ORIGINAL_ARTICLE
Effect of formative evaluation using direct observation of procedural skills in assessment of postgraduate students of obstetrics and gynecology: Prospective study
Introduction: Direct Observation of Procedural Skills (DOPS)is a way of evaluating procedural skills through observation inthe workplace. The purpose of this study was to assess the role ofDOPS in teaching and assessment of postgraduate students and toknow the effect of repeated DOPS on improvement of the skillsand confidence of the students.Methods: This prospective study was conducted in the Obstetricsand Gynecology department of a rural tertiary centre in NorthernIndia in two phases. All postgraduate students (n=20) wererandomly divided year-wise into two groups, using lottery systemsuch that both groups had equal number of first, second andthird year students for didactic lecture/simulation teaching usingmannequins, with hands-on exposure on Active management ofthird stage of labor (AMTSL) and Postpartum hemorrhage (PPH)management. In the first phase, Group 1 received simulationteaching using mannequins with hands on for 4 sittings, and Group2 received didactic lecture on AMTSL. Following the students’performance of AMTSL steps on delivering women, theircompetencies were assessed using DOPS structured checklist often points on 6 sessions. The students’ performance in six DOPSwas compared between the two groups. In the 2nd phase, afterflipping of the groups, group one received didactic lecture, andgroup 2 simulation teaching on PPH management with hands onfor 4 sittings, followed by comparison of six DOPS performancein 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 observedbetween the two groups on first DOPS comparison (1st phase:p=0.000; 2nd phase: p=0.002), with simulation group performingbetter. Comparison of sixth DOPS in the two groups revealed nodifference in both phases, but significant difference on first andsixth DOPS comparison in each group (p=0.000).Conclusion: Repeated DOPS results in improved skills andconfidence of students in managing real life obstetric emergenciesirrespective of the teaching modality.Keywords: Direct observation; Procedural skills; Postpartum hemorrhage; Clinical competency
https://jamp.sums.ac.ir/article_40978_a5ee9129fc052d2a7047c2fe5d78ff90.pdf
2017-01-01
1
5
NAINA
KUMAR
drnainakumar@gmail.com
1
Department of Obstetrics and Gynecology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
LEAD_AUTHOR
NAMIT
KANT SINGH
2
Department of Otolaringology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala,
Haryana, India
AUTHOR
SAMAR
RUDRA
ddrnamitsingh@gmail.com
3
Department of Otolaringology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala,
Haryana, India
AUTHOR
SWANAND
PATHAK
4
Department of Pharmacology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
AUTHOR
ORIGINAL_ARTICLE
Effectiveness of early clinical exposure in learning respiratory physiology among the newly entrant MBBS students
Introduction: Early Clinical Exposure has been conceptualizedto orient medical students towards actual clinical scenario andhelp them correlate their theoretical knowledge with real lifesituations in early years of MBBS courses. In the present studywe explored the outcome of early clinical exposure in the contextof basic science topics (Physiology) in fresh MBBS entrantsand compared their performance with a conventionally taughtcontrol group.Methods: One hundred fifty voluntary students of 1st year MBBS(2015-16) batch consisted the sample of this study. They weredivided into two groups through the simple random method (usingcomputer generated random number table with roll numbers ofthe students). They were evaluated by MCQ (Multiple ChoiceQuestion) and OSCE (Objective Structured Clinical Examination)before and after being taught a basic Physiology topic (respiratorysystem) theoretically. The study group underwent clinicalexposure before the post-test while the control group did not.Performance of the students was compared between the twogroups by unpaired Student’s t-test whereas marks of pre and posttestwithin the same group were compared by paired student’s t–test. Everywhere p<0.05 was considered to be significant.Results: The marks of each group in the pre and post-testsdiffered significantly (p<0.05 in each case). Post-test markswere significantly greater in each group though the level ofimprovement was strikingly higher in the study group (p=0.01).Though there was no significant difference in pre-test marks ofboth groups (p=0.73), post-test marks were significantly higher inthe study group (p=0.04). Among the exposed students, majority(92%) opined that ECE was a better technique being practicallyoriented and more interesting while some (8%) found it to bemore time and energy-consuming, suitable for selective portionsof basic science topics.Conclusion: Early clinical exposure may be an effective techniqueto supplement the traditional theoretical teaching and improve theperformance of fresh medical entrants in Physiology. It has betteracceptability by the students and may be considered for inclusionin the existing pre-clinical curriculum with proper allocation oftime and manpower.Keywords: Early clinical exposure; Undergraduate; Curriculum
