Journal of Advances in Medical Education & Professionalism

A one-day visit of the EEG and EMG/NCV departments during neurology course for medical students of Shiraz University of Medical Sciences

MARYAM POURSADEGHFARD; ALIREZA NIKSERESHT

Volume 7, Issue 1 , January 2019, , Pages 49-50

https://doi.org/10.30476/jamp.2019.41039

Abstract

Dear editor Today, an important part of the patients’diagnostic activities includes paraclinicaltests and procedures, which follow theircompleted history-taking and clinicalexaminations, ... Read More Dear editor Today, an important part of the patients’diagnostic activities includes paraclinicaltests and procedures, which follow theircompleted history-taking and clinicalexaminations, in such a way that many medicalscience sources in different fields considerthem to be follow-up activities of clinicalexaminations. This is also the case in the field ofneurology and many of its specialized subfields.For example, in a patient suspected of seizureand epilepsy, an EEG not only helps to identifythe real patient’s problem or disease, but also todiagnose the type of the disease and contributesto decision-making on the type of the drugto use. The EMG/NCV is also necessary forpatients with a possible peripheral neuropathicinvolvement. In most cases, paraclinicalactivities are performed outside the educationalsettings, such as in laboratories or specialprocedure rooms, and students, residents andlearners are only informed about the results ofthose activities without observing how they areactually performed, so they will not learn thatdiagnostic method and will not gain a deepunderstanding of it, to the point that they may beunfamiliar with the necessity of doing that evenduring their practice. This leads in many casesto unnecessary requests or its postponementin essential conditions. Unfortunately, theabove-mentioned problem is found among bothstudents and residents. Moreover, we foundfew appropriate and useful studies in this areadue to the learners’ unfamiliarity with thisscientific area and their lack of interest andmotivation for research in this regard. For theabove reasons, the educational deputy of theNeurology Department of Shiraz University ofMedical Sciences decided to solve this problemthrough a new training course. During the aboveeducational process, the sixth year studentsof medicine in Shiraz University of MedicalSciences, who are receiving training during theirone-month course of neurology, were dividedinto groups of six to eight members, and eachgroup, together with a resident, visited the EEGand EMG/NCV departments of Imam RezaClinic affiliated to Shiraz University of MedicalSciences as a tour lasting for a few hours outsidethe clinical departments and listened to a fulldescription from doctors, personnel and otherprofessionals in these departments. In addition,they closely visited the patients as well as thedevices used in these departments.Investigations show that different units ofmedical education at Iranian universities ofmedical sciences have regularly been visited,but no periodical and regular visits have beenperformed as part of a predetermined curriculum.However, a relatively similar study conducted atShiraz University of Medical Sciences in 2017reported that holding a short-term (one day anda half) practical laboratory training course couldsignificantly increase the students’ experienceand training (1).Other published studies have been in theform of short-term training courses in thelaboratory or pathological sciences rather thanone-or-two-day visits. However, these studies aresimilar to our educational process in that bothare held during a short term with the aim of thestudents’ further familiarity and readiness. Forexample, a study was conducted on fourth-yearmedical students, in which a one-and-a-half-daycourse was designed to familiarize the studentswith paraclinical methods and help them gainexperience in this regard. The results of thisstudy showed that this one-day course was agreat incentive for the training of some selectedparts of medical education (2). Another study wascarried out in 1987 on medical students, showingthat the students’ preliminary familiarity withthe clinical stages can be very effective if thesestages are held in short terms, in small groups,and with a focus on basic issues (3).The Neurology Department of ShirazUniversity of Medical Sciences hopes to achievethe following goals by implementing the abovementionedtraining course:1. Understanding of the above-mentionedprocesses better by attending the patients’ bedsideand observing the processes closely,2. Familiarizing the students with the reasonsfor requesting each of the two above-mentionedprocedures to prevent unnecessary requestsduring the future years of practice,3. Motivating and encouraging the studentsto study the related subjects better and moreaccurately,4. Encouraging the students to do research ineach of the two above-mentioned areas,5. Familiarizing the students with the difficultyof work and possible problems when doing theabove-mentioned investigations and taking theminto consideration in future years of practice, and6. Familiarizing them with the personnel andusing their experiences.

Fasa University Medical School: a novel experience in medical education

HOSSAIN A. RONAGHY; KHOSROW NASR

Volume 2, Issue 1 , January 2014, , Pages 51-52

Abstract

In early 1970`s A combination of a shortage andmisdistribution of health services and growingpublic dissatisfaction about the health care available,along with increasing expectations, ... Read More In early 1970`s A combination of a shortage andmisdistribution of health services and growingpublic dissatisfaction about the health care available,along with increasing expectations, has put greatstrain on the mind of the staff of the Department ofMedicine Shiraz University School of Medicine, themedical school was known as a center of excellence forphysician training. The school also got its reputationfor its well-trained faculty, a fulltime system. Englishwas the media of instruction and facilities were up todate. The Government of Iran, relatively prosperouswith the sudden increase of oil price embarked onmassive importation of foreign doctors, which didnot, eased the aforementioned problem (1, 2).The Fasa Medical School was conceived, to addresshealth needs of majority of population residingin rural and small communities, by training bothmedical doctor and other health personnel, based onthe philosophy of community orientation, problembasedlearning and student-based curriculum,combined with innovations in staff and studentselection and training (3).The purpose of this report is to give an account ofwhat was originally planned and what has happenedsince the start of Fasa Medical School in April 1978.The health manpower situation in Iran in early 70sIn late 1960’s and early 70’s, Iran’s population wasapproximately 34 million and total numbers ofphysicians were about 14,000 a ratio of 0.41 physiciansper 1000 population (4). At the time, two majorproblems were facing our country. The first was grossmal-distribution of these healthcare facilities, whichwere mostly concentrated in Tehran and big citiesof Iran (1), and the second problem was continuousexodus of Iranian Medical graduates to the Westerncountries (5, 6).The study that was done in 1974 indicated apermanent loss of 1624 Iranian Medical Graduates(IMG) to the United States alone 5-6. Since over %60of Iranian population were residing in about 50,000small villages of 100-1000 population it was suggestedthat physician coverage to these scattered populationwould be close to impossible. Shiraz UniversityMedical School embarked and implemented thisprogram to cover health and sanitary measure ofrural population with astonishing results (1).The idea of Village Health Worker (VHW) wasbased on bare foot doctors of China, and for the firsttime was implemented in non- socialized marketEconomy Country (2). The name of VHW was“Behdar Roustaee,” and within 5 years, providedhealth coverage of approximately 1.5 Million of ruralpopulation of Southern Iran. Similar program waslater initiated in West Azerbaijan under Auspices ofTehran University School of Public Health and WHO(7, 8). In Lorestan and Tehran also similar programswere implemented.Main feature of Fasa Medical School programThe main idea of creating Fasa Medical School wasto create a system in which primary care in smallvillages are provided by VHW with the middle levelhealth workers of “Behdar Roustaee” to be supportedby local physicians who reside in small towns. Thelast step would be connecting the whole network totertiary care system.1. RecruitsHigh school graduate with minimum C average fromsmall towns of Fars province could apply. Severalfaculty members selecting those who would be mostsuitable for this program would interview applicants.During that same period, other medical schools inIran selected high school graduate from test results ofa national examination. This usually meant the top10% of entire nation were recruited.2. FacultyThere were 2 groups of faculty. One was the Shirazfaculty, who designed the program and wrote thecase studies. The other was local faculty including 4who were residents in community medicine and alsoreceived intensive medical education training. These4 were the preceptors for the case studies, hospitalpatients and village programs. There were alsophysicians in the hospital, which would review anddiscuss patients.3. FacilitiesA-Library- included 1500 books, mostly EnglishTexts along with subscription to 10 top InternationalMedical Journal. One US graduated informationscience, graduate of Brat Institute of N. Y., and 2librarians to manage the medical library.B-Labs-30 Microscope with bacteriology facilitiesand equipment along with some pathology labfacilities with part time pathology resident fromShiraz were utilized in Fasa program.C-Classroom-A general conference room withcapacity of 150 along with 15 different classes,equipped with projector and other audiovisualfacilities were provided.D- Audiovisual aids- Fasa was equipped with stateof art recording facilities and indeed with very closeco-operation with the Department. of Medicine andCommunity Medicine different professors discussedcurrent cases, which was presented to student andwere shown in group discussion.E- Hospital- A 50 bed red lion and sun (Equivalentto Red cross)- Hospital was already in operation andFasa got the privilege to have student practice therelater a 500 bed hospital was made adjust-to MedicalSchool, which considered University hospital.4. Curriculum:The first 3 years out of 6, were planned and included3 tracts:The first tract was case studies, one per weeks thatwere designed in a 3-year period to cover all majorproblems. Students were divided in groups of 4 or 5.They were given the patient case and had a preceptorthey had one week to study, discuss, look up and beready to discuss at the end of one week with theirother classmates, who had the same case. These patientstudies were designed in such a way as to permitdiscussion of basic science and pathophysiology ofdisease. The case studies started simple and becamemore complex. But always the emphasis was onproblem solving and self-learning.The second tract was clinical work in the hospital.Again in groups of 4 to 5, they were given a patient.Initially they took history and similar to the casestudies studied and discussed the patient withpreceptor. Gradually, physical exam was added.The third tract was “village health”. Each4- 5 studentswere given a village and simply told that in 3 years,we expected improvement of that village’s health.Defining and solving the problem was left to thestudents… again, they had preceptors and discussionperiods.Two classes of students, each with 18 studentswere selected prior to the Revolution and CulturalRevolution. Of the 36 students admitted to 2 classes 26were transferred to Shiraz University and graduatedwith Shiraz classmates. (The remaining 10 were eitherexpelled or dropped from the from the program)All 26 graduates from this program are presently(August 2013) practicing in Iran and 69% of them inFars province. Unfortunately the curriculum of Fasawas not continued but the concept of local schoolsin smaller cities has been established with a largerphysician output.ConclusionFasa School of Medicine was established to meet theneeds of the underserved and smaller communities,for Shiraz University it emphasized the importanceof relevance of medical education. For Fasa MedicalSchool, education was emphasized on communitybased, student centered, and problem based medicaleducation located in the community and based onteamwork and cooperation. Though its program wasinterrupted, it did show that medical students don’thave to be selected from the top grades and basicscience taught in the classic method is not essential.

A program director’s perspective: advanced positions versus physician-only positions - What’s the best for my program?

GERALD P. ROSEN; S. HOWARD WITTELS; ITALIA SMITH; OMAR VISWANATH

Volume 8, Issue 1 , January 2020, , Pages 53-54

https://doi.org/10.30476/jamp.2019.83627.1109

Abstract

N/A Read More

Challenges of culturally and linguistically different healthcare students in learning environments

ALI ARASH ANOUSHIRVANI; FARZANEH GOLAGHAIE

Volume 7, Issue 2 , April 2019, , Pages 108-109

https://doi.org/10.30476/jamp.2019.44707

Abstract

The increased number of international studentsin higher education systems is recognizedas beneficial not only economically but also interms of preparation of the workforce for theglobal ... Read More The increased number of international studentsin higher education systems is recognizedas beneficial not only economically but also interms of preparation of the workforce for theglobal environment. It is believed that diversityin the student cohort can also be beneficial fordomestic students in terms of increasing culturalawareness and achieving cultural competencygoals. Culturally and linguistically diversestudents (CALD) include students whose firstlanguage andor culture is not of the countrythey study in (1). There are 55,000 internationalstudents in Iran, of whom 26,000 have enrolled inuniversities affiliated to the Ministry of Science,10,000 in different branches of Islamic AzadUniversity, 2,000 in universities affiliated to theMinistry of Health, and 17,000 in AlmustafaInternational University (2). According to thelatest data from the UNESCO, more than 82%of the international students in Iran come fromAfghanistan, 8.7% Iraq, and 6% Syria, Lebanon,and Pakistan combined (3). Meanwhile, theMinistry of Health and Medical Educationfollows a plan for expanding internationalmedical education in eligible Iranian universitiesof medical sciences and, hence, concentrateson mechanisms to align the universities withinternational standards. Although economic,political, and societal factors in both the hostand home countries influence internationalstudents’ decision to select the host country, it isnecessary that the authorities address their needsand problems and then take some measures tosolve them in order to increase the number offoreign applicants in Iranian universities.International students’ difficulties havebeen reported as academically and socially,with cultural and language barriers impactingtheir capacity to integrate with domesticstudents. These students have problemswith language and communication, sufferfrom lack of confidence to speak out and askquestions, and approach the teaching staff.For some international students, adaptationto new environment gets so difficult andfailure to adjust will cause them to experiencepsychological symptoms such as feelings ofinferiority, confusion, homesickness, loneliness,and anxiety (4). Commonly cited key issuesaffecting international students in learningenvironments are communication difficulties,cultural differences, and lack of familiarity withsocial, educational, and professional health careenvironments (5). Most of the literature aboutinternational students comes from Englishspeaking countries, and thus challenges in theAsian and Islamic learning context have notbeen addressed enough in the existing evidence.According to the studies conducted in theinternational learning contexts, there is a greaterpower distance and uncertainty avoidance inthe Asian culture, and these cultural differencesmay create tense interrelationships among thetrainees, staff, and supervisors (6).There is a need to develop understanding,accepting and appreciating the studentsfrom diverse backgrounds in the learningenvironments. For health professional students,the challenges become particularly evident inclinical practice settings. Clinical placement isof vital importance for healthcare disciplinesand covers approximately 50% of the trainingactivities. While clinical learning experiencecan be stressful and anxiety-provoking for anystudent, evidence suggests that this situation issignificantly more complex for CALD students(7, 8). Support from the staff in the clinical areacan be a source of motivation to students andmakes them feel welcome and part of the team,thereby helping them with learning. On thecontrary, failure to provide adequate learningopportunities for these students could resultin graduates who have not met the requiredstandards and competencies of the profession(9). Therefore, the educational problems ofCALD students need to be searched and thereasons should be dealt with to increase theirmotivation for academic success. We suggestthat medical education studies should address theinternational healthcare students’ needs and findstrategies to meet their needs in the classroomand clinical learning situations.

Awareness and use of evidence based medicine (EBM) in medical trainees

MAHDIEH MOMAYYEZI; HOSSEIN FALLAHZADEH; MOHAMMAD MOMAYYEZI

Volume 2, Issue 3 , July 2014, , Pages 137-137

Abstract

The concept of evidence based medicine (EBM)involves a systematic approach for integrationof best available research evidence into medicaldecision making for physicians, medical traineesand ... Read More The concept of evidence based medicine (EBM)involves a systematic approach for integrationof best available research evidence into medicaldecision making for physicians, medical traineesand researchers. The EBM process includes fiveessential steps: formulating the questions, searchingfor evidence, appraising the evidence, and applyingand evaluating the results (1). In a descriptive study,the data about EBM skills obtained from the medicaltrainees showed that printed textbooks served asthe first source of information in 80% of cases andfollowed by E-books as the second source. Thehard copy journals in libraries had the lowest use.Easy access to information was selected as the mainreason for using printed resources. Also, fast accessto information was the most important reason forusing electronic resources. In a study conducted byRohani, it was found that physicians used printedsources more than e-books (2). This was due totheir easy access to the printed reference books.Considering the fact that it takes a lot of time fornew medical information to log in into the referencebooks, effective treatment of a disease may be enteredin printed sources after its efficiency is confirmed.45.2% of the participants were familiar withINLM. 32.1% of the students had attended thetraining course on INLM. 85.7% of the participantswere familiar with the PubMed, 28.6% with theElsevier and 16.7% with Science direct. 31% of theparticipants were familiar with the concept of EBM,but 7.1% were aware of the resources of EBM, and12.2% had attended the special courses on EBM. Theresults of the recent data taken from internet showedthat 53.8% of participants sometimes used it indiagnosis and treatment process and 28.2% of themused it after being developed into textbooks. Also,this information was sometimes useful for 75.8% ofparticipants.Half of the students were familiar with the conceptof EBM, but a few had attended the introductorycourse on EBM. Hanson in his study maintained thatonly 1.9% of physicians used specific methods to findvalid evidence of medicine (3). Taheri showed thatmedical students were satisfied with the workshopon EBM and stated that familiarity with EBM wasessential for proper functioning (4). Therefore, itseems necessary to organize the training workshopson the concepts of EBM as a part of formal trainingfor medical trainees to change the students' attitudes.

The implementation of unique, active learning tools in post-graduate training

OMAR VISWANATH

Volume 7, Issue 3 , July 2019, , Pages 154-155

https://doi.org/10.30476/jamp.2019.45017

Abstract

N/A Read More

The effect of gender bias on medical students and career choices: a cross-sectional study

AKANKSHA GARG; ANURADHA BHIDE

Volume 5, Issue 3 , July 2017, , Pages 155-155

Abstract

Gender equality amongst healthcareprofessionals is no doubt paramount to allowboth equal opportunity and provision of goodquality healthcare. The General Medical Councilencourages that ... Read More Gender equality amongst healthcareprofessionals is no doubt paramount to allowboth equal opportunity and provision of goodquality healthcare. The General Medical Councilencourages that all colleagues should be treatedfairly, but studies have previously demonstratedgender bias against female medical students(1). Whether this might have any impact on thestudents’ decision-making process and careerpathways has yet to be explored.We aimed to evaluate whether doctors gavestudents gender-specific advice and the extentto which this advice influenced the students.Furthermore, we explored whether students felttheir gender affected their career choices. Wecarried out a cross-sectional national study ofBritish clinical medical students. A standardisedquestionnaire was completed by 94 students(54.3% female). The response rate was 88.7%.Results showed that 43.6% (n=41) of studentsreceived career advice based purely on theirgender, and 63.4% (n=26) of these said that thiswould influence their career choices. Importantly,82.9% (n=34) of the students who receivedgender-specific advice were female.Additionally, 41.2% (n=21) of females felttheir gender would restrict their career choicescompared with only 11.6% (n=5) of males(p=0.00142). 37.3% (n=19) of females thoughttheir gender would unfairly disadvantage theircareer progression compared to 4.65% (n=2) ofmales (p=0.00016).Our results highlighted that doctors gave moregender-specific advice to females compared tomales, and that this advice significantly impactsstudents’ decision making process. Furthermore,females disproportionately felt their careers wouldbe disadvantaged and restricted compared withmales. This shows an enormous disparity betweenmale and female attitudes towards medical careers.This can have both long and short-term effects ontraining, career choices and patient interaction.Further research investigating why females feeltheir gender will restrict their careers, and whydoctors give gender-specific advice, particularlytargeted at females must be undertaken to identifythe root cause of the problem.We therefore advocate that medical schools: 1)promote gender equality through seminars, talksand increase accessibility to good female rolemodels; and 2) train clinical teachers to impartgeneric career advice as opposed to genderspecificcareer advice.

Professionalism ethics in pharmacy education: Do students have acceptable knowledge or it is a white paper in pharmacy education curriculum?

HOSSEIN KHOLGHIPOUR; ALI DEHSHAHRI; HOSSEIN MAHMOODIAN

Volume 6, Issue 4 , October 2018, , Pages 190-191

https://doi.org/10.30476/jamp.2018.41033

Abstract

Dear Editor, In pharmacy, professionalism must containthe skills necessary to be a capable pharmacypractitioner. It seems that pharmacy studentsdo not become professionals after graduationfrom ... Read More Dear Editor, In pharmacy, professionalism must containthe skills necessary to be a capable pharmacypractitioner. It seems that pharmacy studentsdo not become professionals after graduationfrom the pharmacy school. To be a professionalpharmacist, students should have a lifelongcommitment to the society and patients.Evolving professional knowledge, attitudesand behaviors is a critical step in providinghigh quality patient care (1). In the last previousyears, pharmacy practice has changed from drugprescription to patient-centered communicationand more stress on pharmacists’ accountabilityfor the best treatment outcomes. Thus,pharmacists are accountable for providing goodhealth care facilities. In this regard, pharmacistsshould cooperate well with other health careprofessionals and patients (2).An important component of professionalismin pharmacy is ethics education (3). The necessityof ethics education in pharmacy highlightsthe significance of ethical considerationsby pharmacists (2). The significant servicedelivered by pharmacists in Iran is respondingthe patients’ questions. Therefore, pharmacistsmust be up to date with ethical issues and applythe best ethical responses to different patients’problems (2). In Shiraz University of MedicalSciences, the medical ethics department isresponsible for ethics education for all medicaland paramedical students including pharmacystudents. This education consists of one weekworkshop including important issues in pharmacyethics. This is a part of core pharmacy educationcurriculum and all of the students shouldparticipate in this course.In order to measure the students’ knowledgeabout ethics in pharmacy education, weconducted a survey with an 18 item valid andreliable questionnaire containing three majordomains: truthfulness, professional commitment,respect for patients’ rights and confidentiality ofpatients’ information). 162 pharmacy studentsin 7 to 12 semesters in Shiraz pharmacy schoolwere selected through simple random samplingmethod. All of the students filled out thequestionnaire based on a 5 point Likert scale.The results showed that 14 (8.6%) students hada moderate level of knowledge, 68 (42%) had agood level of knowledge, and 80 (49.4%) hada very good level of knowledge. There was nosignificant relationship between gender andlevel of knowledge. There was a significantrelationship between the level of knowledge andeducational semester. Senior students had higherknowledge. The best results were in the domainof respect for patients’ right and confidentiality ofpatients’ information. These results showed thatstudents had an acceptable level of knowledge,especially in the field that is necessary for theirfuture profession (patients’ right and patients’confidentiality). Pharmacy students shouldestablish good relationships with each other,patients, and other health care professionals.Therefore, a professional behavior should beencouraged more than focusing on knowledge. Inthis study, it was not possible to follow the studentsin future years to measure their professionalbehavior, but it is recommended for futurestudies. However, it seems that this knowledgewill not necessarily change to improvement inpractice in pharmacist because pharmacy is not ascience of pure knowledge. The closer integrationof knowledge and practice named “practice-basedknowledge” is an important area that is essentialto be considered by pharmacists (4).Pharmacy students must remain up to datewith changes in their profession, which maycontain new practice guidelines, new pharmacyand therapeutic products, and new technologies.In order to improve the students’ professionalbehavior, they should participate in communityservices, volunteering programs, (serving andhelping others), health education services andlocal health care organizations. After graduation,participation in Continuing ProfessionalDevelopment instead of Continuing PharmacyEducation is necessary to maintain the knowledgeand behavior in this field. In ContinuingProfessional Development, learning occursin lifetime and continues after the classroomin everyday practice (5). Excellence shouldbe considered not only in the undergraduatepharmacy education, but also after graduationtraining, and during practice. Finally, it should bementioned that pharmacy students must remainknowledgeable and pursue guidance to achievethe goal of excellence in professional ethics.

Misconceptions and Integration

SARA MORTAZ HEJRI; AZIM MIRZAZADEH; MOHAMMAD JALILI

Volume 3, Issue 4 , October 2015, , Pages 196-200

Abstract

Introduction: Pervasive beliefs regarding curricular reformand integration have flourished among medical students, facultymembers and medical school administrators. These conceptshave ... Read More

PhD supervisor-student relationship

FILIPE PRAZERES

Volume 5, Issue 4 , October 2017, , Pages 213-214

Abstract

Dear Editor, The relationship between the PhD supervisorand the PhD student is a complex one. Whenthis relationship is neither effective nor efficient,it may yield negative consequences, ... Read More Dear Editor, The relationship between the PhD supervisorand the PhD student is a complex one. Whenthis relationship is neither effective nor efficient,it may yield negative consequences, such asacademic failure (1).The intricacy of the supervisor-studentrelationship may be in part comparable to the onebetween the physician and his/her patient [see,for example (2)]. Both interactions develop overseveral years and the players involved in eachrelationship – PhD supervisor-student on the oneside and physician-patient on the other side – mayat some point of the journey develop differentexpectations of one another [see, for example (3,4)] and experience emotional distress (5).In both relationships, the perceived satisfactionwith the interaction will contribute to the successor failure of the treatment in one case, and inthe other, the writing of a thesis. To improve thementioned satisfaction, not only there is a needto invest time (6), as does the physician to his/her patients, but also both the supervisor andthe PhD student must be willing to negotiate aresearch path to follow that would be practicaland achievable. The communication between thephysician and patient is of paramount importancefor the provision of health care (7), and so is thecommunication between the supervisor and PhDstudent which encourages the progression of boththe research and the doctoral study (8).As to a smooth transition to the postgraduatelife, supervisors should start thinking aboutproviding the same kind of positive reinforcementthat every student is used to experience in theundergraduate course. The recognition for a jobwell done will mean a lot for a PhD student, asit does for a patient. One good example is theincrease in medication compliance by patientswith high blood pressure who receive positivereinforcement from their physicians (9).Supervisors can organize regular meetingsfor (and with) PhD students in order to not onlydiscuss their projects but also improve theircoping skills, including critical thinking andproblem-solving methods (5). The act of sharingknowledge and experiences can motivate the PhDstudents to persevere in their studies (10).When needed, supervisors should use theirpower of influence to increase the time that thestudent has available to devote to research whilemaintaining a part of their employment activities(health care‑related or not), since many PhDstudents are also full-time workers.Last but not least, supervisors and facultymembers must encourage PhD students topursue the available funding opportunities.Socioeconomic problems are known to be an issuefor PhD students (5). Without the supervisor’ssupport – by dealing with PhD student’s emotionsand personality –, research time, funding, and thestudent’s proactiviness, the doctoral journey may not attain success.

Are healthy lifestyle behaviors positively associated with the academic achievement of the university students?

FATEMEH BAKOUEI; SHABNAM OMIDVAR; SEYED JALIL SEYEDI-ANDI; SAREH BAKOUEI

Volume 7, Issue 4 , October 2019, , Pages 224-229

https://doi.org/10.30476/jamp.2019.74888.

Abstract

Introduction: Universally, the number of students attending the university education is high and increasing. The future of academic graduates is affected by their academic ... Read More

Mentoring medical students by their Peers, Three Years’ experience at Shiraz Medical School

SULMAZ GHAHRAMANI; FATEMEH SEDDIGH; ALI REZA TORABI JAHROMI; AAZAM KHANDEL; PARISA NEMATOLLAHI; ZAHRA HASHEMPOOR; AMIRALI RASTEGAR KAZEROONI

Volume 7, Issue 3 , July 2019, , Pages 156-157

https://doi.org/10.30476/jamp.2019.45018

Abstract

Mentoring involves two-way communication, learning and progress. Students participating in this process receive guidance from senior students and professors on how to deal with challenges ... Read More

Combination of different clinical reasoning tests in a national exam

ANAHITA SADEGHI; ALI ALI ASGARI; NEZARALI MOULAEI; VAHID MOHAMMADKARIMI; SOMAYEH DELAVARI; MITRA AMINI; SETAREH NASIRI; ROGHAYEH AKBARI; MOJGAN SANJARI; IRAJ SEDIGHI; PARISA KHOSHNEVISASL; MANOUCHEHR KHOSHBATEN; SAEED SAFARI; LEILY MOHAJERZADEH; PARISA NABEIEI; BERNARD CHARLIN

Volume 7, Issue 4 , October 2019, , Pages 230-234

https://doi.org/10.30476/jamp.2019.83101.1083

Abstract

Introduction: Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess ... Read More Introduction: Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students’ clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam.Methods: A total of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named “Medical Olympiad”. The ninth Medical Olympiad was held in Shahid Beheshti University of Medical Sciences, Tehran, Iran, under the direct supervision of the Ministry of Health and Medical Education in summer 2017. The expert group designed a combination of four types of clinical reasoning tests to assess both analytical and non-analytical clinical reasoning. Mean scores of SCT, CRP, KF, and CIP were measured using descriptive statistics. Reliability was calculated for each test and the combination of tests using Cronbach’s alpha. Spearman’s correlation coefficient was used to evaluate the correlation between the score of each subtest and the total score. SPSS version 21 was used for data analysis and the level of significance was considered <0.05.Results: The reliability of the combination of tests was 0.815. The reliability of KF was 0.81 and 0.76, 0.80, and 0.92 for SCT, CRP, and CIP, respectively. The mean total score was 169.921±41.54 from 240. All correlations between each clinical reasoning test and total score were significant (P<0.001). The highest correlation (0.887) was seen between CIP score and total score.Conclusion: The study showed that combining different clinical reasoning tests can be a reliable way of measuring this ability.

Social accountability: Attitudes and awareness among undergraduate medical students in Morocco

MAJDA SEBBANI; LATIFA ADARMOUCH; ADIL MANSOURI; MOHAMED AMINE

Volume 9, Issue 1 , January 2021, , Pages 1-7

https://doi.org/10.30476/jamp.2020.87197.1298

Abstract

Introduction: As future health professionals, medical students should be aware of their social accountability and their role in the society. The aim was to assess the attitudes ... Read More Introduction: As future health professionals, medical students should be aware of their social accountability and their role in the society. The aim was to assess the attitudes and awarenessof medical students regarding the social accountability and to identify the factors determining their attitudes and possible levers for action.Methods: Online survey among undergraduate students at the medical school in 2019 (N=2128). The data collection tool was developed based on the literature review, the principles of social accountability SR and the toolkit (The development of the Students’ Toolkit on Social Accountability of Medical Schools was a collaboration between the International Federation of Medical Students’ Associations (IFMSA) and the Training for Health Equity Network (THEnet). The data were collected inDecember by LimeSurvey software version 1.90 and analyzed by SPSS version 16 according to the usual descriptive and bivariate. The Fisher test was used to compare two percentages and theStudent t-test to compare two means on two independent samples (significance level was 0.05). The verbatims were grouped and analyzed. Results: 271 students participated (response rate=12.7%). The mean age was 20.6±2.6 years (N=257). The Female/Male ratio was 1.85. Only 33.5% had heard of social accountability. It waslinked to “commitment to the community” in 75.1% of cases, “to be a good citizen” in 66.1% and “to be responsible for one’s actions” in 56.4%. Nearly 79% thought that students did not really have a role in society and that they should focus on their studies. Being a member of an association was a factor determining the positive attitude towards the SA (82.1% versus 65.2%, P=0.031). Students believed that the school had some strategies of social accountability. The results of the verbatim emphasize the need to multiply the practices and opportunities for interaction with thesocial environment for students.Conclusion: The level of knowledge of the concepts by the students seems to be average. It would be necessary to look for the means to plead in favor of reinforcing our school strategies to concretize the principles of SR while training the students.

Multidisciplinary Programed Learning Simulation to Improve Visual Blood Loss Estimation for Obstetric Trauma Scenarios

JANE PONTERIO; MALEEHA AHMAD; APARNA VANCHESWARAN; NISHA LAKHI

Volume 10, Issue 1 , January 2022, , Pages 1-11

https://doi.org/10.30476/jamp.2021.91990.1466

Abstract

Introduction: We designed and implemented a Programmed Learning Simulation (PLS) exercise depicting obstetric scenarios of hemorrhage to train anesthesiologists, ancillary ... Read More Introduction: We designed and implemented a Programmed Learning Simulation (PLS) exercise depicting obstetric scenarios of hemorrhage to train anesthesiologists, ancillary staff, and surgeons to accurately estimate blood loss visually. We then measured the efficacy of this exercise in a clinical setting.Methods: We conducted a prospective study to assess the effect of implementing a PLS exercise on quantification of blood loss in an operative setting. The PLS exercise consisted of 13 simulationstations of varying quantities of simulated blood loss paired with standardized objects of known volume. Eighty-eight individuals participated including attending physicians, residents, medicalstudents, and ancillary staff participated in this study. The PLS was part of regularly scheduled continuing medical education activities; thus, the sampling used was non-randomized convenience method. The percent error was calculated for each of the 13 stations. A subgroup analysis was performed to assess the effect of the years of experience, size of hemorrhage, and occupation on accuracy. Univariate analyses for continuous variables were compared using a one-way ANOVA test. For the comparison of the three groups (years of experience and size of hemorrhage), a p-value of determine the effect of PLS in a clinical setting, the percent error of blood loss estimation for cesarean deliveries during the twomonth period after the PLS exercise was compared to the twomonth period immediately prior to using the student’s t-test with p Results: During Part A, the baseline performance of the participants was evaluated during the PLS activity. The PLS data showed no significant difference in absolute value of mean percent error estimation (standard deviation) across professions: student 63.61% (69.74), ob/gyn 56.91% (47.72), ancillary 62.15% (77.90), general/trauma surgeon 66.70% (65.06), anesthesia 61.51% (63.12). (P=0.681), or levels of experience 0-5: 62.21% (60.06), 6-10 years: 56.22% (52.66), greater than 10 years: 61.89% (71.89) (P=0.831). However, mean percent error of estimation was higher when participants estimated smaller samples 77.7% (104.73) compared to either medium 56.8% (49.06) or large 57.9% (46.19) samples (p <0.001). For Part B, 179 cesarean deliveries occurred during the pre-intervention period and 193 occurred during the postintervention period. Mean error in provider estimation of blood loss significantly improved from 47% (68.51) pre-intervention to 31% (32.70) post-intervention (P=0.009). Conclusion: We believe our described PLS activity was effective in teaching techniques for visual blood loss estimation. This was reflected by improved competency in a clinical setting, demonstrated by more accurate visually estimated blood loss during the period immediately following simulation activity compared to a prior time frame. Further research is needed to assess the impact of simulation activities on patient outcomes, such as utilization of blood products and patient morbidity.

Policy on Duplicate Publication: Professional Ethics

JAVAD KOJURI; PARISA NABEIEI; NASRIN SHOKRPOUR

Volume 11, Issue 1 , January 2023, , Pages 1-2

https://doi.org/10.30476/jamp.2022.97492.1761

Abstract

- Read More

Integrating Research and Teaching in Medical Education: Challenges, Strategies, and Implications for Healthcare

YASAR AHMED; MOHAMED HASAN TAHA; SIMAA KHAYAL

Volume 12, Issue 1 , January 2024, , Pages 1-7

https://doi.org/10.30476/jamp.2023.99751.1854

Abstract

Introduction: The integration of research and teaching in medical education offers numerous benefits, fostering critical thinking and analytical skills in students. Institutions worldwide ... Read More Introduction: The integration of research and teaching in medical education offers numerous benefits, fostering critical thinking and analytical skills in students. Institutions worldwide have recognized the significance of this nexus and have implemented initiatives to link teaching with disciplinebased research, promoting interdisciplinary collaboration. This article aims to explore the challenges and recommendations for integrating research and teaching in medical schools and provide recommendations to overcome these challenges.Methods: We conducted a comprehensive review of the literature to identify the common challenges faced by medical institutions in integrating research and teaching. PubMed, Scopus, Web of Science, ERIC, and Google Scholar databases were searched to assess the literature that met the study objectives with explicit inclusion and exclusion criteria. We also examined successfulstrategies employed by some institutions to promote researchteaching integration.Results: The challenges identified include limited resources, the need to balance research and curriculum requirements, and the importance of cultivating a research-oriented institutionalculture. Successful strategies involve curriculum updates, faculty motivation, and cross-disciplinary collaboration. Implementing strategies involve vertically and horizontally integrating researchmethodology throughout the undergraduate curriculum and crossintegrating traditional medical courses with other disciplines. Collaboration between universities, enterprises, and schools canenhance comprehensive cooperation.Conclusion: To create a research-oriented learning environment, medical institutions should address these challenges and implement effective strategies. This approach will not only nurture researchoriented healthcare professionals but also advance medical knowledge for the benefit of patient care. By addressing these challenges and implementing appropriate strategies, medicalinstitutions can create a research-oriented learning environment, nurturing research-oriented healthcare professionals and advancing medical knowledge to improve patient care.

Mentoring as an Appropriate Strategy for Medical Faculty Member Development in Higher Education: A Systematic Review

MASOUD ABDOLLAHI; FATEMEH HESHMATI NABAVI

Volume 11, Issue 1 , January 2023, , Pages 3-14

https://doi.org/10.30476/jamp.2022.97103.1740

Abstract

Introduction: Human resources development, especially faculty members who play a substantial role in education, isof great importance and can lead to enhanced competence and participation ... Read More

Students’ perception and learning on case based teaching in anatomy and physiology: An e-learning approach

NEERAJ VEDI; PUJA DULLOO

Volume 9, Issue 1 , January 2021, , Pages 8-17

https://doi.org/10.30476/jamp.2020.87332.1304

Abstract

Introduction: Case based teaching (CBT) has been accepted as an effective interactive learning strategy. Digital portals allow the students to learn the content at their own ... Read More

Exploring BAME Student Experiences in Healthcare Courses in the United Kingdom: A Systematic Review

CALLUM SINGH GREWAL; MOHAMMED BILAL KHAN; JASMIN KIRAN KAUR PANESAR; SIMAL ASHER; NAVJYOT MEHAN

Volume 12, Issue 1 , January 2024, , Pages 8-17

https://doi.org/10.30476/jamp.2023.98882.1825

Abstract

Introduction: Black, Asian, and Minority Ethnic (BAME) students in healthcare-related courses are exposed to various challenging experiences compared to their White counterparts, not ... Read More

Are Online Synchronous Team-Based-Learning (TBL) pedagogy effective?: Perspectives from a study on medical students in Oman

MOHAN B SANNATHIMMAPPA; VINOD NAMBIAR; RAJEEV ARAVINDAKSHAN; ANIL KUMAR

Volume 10, Issue 1 , January 2022, , Pages 12-21

https://doi.org/10.30476/jamp.2021.92361.1481

Abstract

Introduction: Team-based learning (TBL) is a highly structured, instructive, and student-focused pedagogy used by medical educators to foster the students’ learning. ... Read More Introduction: Team-based learning (TBL) is a highly structured, instructive, and student-focused pedagogy used by medical educators to foster the students’ learning. The present study aimed to qualitatively explore the students’ perception of the effectiveness of online synchronous TBL pedagogical strategy in promoting learning outcomes.Methods: A cross-over interventional study was conducted on MD4 year medical students, using four modified TBL sessions on common immunological diseases on four different dates. 139 participants were divided into 4 groups [35 each in A, B, C, & 34 in D]. For TBL session 1, Group A and group B were the study and control groups, respectively. For the second session on different topics, the groups were reversed with group B and group A as the study and control groups, respectively. The same was followed for groups C and D. The means and standard deviations of the pre-test and post-test scores were compared after calculating the improvement in scores from pre- to post-tests. Repeated measures ANOVA suitably coded in SPSS for cross-over design was used to find out confounding by sequence of interventions with a p-value of on a 3-point Likert scale. The data were analyzed using SPSS version 22 and expressed as number and percentage. Results: The post-test scores of the students who participated in the TBL session were significantly higher when compared to the self study (SS) arm. The overall improvement in scores was 4.98 (1.4) in TBL group, whereas in the SS arm it was only 2.29 (1.51). The new method was found far superior to the self-study method regardless of being applied before or after the comparison mode of self-study (p <0.0001). The scores of the self-study was marginally better when offered first rather than after a TBL session, indicating the negative effect of cross-over on SS mode (P=0.024). The overall response of our students toward the effectiveness of online TBL pedagogy was overwhelmingly positive in terms of an opinion survey which had a Cronbach’s alpha of 0.932. The majority (>80%) perceived TBL as an enjoyable active session that promoted their active participation and engagement through student-led discussions. Many stated that TBL enhanced their critical thinking, problem-solving ability, communication skills, and knowledge. Conclusion: TBL is an instructive and highly structured teachinglearning strategy, welcomed by the majority of our participants. Online TBL sessions are effective in fostering the students’learning and can be used confidently when needed.

Teaching Clinical Skills Using Online Modality through Modified Peyton’s Framework: An Experience from a Medical University in Pakistan

SANA SAEED; UROOJ KASHIF; SAMAR ZAKI; KHALID SAMAD; MUHAMMAD ZUHAIR YOUSUF; MAHANOOR RAZA; SHAHJAHAN JABBAR; UNAB I. KHAN

Volume 11, Issue 1 , January 2023, , Pages 15-23

https://doi.org/10.30476/jamp.2022.95986.1669

Abstract

Introduction: Medical institutions worldwide faced an unprecedented situation during COVID-19 of identifying alternative strategies to sustain the continuum of learning process. This ... Read More Introduction: Medical institutions worldwide faced an unprecedented situation during COVID-19 of identifying alternative strategies to sustain the continuum of learning process. This led to several innovations in the traditional medical curriculum. This study explored the effectiveness and feasibility of using the Peyton’s framework modified for a virtual platform (Microsoft Teams) for teaching clinical skills to first and second-year medical students at The Aga Khan University, Karachi, Pakistan.Methods: In 2020-2021, the modified Peyton’s framework was integrated in the clinical skills (CS) curriculum for all first- and second-year students (N=200). For evaluation, a mixed-method design was used, with pre-and post-session questionnaires. Students’satisfaction was obtained through the standard session evaluation tool of the university. For the qualitative arm, to explore the instructors’experiences, purposive sampling was used (n=8) and a focused group discussion (FGD) was conducted. Finally, performance of the students at the end of year summative Objective Structured Clinical Examination (OSCE) was compared with the students of previous year. Quantitative data were analysed using STATA® version 15.1, using paired t-test to compare the differences in OSCE scores in selected CS stations. A p-value of <0.05 was considered significant for all tests. The FGD was transcribed and analysed through manual content analysis.Results: Nine clinical skills (that included history and examination skills) were taught using the virtual platform. There was a significant improvement in post-session questionnaires in seven of these skills (P<0.01). Session evaluations showed that most students were satisfied with the learning experience. The instructors showed that the online teaching offered a promising platform for teaching history taking skills. The OSCE scores showed mixed results, with significant improvement in two out of four repeated stations by using paired t-test [abdominal exam (87.33±8.99, <0.001); and precordial examination (88.45±8.36, 0.001)].Conclusions: Modifying Peyton’s framework to a virtual platform allowed us to sustain the continuum of clinical education during the COVID-19 pandemic. The results support the use of a blended learning environment for teaching clinical skills.

Students’ engagement and perceptions of small group tutorial classes among undergraduate medical students

SHIVANANDA NAYAK B; VINEETH SRIDEVI; PRADEEPKUMAR SAHU; NAGENDRA SUBBARAMAIAH; LATHA TELANG; PRASHANTHKUMAR GOUDAPPALA; CHANDRAKANTH HALAPPA KARIAPPA; AKANKSHA SHARMA; MAANASA SAGARI K; AKASH S NAYAK

Volume 9, Issue 1 , January 2021, , Pages 18-25

https://doi.org/10.30476/jamp.2020.86925.1280

Abstract

Introduction: Small group teaching is an educational strategy that may be used to facilitate learning. Tutorials enable an adult approach toward learning where students take ... Read More Introduction: Small group teaching is an educational strategy that may be used to facilitate learning. Tutorials enable an adult approach toward learning where students take responsibility for their own learning. We aimed to investigate the students’engagement and perceptions of small group tutorial classes among undergraduate medical students.Methods: A cross‑sectional, descriptive survey was conducted at the Subbaiah Institute of Medical Sciences, where we collected the data from 300 undergraduate students using conveniencesampling method. A self‑administered questionnaire consisting of 22 items which was piloted on 20 students, and six experienced medical educators were consulted for face validation. The internalconsistency of the questionnaire measured by Cronbach’s alpha reliability test was 0.80. It was used to measure the students’perception on the effectiveness of tutorials with regard to learningexperience, teamwork, confidence, communication skills, and role of the teacher. Statistical analyses included mean and standard deviation for the description of each item, t‑test to compare the mean scores for gender and class year, and one‑way analysis of variance between groups for age group comparisons using SPSS version 24 software. Results: Students’ overall perceptions of small group teaching effectiveness showed that tutorials were beneficial to their learning process (mean: 3.61±0.50). The majority of the students havepositive perceptions toward small group effectiveness, particularly in learning experience (mean: 3.72±0.68) and teamwork (mean: 3.36±0.59). A significant difference was found between year 1 and year 2 students with regards to learning experience (p <0.001), teamwork (p <0.05), communication skills (p <0.05), and the role of the tutor (p <0.001). Additionally, the mean scores, measuring overall effectiveness of tutorials, for the 2nd year students were significantly higher than that for the 1st year students (3.70±0.41and 3.50±0.57, (p <0.001).Conclusions: The data of this study show that tutorial is an effective small group teaching method for medical students compared to large group teaching.

Clinical Supervision of Medical Students in Primary Health Care Services: General Practitioners’ Perspectives in Morocco

SAMIRA ESSOLI; GHITA HOUDALI; ADIL MANSOURI; OUASSIM MANSOURY; LATIFA ADARMOUCH; MOHAMED AMINE; MAJDA SEBBANI

Volume 12, Issue 1 , January 2024, , Pages 18-27

https://doi.org/10.30476/jamp.2023.100060.1868

Abstract

Introduction: Clinical supervision is crucial to establish a learning climate in which the supervisor guides the supervised. Clinical supervisors might have numerous barriers and motivations. ... Read More

Perceptions of Medical Undergraduate Students on Curricular Changes in Anatomy: An Embedded Design Mixed Method Study

APARNA MURALEEDHARAN; SARANYA RAGAVAN; NUTAN NALINI BAGE; REMA DEVI

Volume 10, Issue 1 , January 2022, , Pages 22-29

https://doi.org/10.30476/jamp.2021.92149.1472

Abstract

Introduction: Implementation of competency-based medical education (CBME) offers challenges to the faculty and students. As a part of the new curriculum by the National Medical Council ... Read More Introduction: Implementation of competency-based medical education (CBME) offers challenges to the faculty and students. As a part of the new curriculum by the National Medical Council of India, we introduced certain teaching and assessment modifications in anatomy. There are few studies on the actual implementation of CBME. The current study aimed to assess the perceived usefulness of the teaching, learning, and assessment methodology (TLAM) based on written feedback from students.Methods: All the 147 first MBBS students of the batch who had undergone the new teaching learning methodology answered the questionnaire on usefulness of the various TLAMs on a 3-point Likert scale which was taken as quantitative data. They were also asked to pen down their opinions and suggestions about the TLAM which was thematically analysed and considered as qualitative data. Face and content validity was assessed prior to administration of the questionnaire. Descriptive statistics were used for quantitative variables. Qualitative data were analysed bythematic analysis. Results: 100% of the students found vertical integration and small group teaching as useful. Seminars and quizzes were reported as useful to extremely useful by 75.5% of the students. Self-directed learning and near-peer teaching was also appreciated well by 78% of students. In Embryology and Neuroanatomy, these active learning methods were not found to be useful as these topics were difficult to understand. Overall, the new TLAM introduced as per the new medical curriculum was found useful for the majority of students.Conclusion: This study provides valuable insights on the teaching, learning, and assessment methods as formulated by the competency-based medical curriculum. Though active learning methods are the integral principles of andragogy, the concepts which are difficult to understand need to be taught using the traditional teaching methodology.

Volume 12 (2024)

Volume 11 (2023)

Volume 10 (2022)

Volume 9 (2021)

Volume 8 (2020)

Volume 7 (2019)

Volume 6 (2018)

Volume 5 (2017)

Volume 4 (2016)

Volume 3 (2015)

Volume 2 (2014)

Volume 1 (2013)

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract