowest was related to the information management skills dimension (19.54). Information management skills (r = 0.881, P < 0.001), computer literacy (r = 0.871, P < 0.001), and informatics literacy (r = 0.976, P < 0.001) were significantly correlated with nursing informatics competency. Faculty members reported the highest use of multimedia content development (mean score = 4.19) and the lowest use of robotic surgery (mean score = 1.71).

Faculty members’ informatics competency was reported to be at a proficient level. However, due to advancements in technology and transformations in nursing care, it seems necessary to improve nursing faculty members’ abilities in all aspects, particularly in the information management skills dimension. It is recommended to hold faculty development programs regarding the integration of technology into the curriculum to elevate the quality of education.

To describe the impact of the COVID-19 pandemic on ophthalmic residency training in Nigeria, as experienced by trainers in their local institutions during the first 12 months of the pandemic.

A nationwide, cross-sectional web-based survey was conducted among ophthalmology trainers in accredited ophthalmic residency training institutions in Nigeria during the 13th month of the pandemic (April 2021).

A total of 162 trainers from 30 training institutions responded, yielding a response rate of 63%. The mean age of respondents was 51.3 ± 8.6 years. Respondents were affiliated with federal government-owned hospitals (71%), state government-owned hospitals (20.4%), and mission/private hospitals (8.6%). Trainers reported that COVID-19 had a ‘very severe’ or ‘severe’ negative impact on various aspects of training, including surgical skills transfer (73.5%), clinical skills transfer (48.8%), refraction training (46.3%), soft skills transfer (38.2%), and research training (37.6%) in the first year of the pandemic. Facilities for online learning were available to 125 trainers (77%), while 31 trainers (19%) had access to surgical simulation facilities, 32 trainers (20%) used teleophthalmology, and 68 trainers (42%) had access to Electronic Medical Records (EMR). Teleophthalmology and EMR facilities were more available to trainers in private or mission centers compared to those in publicly-owned training institutions.

The COVID-19 pandemic had a significantly negative impact on ophthalmic residency training in Nigeria, with surgical training being the most affected area. Online learning technologies played an essential role in mitigating some of these impacts.

Reflection on both student and teacher perspectives is crucial for effective communication and professional relationships during education.

This observational cohort study aimed to compare students' self-assessment with teacher assessments, as well as with estimated self-assessment and estimated teacher-assessment, using the pictorial representation of illness and self-measure (PRISM) during an objective structured clinical examination (OSCE). Additionally, it sought to compare self-assessment and teacher-assessment with OSCE scores.

Fourth-year dental students (n = 44) were included at the beginning of their clinical course. Three tasks were selected for the OSCE exams: Oral examination on a model (task 1), matrix placement (task 2), and endodontic radiograph evaluation (task 3). Objective structured clinical examination scores were rated by an independent rater. Students and one of three calibrated teachers used PRISM to evaluate their respective assessments independently and blinded from each other. The relationships between the different assessments were determined using the Pearson correlation coefficient.

For task 1, a moderate correlation was found between students' self-assessment and estimated self-assessment (r = 0.44, P < 0.01). For task 2, moderate correlations were observed between self-assessment and teacher-assessment, estimated teacher-assessment and teacher-assessment, as well as between self-assessment and estimated self-assessment (P ≤ 0.01). For task 3, moderate correlations were found between self-assessment and teacher-assessment, and between self-assessment and estimated self-assessment (P < 0.01).A moderate negative correlation between self-assessment and the OSCE score was observed only for task 2 (r = -0.41, P = 0.01). Moderate negative correlations between teacher-assessment in PRISM and the OSCE score were found for all three tasks (P < 0.01).

Self-assessment and teacher-assessment using PRISM exhibited task-dependent correlations, while results for estimated assessments varied. PRISM may serve as a promising tool for feedback and discussion in the future, as it seems capable of highlighting different views and expectations in the teaching context. Further studies are needed to confirm these findings.

Resuscitation training should be based on facts, skills, and attitudes, using appropriate teaching methods and aids. Training through multimedia is one of the student-oriented methods. This method encourages learners to actively engage in training and take responsibility for their own learning.

The present research aimed to assess the learning experiences of medical interns regarding neonatal resuscitation training using the multimedia method.

This study was a qualitative conventional content analysis conducted on 17 interns in the last semester of general medicine at the Department of Pediatrics, Alborz University of Medical Sciences. The multimedia method in this study involved a camera connected to a television, recording the interns' activities during resuscitation procedure education. After completing each procedure, the TV showed the recorded activity films to the participants using the on-and-off method. Data were collected through focus group meetings, where students discussed their experiences of participating in this intervention. Their words were converted to written meaning codes and categorized based on similarities and differences.

A total of 17 general medicine interns from the last semester, admitted in 2015, participated in this study. Two themes and five subthemes were extracted from the results of conventional content analysis. The results were categorized into two themes: Strengths, which included the subthemes of educational pedagogy and feedback, and weaknesses, which included the subthemes of time, stakeholders, and facilities. Overall, this multimedia method is considered useful for learning. It had some advantages, such as providing detailed feedback, but also had weaknesses, such as the expense of use.

It seems that the multimedia method is influential in enhancing interns' learning by providing feedback after conducting neonatal resuscitation. Encompassing different learning aspects and various strengths, this combined method encourages learners' participation in training. Additionally, it can help reduce medical errors and maintain patient safety by developing the necessary skills among interns.

Professors in universities and educational institutions hold a crucial role in crafting educational approaches utilizing cutting-edge technologies. They need to possess significant expertise in e-learning and tackle the obstacles associated with delivering education and utilizing Information and communication technologies within higher education. To effectively navigate these challenges and adaptations, professors need to equip themselves with new educational techniques through training and readiness to adeptly incorporate emerging technologies into their teaching practices, thus enhancing the educational journey for students. By identifying, understanding, and ranking professors' requirements and preferences, effective and diverse educational initiatives can be tailored to meet their needs.

This research aimed to recognize the educational needs of medical science professors in the field of e-learning from the experts' point of view and prioritize these needs utilizing the analytic hierarchy process (AHP).

This practical study was conducted in 2022 using a process-oriented approach and AHP. The main stages included the creation of a hierarchical structure, comparative judgment, and determining priorities. In the first step, 13 criteria were identified, which were derived from scientific articles and previous research. In the second step, the pairwise comparison matrix was used for comparative judgment, and the weight of each criterion was calculated. The third step involved determining priorities based on the weight of each criterion and the inconsistency ratio. The participants of this study included professors of basic and clinical sciences from different faculties.

The results of this study demonstrated that from the point of view of experts and participants, among the 13 criteria, the skills of virtual teaching (with weights of 0.146 and 0.148), electronic content production (with weights of 0.093 and 0.092), and holding online training courses (with the weights of 0.092 and 0.100) formed the three main needs of medical science professors in the field of e-learning and had the highest degree of importance and necessity compared to other criteria.

Identifying the educational needs of medical science professors for organizing and designing necessary programs to enhance knowledge, skills, and empowerment will lead to improving the quality of e-learning, and eventually, reducing professors’ concerns in this area.

Diverse perspectives have been documented regarding the attributes of outstanding university faculty members. It is crucial to consider the evolving demands and expectations of students at the University of Medical Sciences, which change with age and educational stages. Extracting students' opinions and expectations can yield valuable insights into the attributes required of faculty members in academic institutions.

This study aimed to identify health professions students’ perceptions of the attributes of a good faculty member.

A qualitative study was conducted using a conventional content analysis approach. The participants in this study were health professions students (medicine, nursing, midwifery, laboratory sciences, operating room technology, anesthesia, prehospital emergency, pharmacy, dentistry, and health) at Alborz University of Medical Sciences, who were purposefully selected. Study data were gathered by conducting in-depth, face-to-face, and semi-structured personal interviews with 23 students, as well as a group interview with seven students. The data analysis followed the conventional content analysis approach, using the steps proposed by Lundman and Granheim.

Study participants’ perceptions of good faculty attributes fell into two main categories: Personality attributes and professional attributes. Personality attributes included appearance and personality traits. Professional attributes encompassed scientific and scholarly qualities, as well as teaching skills.

Our findings reveal that study participants placed significant emphasis on both personality and professional attributes when defining good faculty characteristics. Sub-categories such as appearance, personality traits, scientific expertise, and teaching skills emerged as important factors shaping student perceptions of faculty members. This underscores the multifaceted nature of what constitutes an effective faculty member in students' eyes and highlights the importance of cultivating a diverse range of attributes within academia. Future research could delve deeper into each sub-category to refine our understanding of what truly defines effective faculty members.

During the last two decades, especially during the COVID-19 pandemic, virtual teaching methods have been widely utilized in nursing education.

To investigate the effectiveness of this method, this study was conducted to explore the experiences of nursing students regarding virtual education.

This qualitative study employed a content analysis approach at Zanjan University of Medical Sciences over two academic semesters in 1400. Purposeful sampling included 20 nursing students from various academic semesters, both male and female. Data collection was conducted through semi-structured and in-depth interviews. Conventional content analysis was used to analyze the interviews, and data analysis was performed manually.

A total of 151 initial codes were extracted. After merging similar codes, 123 semantic units were ultimately organized into 21 subcategories and six main categories: Advantages and disadvantages, emotional reactions, teaching-learning process, responsibility and procrastination, motivation, and organizational factors related to virtual education based on the students' experiences.

Given the widespread use of virtual education, it is essential to identify the strengths, problems, and inhibiting factors associated with this type of education, especially in the training of medical students. Educational planners should strive to enhance the effectiveness of virtual education.

Improving the knowledge and skills of medical students using new educational methods to deal with trauma can help reduce the mortality and morbidity of injured patients.

This study aimed to compare the effect of traditional training with combined trauma management training using educational videos on the knowledge and skills of medical interns at Mashhad University in 2021.

This educational intervention study involved two groups during the academic year 2019 - 2020. Eighty-seven medical interns participated over a six-month period and were randomly assigned to either the intervention or control group. Data collection tools included a demographic questionnaire, a clinical skills checklist covering seven skills, and a pretest-posttest MCQ test. Statistical tests used included the independent univariate test and multiple linear regression, analyzed with Stata Ver 17 software. The significance level was set at 0.05.

The average knowledge score of the intervention and control groups before the intervention was 12.09 ± 3.06 and 13.00 ± 3.01, respectively. After the intervention, the average knowledge score was 14.84 ± 3.30 in the intervention group and 15 ± 2.98 in the control group. The average skill score of the students before the intervention in the intervention and control groups was 7.00 ± 2.67 and 7.56 ± 2.42, respectively. After the intervention, the skill score was 10.67 ± 3.70 in the intervention group and 8.72 ± 3.46 in the control group.

Although the advanced trauma life support course in Iran is relatively new, its positive impact on increasing the skills of medical students suggests a need to review traditional teaching methods. Incorporating new combined methods could enhance the quality of education and improve the skill levels of young doctors.

Nowadays, medical education is increasingly aligned with the competency-oriented approach worldwide.

This study aimed to evaluate the competency-oriented nature of medical sciences education in Iran.

This study is of a qualitative-analytical-applied nature and consists of 2 phases: A synthesis research phase conducted through a scoping review and a qualitative content analysis phase carried out through focus group discussions.

The results, obtained by combining 11 articles and conducting qualitative content analysis through focus group discussions involving 14 professors and doctoral students in medical science education, showed a significant gap between Iran's medical science education and a competency-oriented approach. This gap is evident in 4 dimensions: Teaching-learning, assessment, context-infrastructure, and planning, with a total of 13 sub-categories identified.

The research showed that the gap between the current situation and competency-oriented medical science education is particularly pronounced in basic and theoretical courses. Therefore, those involved in this field should be given more attention to addressing this gap.

E-learning has emerged as a crucial method of education, extensively embraced by individuals aiming to improve their skills. Providing empowerment courses in this field for faculty members within a flexible learning framework can bolster the effectiveness of education.

This research, which is applied, innovative, and technological, involves collecting quantitative and qualitative data. By reviewing the literature, analyzing sample platforms, and conducting interviews with experts in e-learning and medicine, we identified the educational elements and software features that meet user needs and preferences. A questionnaire, filled out by 30 professors from the Shahid Beheshti University of Medical Sciences, informed the development of the educational course. This course, designed according to the Ashur model, focuses on identifying user interface characteristics for software environment design and programming.

The analysis showed that faculty members are familiar with design patterns but need more knowledge of software and content production tools. The preference for asynchronous course delivery and content presented in written text, along with diverse forms of counseling and support (SMS, phone calls, social networks, and email), emerged as significant for the design of the platform environment.

The faculty empowerment course, designed based on the Ashur model with considerations for learning environment design, including user interface and user experience, has been prepared for programming and implementation on an appropriate platform.

Medical education emphasizes the importance of facilitating deep learning, promoting professional behavior, and fostering skillful problem-solving in practical courses.

To determine student satisfaction, knowledge, and skill levels using the virtual flipped classroom method for the pre-laboratory immunohematology course in laboratory sciences.

This semi-experimental (before-after) study included 42 laboratory science students who completed the practical immunohematology course. The intervention involved three steps of the virtual flipped classroom method. Knowledge was assessed with multiple-choice questions (MCQs), satisfaction was measured using a rating scale, and students' skills were evaluated using a rating scale. Data were analyzed using descriptive and analytical statistical tests in STATA 14.

The results showed that the post-test knowledge score had an average of 7.42, significantly higher than the pre-test score of 4.04 (P < 0.05). Additionally, 92.85% of students reported being satisfied with the course. Regarding skill evaluation, 95.23% of students stated, "I think I have now really achieved it or a part of it."

The virtual flipped classroom method in the immunohematology pre-laboratory course had a positive impact on students' learning and satisfaction. This teaching approach has the potential to improve teaching effectiveness, create an interactive learning atmosphere, and could be implemented in similar courses.

Game-based learning (GBL) and gamification have recently been applied in medical education. Both approaches utilize methods to teach specific skills or knowledge in a more motivating manner than traditional teaching.

This study aimed to evaluate the impact of GBL and gamification in an emergency medicine (EM) residency training program by comparing education through e-learning with GBL and gamification.

We randomly enrolled EM residents into two groups. Over the course of one educational year, one group of residents participated in a GBL and gamification course (10 designed GBL and gamification sessions), while the other group received e-learning materials (10 designed podcasts and videos). Traditional training programs continued as routine in both groups. After the intervention, we assessed learners' educational achievements (exam scores) in both groups. Additionally, EM residents' viewpoints (in the first group) on the innovative program were collected using the model for the evaluation of educational games (MEEGA). Finally, the short version of the postgraduate hospital educational environment measure (PHEEM) was administered to evaluate learners' general feedback (in the first group) about the new educational environment after the intervention.

Game-based learning and gamification significantly improved scores in written, oral, and electronic exams assessing knowledge, skills, clinical reasoning, and judgment among EM residents (P-value < 0.05). All MEEGA items under “Usability” and “Player Experience” had mean scores > 3 (indicating agree and totally agree) (median score = 3 - 4). All PHEEM items under “Teacher Support and Skills” and “Work Conditions and Allocated Time for Learning” also had mean scores > 3 (indicating agree and totally agree) (median score = 4).

Game-based learning and gamification enhanced EM residents’ knowledge, skills, clinical reasoning, and judgment. Learners largely agreed on the positive impact of the intervention on their residency training program.

Choosing a medical specialization is a crucial, career-defining decision for medical students and junior doctors.

This study aimed to identify variables impacting junior postgraduate doctors' and medical students' choice of specialty in Oman.

A cross-sectional study was conducted at Sultan Qaboos University (SQU) and the Oman Medical Specialty Board (OMSB) in Muscat, Oman. A two-part, self-administered questionnaire was electronically distributed to 247 respondents of different positions and levels of education, including doctors enrolled in the General Foundation Program, interns, and medical students undergoing their junior and senior clinical rotations. Sociodemographic characteristics were compared to determine factors influencing the choice of medical specialization.

The most popular choice of specialty was pediatrics (14.6%), followed by family medicine (10.9%), psychiatry (9.3%), and general medicine (8.5%). Medical specialties were chosen more frequently than surgical or diagnostic specialties (60.7% vs. 27.5% and 10.9%, respectively), regardless of gender or current position/level. Significant variations in specialty preferences were observed based on the respondents’ level of paternal educational attainment (P = 0.026) and future desired location of residency (P < 0.001). The factors identified by the participants as most important when selecting preferred specialties were working hours/lifestyle after completion of training (77.3%), positive experiences with a clinician/teacher of a particular specialty (72.5%), and income potential (70.9%).

The findings of this study may contribute to healthcare workforce planning strategies aimed at supporting insufficiently staffed specialties, taking into account the needs of patients as well as the interests and preferences of future doctors.