https://jamp.sums.ac.ir/article_40979_8120051c24138d5812d55466a6d34c08.pdf
2017-01-01
6
10
PIYALI
DAS
dr.piyali@yahoo.com
1
Physiology, Bankura Sammilani Medical College, Bankura, India
LEAD_AUTHOR
SUBHRADEV
BISWAS
2
Institute of Post Graduate Medical Education and Research, Kolkata,
India
AUTHOR
RAMJI
SINGH
sramji57@gmail.com
3
Physiology, All India Institute of Medical Sciences, Patna, India
AUTHOR
SANHITA
MUKHERJEE
drsanhita@gmail.com
4
Physiology, CNMC, Kolkata, India
AUTHOR
SHARMISTHA
GHOSHAL
sharmisthaghoshal@ymail.com
5
Physiology, Bankura Sammilani Medical College, Bankura, India
AUTHOR
DEBASIS
PRAMANIK
debe_pram@yahoo.co.in
6
Physiology, Bankura Sammilani Medical College, Bankura, India
AUTHOR
ORIGINAL_ARTICLE
Medical education in cyberspace: Critical considerations in the health system
Introduction: Over the past few decades, two revolutionaryapproaches 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 Harvardand Johns Hopkins used a wide range of cyberspace capabilitiesto increase their competitiveness. Researchers have expressed thatcyberspace will change health system’s main objective of trainingphysicians and medical education. We conducted this study toidentify 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 stepsof a critical literature review, combined with the ‘Four-phasemethod’ adopted by Carnwell and Daly. We focused on particularliterature on health and cyber system functions; it was associatedwith 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 beapplied for the success of medical education on cyberspace. Theresults were summarized and appraised in more details.Conclusion: Medical education on cyberspace is a complexinterdisciplinary system. It is important that all aspects of thehealth systems be involved as integral to the development of cyberbased medical education; without this convergence, we will beconfused by the decisions made by others within the system. Healthsystem should also communicate with those external sectors thatare critical to achieving better learning on cyberspace. Integratedplanning, governance and management of medical education incyberspace are pivotal elements for the promotion.Keywords: Medical education; Educational technology; Health informationtechnology; Health system
https://jamp.sums.ac.ir/article_40980_7d5eb346b5bce448452649c1779a3faf.pdf
2017-01-01
11
20
SHAHRAM
YAZDANI
sh_yaz@yahoo.com
1
Faculty of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
ZOHREH
KHOSHGOFTAR
bkhoshgoftar@yahoo.com
2
Faculty of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
SOLEIMAN
AHMADY
soleiman.ahmady@gmail.com
3
Faculty of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
HASSAN
RASTEGARPOUR
4
Department of Educational Technology,
Kharazmi University, Tehran, Iran
AUTHOR
SEYED ABBAS
FOROUTAN
5
Department of Physiology and Neuroscience Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
ORIGINAL_ARTICLE
Effectiveness of resident as teacher curriculum in preparing emergency medicine residents for their teaching role
Introduction: Over the past 30 years, recognizing the need andimportance of training residents in teaching skills has resulted inseveral resident-as-teacher programs. The purpose of this studywas to explore the impact of this teaching initiative and investigatethe improvement in residents’ teaching skills through evaluatingtheir satisfaction and perceived effectiveness as well as assessingmedical students’ perception of the residents’ teaching quality.Methods: This research is a quasi-experimental study with pre- andpost-tests, continuing from Dec 2010 to May 2011 in Imam Hospital,Tehran University of Medical Sciences. In this survey, EmergencyMedicine Residents (n=32) participated in an 8-hour workshop. Theprogram evaluation was performed based on Kirkpatrick’s model byevaluation of residents in two aspects: self-assessment and evaluationby interns who were trained by these residents. Content validity ofthe questionnaires was judged by experts and reliability was carriedout by test re-test. The questionnaires were completed before andafter the intervention. Paired sample t-test was applied to analyzethe effect of RAT curriculum and workshop on the improvement ofresidents’ teaching skills based on their self-evaluation and Mann–Whitney U test was used to identify significant differences betweenthe two evaluator groups before and after the workshop.Results: The results indicated that residents’ attitude towards theirteaching ability was improved significantly after participatingin the workshop (p<0.001). The result of residents’ evaluationby interns showed no significant difference before and after theworkshop (p=0.07).Conclusion: On the whole, the educational workshop for Residentsas Teacher for emergency medicine residents resulted in favorableoutcomes in the second evaluated level of Kirkpatrick’s model,i.e. it showed measurable positive changes in the self-assessmentsof medical residents about different aspects of teaching abilityand performance. However, implementing training sessionsfor resident physicians, although effective in improving theirconfidence and self-assessment of their teaching skills, seemsto cause no positive change in the third evaluated level ofKirkpatrick’s model, i.e. the residents’ behaviors, and it does notseem to raise students’ satisfaction or meet their expectations.Keywords: Resident as teacher; Curriculum; Emergency medicine
https://jamp.sums.ac.ir/article_40981_bd9877461873dc9b05024c1838c2395e.pdf
2017-01-01
21
25
HOOMAN
HOSEIN NEJAD
1
Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
MEHDI
BAGHERABADI
mehdi.bagherabadi@yahoo.com
2
1Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Emergency
Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
AUTHOR
ALIREZA
SISTANI
ali_r_sis@yahoo.com
3
1Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 3Department of Emergency Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
AUTHOR
HELEN
DARGAHI
helen.dargahi@yahoo.com
4
Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
ORIGINAL_ARTICLE
Empowering education: A new model for in-service training of nursing staff
Introduction: In-service training of nurses plays an indispensablerole in improving the quality of inpatient care. Need to enhancethe effectiveness of in-service training of nurses is an inevitablerequirement. This study attempted to design a new optimal modelfor in-service training of nurses.Methods: This qualitative study was conducted in two stagesduring 2015-2016. In the first stage, the Grounded Theory wasadopted to explore the process of training 35 participating nurses.The sampling was initially purposeful and then theoretically basedon emerging concept. Data were collected through interview,observation and field notes. Moreover, the data were analyzedthrough Corbin-Strauss method and the data were coded throughMAXQDA-10. In the second stage, the findings were employedthrough Walker and Avant’s strategy for theory construction so asto design an optimal model for in-service training of nursing staff.Results: In the first stage, there were five major themes includingunsuccessful mandatory education, empowering education,organizational challenges of education, poor educationalmanagement, and educational-occupational resiliency.Empowering education was the core variable derived from theresearch, based on which a grounded theory was proposed. Thenew empowering education model was composed of self-directedlearning and practical learning. There are several strategiesto achieve empowering education, including the fostering ofsearching skills, clinical performance monitoring, motivationalfactors, participation in the design and implementation, andproblem-solving approach.Conclusion: Empowering education is a new model for in-servicetraining of nurses, which matches the training programs withandragogical needs and desirability of learning among the staff.Owing to its practical nature, the empowering education canfacilitate occupational tasks and achieving greater mastery ofprofessional skills among the nurses.Keywords: Grounded theory; Model; Nurse; Training
https://jamp.sums.ac.ir/article_40982_3af045f615514551a641db7abcd5e7dd.pdf
2017-01-01
26
32
MAHMUD
CHAGHARI
ebadi1347@yahoo.com
1
Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
AUTHOR
MOHSEN
SAFFARI
2
Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
AUTHOR
ABBAS
EBADI
ebadi1347@bmsu.ac.ir
3
Behavioral Sciences Research Center, Nursing faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
AHMAD
AMERYOUN
4
Health Management Research Center, Baqiyatallah University of Medical
Sciences, Tehran, Iran
AUTHOR
ORIGINAL_ARTICLE
Dynamics of self-directed learning in M.Sc. nursing students: A qualitative research
Introduction: Working in the complex and ever changinghealthcare settings forces the nurses and nursing students to beequipped with lifelong learning skills. One of the lifelong learningskills is self-directed learning. This study aimed to explore theM.Sc. nursing students’ self-directed learning activities.Methods: A qualitative design using conventional content analysisapproach was used in this study. Semi-structured interviews wereconducted with twelve Iranian M.Sc. nursing students who wereselected using purposive sampling.Results: Data analysis indicated that the M.Sc. nursing studentsperformed different activities in their self-directed learning.These activities were categorized into four main themes andten 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 studentsperformed different intellectual and experiential self-directedactivities for promoting their learning. Besides, the students’perseverance and inquisitiveness played an important role in theirself-directed learning in the challenging clinical environments.Keywords: Self-directed learning; Qualitative study; Nursing student
https://jamp.sums.ac.ir/article_40983_e8231082176bff0f249c3ee0f2669e46.pdf
2017-01-01
33
41
FATEMEH
SHIRAZI
marziehsh2006@yahoo.com
1
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
FARKHONDEH
SHARIF
fsharif@sums.ac.ir
2
Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
ZAHRA
MOLAZEM
molazemzah@yahoo.com
3
Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
MAHBOOBEH
ALBORZI
mahboobeh.alborzi@gmail.com
4
Department of Foundations of Education, College of Education and Psychology, Shiraz University, Shiraz, Iran
AUTHOR
ORIGINAL_ARTICLE
Evaluation of information literacy status among medical students at Shiraz University of Medical Sciences
Introduction: The information literacy status and the use ofinformation technology among students in the globalization age ofcourse plans are very momentous. This study aimed to evaluate theinformation literacy status and use of information technology amongmedical students of Shiraz University of Medical Sciences in 2013.Methods: This was a descriptive-analytical study with crosssectionalmethod. The study population consisted of all medicalstudents (physiopathology, externship and internship) studyingat Shiraz University of Medical Sciences. The sample size(n=310) was selected by systematic random sampling. Thetool of data gathering was LASSI questionnaire (assigned byAmerica research association) with 48 closed items in five-pointLIKERT scale. The questionnaire included two distinct parts ofdemographic questions and the information literacy skills basedon the standards of information literacy capacities for academiceducation. The content validity was acquired by professors’and experts’ comments. The reliability was also calculated byCronbach’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 theremaining (29.7%) were males. The mean score of informationliteracy and its five subgroups among the students weren’t at adesirable level. The mean scores of information literacy foreducational grades from the highest to lowest belonged to theinternship, physiopathology and externship. The results showedthat the highest average was related to the effective access abilityto information among interns (9.27±3.57) and the lowest onewas related to the ability of understanding legal and economicalcases related with using information among externs (3.11±1.32).The results of ANOVA showed that there wasn’t a significantdifference between educational grades and information literacy.Finally, the result of independent t-test did not show a significantdifference between the two genders in information literacy.Conclusion: Regarding the importance of information literacy formedical students and undesirable status of information literacyamong students, the current educational plans will need to be revised.Keywords: Medical students; Information literacy; Technology; Medical informatics
https://jamp.sums.ac.ir/article_40984_50f4990877cc4d5d54931453d87299ee.pdf
2017-01-01
42
48
LEILA
BAZRAFKAN
bazrafkanl@gmail.com
1
Quality Improvement in Clinical Education Research Center, Education Development Center, Shiraz University of medical Sciences, Shiraz, Iran
AUTHOR
ALI ASGHAR
HAYAT
ali.hayat63@gmail.com
2
Quality Improvement in Clinical Education Research Center, Education Development Center, Shiraz University of medical Sciences, Shiraz, Iran
AUTHOR
KARIM
ABBASI
negar242@gmail.com
3
Quality Improvement in Clinical Education Research Center, Education Development Center, Shiraz University of medical Sciences, Shiraz, Iran
AUTHOR
AGHDAS
BAZRAFKAN
fardidm@sums.ac.ir
4
School of Medicine, Shiraz University of medical Sciences, Shiraz, Iran
AUTHOR
AZADAH
ROHALAMINI
5
Shiraz University of medical Sciences, Shiraz, Iran
AUTHOR
MOZHGAN
FARDID
mfardid@gmail.com
6
Department of Health Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR