Journal of Advances in Medical Education & Professionalism

Setting objectives for a competency-based undergraduate obstetrics and gynecology curriculum

AJAY HALDER; ANKUR JOSHI; RAGINI MEHROTRA; BERTHA RATHINAM; SUSHRUTA SHRIVASTAVA

Volume 6, Issue 4 , October 2018, , Pages 147-154

https://doi.org/10.30476/jamp.2018.41028

Abstract

Introduction: Little emphasis on standardization, less stringentoutcome measurement and resource constrains can result indeteriorating competencies among medical graduates in acountry ... Read More Introduction: Little emphasis on standardization, less stringentoutcome measurement and resource constrains can result indeteriorating competencies among medical graduates in acountry with rapidly increasing number of medical institutionslike India. A competency-based curriculum is where we carefullydesign curricular experiences to achieve pre-identified outcomes.In this study, we aimed to define the outcome objectives of acompetency-based undergraduate Obstetrics and Gynaecologycurriculum which is comprehensive, and is based on the presentday need of our society. These objectives can serve as the basis fordesigning a suitable curriculum with aligned teaching learningand assessment methods.Methods: This is an observational study in which a Delphitechnique was used to identify the outcome objectives representingcompetencies specific to the subject of obstetrics and gynaecologyat graduate level. The six core competencies identified byAccreditation Council for Graduate Medical Council formed theframework to identify these competencies. Then, a cross-sectionalcountrywide survey was conducted among purposively sampledteachers and clinical experts through a postal questionnaire toknow the relative importance of the identified outcome measuresand need for their inclusion in a contemporary outcome-basedcurriculum.Results: Ninety four medical teachers and clinical experts,belonging to institutes across the county, with demonstrableinterest and expertise in the field of medical education identified38 outcome objectives for the curriculum. There were twentyone “vital”, fourteen “essential”, two “desirable” and one“optional” outcome objectives identified. There were eighteenoutcome objectives for “patient care” domain, nine for “medicalknowledge”, four for “Practice based learning and improvement”,three for “professionalism”, two for “system based practice”, andtwo for “interpersonal and communication skills”.Conclusion: The outcome objectives for a competency-basedobstetrics and gynaecology curriculum in an Indian context weredefined.Keywords: Outcome, Objectives, Competency, Obstetrics, Gynecology, Curriculum

A brief description of Medical Education Master Program in Shiraz University of Medical Sciences

FARNAZ TAKMIL; MITRA AMINI; PARISA NABEIEI; LEILA BAZRAFKAN; MOHAMMAD REZA DEHGHANI; RITA REZAEE; SHIRIN GHANAVATI; JAVAD KOJURI

Volume 3, Issue 4 , October 2015, , Pages 153-153

Abstract

As Medical sciences become more advanced andgrow each day, so do the challenges of medicaleducation. To overcome the new obstacles whichare an inseparable part of science evolution, ... Read More As Medical sciences become more advanced andgrow each day, so do the challenges of medicaleducation. To overcome the new obstacles whichare an inseparable part of science evolution, it isnecessary to renew and improve the educationalsystem .Achieving this, requires individuals whoare educated in the new methods of learning andtherefore can lead others through educationalsystem development. During the past decade,these facts have led many medical universitiestoward establishing and pursuing new masterand PhD. programs of medical education. As aPioneer in the field of medical education and thefirst teacher training center in EMRO since 1972,Shiraz University of Medical Sciences (SUMS)has also contributed to educational systemtransformation by establishing master courses inmedical education since 2008, with a goal of notonly updating faculties` educational knowledgebut also training efficient educational experts. InSUMS, these courses which are also mentionedin Dr. ARA Tekian’s article in Chicago University(1), were designed based on reviewing what Someof the greatest universities in the field of educationsuch as Dundee, Maastricht and Chicago Universityhave done. The courses last for five semestersand are available for all medical and paramedicalfaculty members, GPs and paramedical masters.To enter the program applicants must send theirresume including their degree, previous education,and published articles. Moreover, they must alsotake part in an entrance exam which evaluatestheir knowledge of general English language alongwith their educational knowledge and computerskills. These courses are conducted using thenewest methods and references of learning suchas “A practical guide for medical teachers” (2).The students are also asked to study the mostrecent AMME Guidelines which are provided forthem. According to students’ work field, in eachsemester, proper homework has been considered toimprove what they’ve been instructed in practice.After becoming educational experts, thesestudents can be hired in different sections ofeducation departments, acting as educationalambassadors, initiating educational leaders &curriculums designers which, in turn, can littleby little change the culture and face of education,hoping that these changes may someday result inspurring medical educational system.

Social media and impression management: Veterinary medicine students’ and faculty members’ attitudes toward the acceptability of social media posts

APRIL A. KEDROWICZ; KENNETH ROYAL; KEVEN FLAMMER

Volume 4, Issue 4 , October 2016, , Pages 155-162

Abstract

Introduction: While social media has the potential to be used tomake professional and personal connections, it can also be usedinappropriately, with detrimental ramifications for the ... Read More

Lifelong learning along the education and career continuum: metaanalysis of studies in health professions

OKSANA BABENKO; SUDHA KOPPULA; LIA DANIELS; LINDSEY NADON; VIJAY DANIELS

Volume 5, Issue 4 , October 2017, , Pages 157-163

Abstract

Introduction: Lifelong learning is an integral part of healthprofessionals’ maintenance of competence. Several studies haveexamined the orientation toward lifelong learning at variousstages ... Read More

The impact of a high fidelity simulation-based debriefing course on the Debriefing Assessment for Simulation in Healthcare (DASH)© score of novice instructors

ISSAM TANOUBI; IHEB LABBEN; SALMA GUÉDIRA; PIERRE DROLET; ROGER PERRON; ARNAUD ROBITAILLE; MIHAI GÉORGESCU

Volume 7, Issue 4 , October 2019, , Pages 159-164

https://doi.org/10.30476/jamp.2019.74583.0

Abstract

Introduction: Experiential learning, followed by debriefing, is at the heart of Simulation-Based Medical Education (SBME) and has been proven effective to help master several ... Read More Introduction: Experiential learning, followed by debriefing, is at the heart of Simulation-Based Medical Education (SBME) and has been proven effective to help master several medical skills.We investigated the impact of an educational intervention, based on high-fidelity SBME, on the debriefing competence of novice simulation instructors.Methods: This is a prospective, randomized, quasi-experimental, pre- and post-test study. Sixty physicians without prior formal debriefing expertise attended a 5-day SBME seminar targeted ondebriefing. Prior to the start of the seminar, 15 randomly chosen participants had to debrief a spaghetti and tape team exercise. Thereafter, the members of each team assessed their debriefer’sperformance using the Debriefing Assessment for Simulation in Healthcare (DASH)© score. The debriefing seminar that followed (intervention) consisted of 5 days of teaching that included theoretical and simulation training. Each scenario was followed by a Debriefing of the Debriefing (DOD) session conducted by the expert instructor. At the end of the course, 15 randomly chosen debriefers had to debrief a second tower building exercise and were re-evaluated with the DASH score by their respective team members. The Wilcoxon signed-rank test was used to compare pre- and post-test scores. Statistical tests were performed using GraphPad Prism 6.0c for Mac.Results: A significant improvement in all items of the DASH score was noted following the seminar. The debriefers significantly improved their performance with regard to “maintaining an engaging learning environment” (Median [IQR]) (4[3-5] after the pre-test vs. 5.5[5-6] after the post-test, P<0.001); “structuring the debriefing in an organized way” (5[4-5] after the pre-test vs. 5[5-6] after the post-test, p=0.002); “provoking engaging discussion” (4[3-5.75] after the pre-test vs. 6[5-6]after the post-test, P<0.001); “identifying and exploring performance gaps” (5[4-6] after the pre-test vs. 6[5-6] after the post-test, P=0.014); and “helping trainees to achieve and sustain good future performance” (4[3-5] after the pre-test vs. 6[5-6] after the post-test, P<0.001).Conclusion: A simulation-based debriefing course, based mainly on DOD sessions, allowed novice simulation instructors to improve their overall debriefing skills including, more specifically, the abilityto foster engagement in discussions and maintain an engaging learning environment.

Supportive atmosphere in medical education in the post-COVID-19 era: We are not out of the woods yet!

ALI ARDEKANI; MITRA AMINI; RITA REZAEE

Volume 10, Issue 4 , October 2022, , Pages 217-218

https://doi.org/10.30476/jamp.2022.96371.1697

Abstract

- Read More

Improving Role Modeling in Clinical Teachers: A Narrative Literature Review

ELAHEH MOHAMMADI; HOMAN SHAHSAVARI; AZIM MIRZAZADEH; AMIR ALI SOHRABPOUR; SARA MORTAZ HEJRI

Volume 8, Issue 1 , January 2020, , Pages 1-9

https://doi.org/10.30476/jamp.2019.74929.

Abstract

Introduction: Students observe role models and learn from them in a variety of educational settings. Although it is known that role models impact the professional and character ... Read More

Department of medical education; A personal history

BAHMAN JOORABCHI

Volume 1, Issue 1 , January 2013, , Pages 2-6

Abstract

This is a brief overview of the history of formal introduction of the art andscience of education into the sphere of medical education in Shiraz. Before this introduction medical education ... Read More

Comparison of the students’ satisfaction about the performance of academic advisors before and after the Advisor Project in Shahrekord University of Medical Sciences

MASOUMEH DELARAM; SARA HOSSEINI

Volume 2, Issue 1 , January 2014, , Pages 6-11

Abstract

Introduction: Inappropriate advice interferes with the students’ achievementof educational and professional goals and they may fail to use proper resourcesfor their educational needs. ... Read More

Effectiveness of early clinical exposure in learning respiratory physiology among the newly entrant MBBS students

PIYALI DAS; SUBHRADEV BISWAS; RAMJI SINGH; SANHITA MUKHERJEE; SHARMISTHA GHOSHAL; DEBASIS PRAMANIK

Volume 5, Issue 1 , January 2017, , Pages 6-10

Abstract

Introduction: Early Clinical Exposure has been conceptualizedto orient medical students towards actual clinical scenario andhelp them correlate their theoretical knowledge with real ... Read More 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

The professionalization of Iranian hospital social workers

MALIHEH KHALVATI; HOSSEIN FEKRAZAD; MARYAM RAFATJAH; LEILA OSTADHASHEMI; HAMID REZA KHANKEH

Volume 6, Issue 1 , January 2018, , Pages 6-13

https://doi.org/10.30476/jamp.2018.43342

Abstract

Introduction: Identity is formed through our understanding ofourselves and what others perceive of our actions and how we dothings. Formation of professional identity includes development,advancement ... Read More

Assessing clinical reasoning skills using Script Concordance Test (SCT) and extended matching questions (EMQs): A pilot for urology trainees

SYED MUHAMMAD NAZIM; JAMSHEER J. TALATI; SHEILA PINJANI; SYED RAZIUDDIN BIYABANI S; MUHAMMAD HAMMAD ATHER; JOHN J. NORCINI

Volume 7, Issue 1 , January 2019, , Pages 7-13

https://doi.org/10.30476/jamp.2019.41038

Abstract

Introduction: Clinical reasoning skill is the core of medicalcompetence. Commonly used assessment methods for medicalcompetence have limited ability to evaluate critical thinking andreasoning ... Read More Introduction: Clinical reasoning skill is the core of medicalcompetence. Commonly used assessment methods for medicalcompetence have limited ability to evaluate critical thinking andreasoning skills. Script Concordance Test (SCT) and Extended Matching Questions (EMQs) are the evolving tests which areconsidered to be valid and reliable tools for assessing clinicalreasoning and judgment. We performed this pilot study to determinewhether SCT and EMQs can differentiate clinical reasoning abilityamong urology residents, interns and medical students. Methods: This was a cross-sectional study in which an examinationwith 48 SCT-based items on eleven clinical scenarios and four themedEMQs with 21 items were administered to a total of 27 learners atthree differing levels of experience i.e. 9 urology residents, 6 internsand 12 fifth year medical students. A non-probability conveniencesampling was done. The SCTs and EMQs were developed fromclinical situations representative of urological practice by 5 contentexperts (urologists) and assessed by a medical education expert.Learners’ responses were scored using the standard and the graduatedkey. A one way analysis of variance (ANOVA) was conducted tocompare the mean scores across the level of experience. A p-value of <0.05 was considered statistically significant. Test reliability was estimated by Cronbach α. A focused group discussion with candidates was done to assess their perception of test. Results: Both SCT and EMQs successfully differentiated residents from interns and students. Statistically significant difference in mean score was found for both SCT and EMQs among the 3 groups using both the standard and the graduated key. The mean scores were higher for all groups as measured by the graduated key compared to the standard key. The internal consistency (Cronbach’s α) was 0.53 and 0.6 for EMQs and SCT, respectively. Majority of the participants were satisfied with regard to time, environment, instructions provided and the content covered and nearly all felt that the test helped them in thinking process particularly clinical reasoning.Conclusion: Our data suggest that both SCT and EMQs are capable of discriminating between learners according to their clinical experience in urology. As there is a wide acceptability by all candidates, these tests could be used to assess and enhance clinical reasoning skills. More research is needed to prove validity of these tests.

Clinical education stressors in medical trainees in Shahid Sadoughi University of Medical Sciences, Yazd

MAHDIEH MOMAYYEZI; HOSSEIN FALLAHZADEH; MOHAMMAD MOMAYYEZI

Volume 4, Issue 1 , January 2016, , Pages 8-12

Abstract

Introduction: Stress is an important factor in the educationalprocess. Teaching and learning are stressful processes. Thisstress can affect one’s ability and change his/her performance.The ... Read More

Impact of media literacy education on knowledge and behavioral intention of adolescents in dealing with media messages according to stages of change

NARJES GERAEE; MOHAMMAD HOSSEIN KAVEH; DAVOD SHOJAEIZADEH; HAMID REZA TABATABAEE

Volume 3, Issue 1 , January 2015, , Pages 9-14

Abstract

Introduction: Mass media influence the health behaviors ofadolescents. Evidence shows that traditional strategies suchas censorship or limitation are no longer efficient; therefore,teaching ... Read More Introduction: Mass media influence the health behaviors ofadolescents. Evidence shows that traditional strategies suchas censorship or limitation are no longer efficient; therefore,teaching media literacy is the best way to protect adolescents fromharmful effects. The aim of this pilot study was to evaluate theeffects of a media literacy training program on knowledge andbehavioral intention of a sample of female students according tothe stages of change in dealing with media messages.Methods: The study was conducted based on a pre-test and posttestcontrol group design. Some 198 female students including 101in the intervention group and 97 in the control group participatedin this study. The educational program was run using interactiveteaching-learning techniques. Data collection was performedusing a validated and reliable self-administered questionnaire inthree phases including a pre-test, post-test, 1 and post-test, 2. Theresearch data was analyzed through SPSS statistical software,version 14 using both descriptive and inferential statistics.Results: The results of the study showed a significant increase(p=0.001) in the intervention group’s knowledge mean scoresafter the training program. On the other hand, the difference wasnot significant in the control group (p=0.200). A considerablepercentage of the participants, in the intervention and controlgroups, were in pre contemplation and contemplation stagesin the pre-test (64 and 61, respectively). After the intervention,however, a significant improvement (p=0.001) was observed inthe intervention group’s stages of change compared to that inthe control group. The distribution of the control group studentsregarding the stages of change was similar to that in the pre-test.Conclusion: The study findings revealed that the planned educationprograms are efficient to improve the adolescents’ knowledge andbehavioral intention in dealing with mass media messages.Keywords: Media literacy, Education, Adolescents, knowledge

Emotional intelligence in nursing students

MAASOUMEH BARKHORDARI; PARISA ROSTAMBEYGI

Volume 1, Issue 2 , April 2013, , Pages 46-50

Abstract

Introduction: Emotion is fundamental to nursing practice and EmotionalIntelligence is considered as an important characteristic of nurses that can affect the quality of their work ... Read More

Emotional intelligence as a predictor of self-efficacy among students with different levels of academic achievement at Kermanshah University of Medical Sciences

AMENEH GHARETEPEH; YAHYA SAFARI; TAHEREH PASHAEI; MANSOUR RAZAEI; MOHAMMAD BAGHER KAJBAF

Volume 3, Issue 2 , April 2015, , Pages 50-55

Abstract

Introduction: studies have indicated that emotional intelligenceis positively related to self-efficacy and can predict the academicachievement. The present study aimed to investigate ... Read More

The impact of the teachers’ non-verbal communication on success in teaching

FATEMEH BAMBAEEROO; NASRIN SHOKRPOUR

Volume 5, Issue 2 , April 2017, , Pages 51-59

Abstract

Introduction: Non-verbal communication skills, also called signlanguage or silent language, include all behaviors performed in thepresence of others or perceived either consciously ... Read More Introduction: Non-verbal communication skills, also called signlanguage or silent language, include all behaviors performed in thepresence of others or perceived either consciously or unconsciously.The main aim of this review article was to determine the effectof the teachers’ non-verbal communication on success in teachingusing the findings of the studies conducted on the relationshipbetween quality of teaching and the teachers’ use of non-verbalcommunication and also its impact on success in teaching.Methods: Considering the research method, i.e. a review article,we searched for all articles in this field using key words suchas success in teaching, verbal communication and non-verbalcommunication. In this study, we did not encode the articles.Results: The results of this revealed that there was a strongrelationship among the quality, amount and the method of usingnon-verbal communication by teachers while teaching. Based onthe findings of the studies reviewed, it was found that the morethe teachers used verbal and non-verbal communication, the moreefficacious their education and the students’ academic progresswere. Under non-verbal communication, some other patterns wereused. For example, emotive, team work, supportive, imaginative,purposive, and balanced communication using speech, body, andpictures all have been effective in students’ learning and academicsuccess. The teachers’ attention to the students’ non-verbalreactions and arranging the syllabus considering the students’mood and readiness have been emphasized in the studies reviewed.Conclusion: It was concluded that if this skill is practicedby teachers, it will have a positive and profound effect on thestudents’ mood. Non-verbal communication is highly reliable inthe communication process, so if the recipient of a message isbetween two contradictory verbal and nonverbal messages, logicdictates that we push him toward the non-verbal message and askhim to pay more attention to non-verbal than verbal messagesbecause non-verbal cues frequently reveal the intention of thesender of the information and reflect his/her emotional reactions.Based on the obtained results of this study, it is recommendedthat attention to non-verbal communication skills can make apositive change in the future of a student’s life. It seems necessaryfor the teachers to practice and learn effective communicationskills, especially for those who always interact with a largegroup of students. One of the factors contributing to the success or failure of students is the quality of the relationship and howthe teacher builds this relationship with students. Especially, itis more effective for students who are more responsive to humanrelations and communication skills. Finally, it is recommendedthat the teachers should improve their communication skills tohave better communication with their audience. The authoritiesare recommended to help improve the teachers’ level ofcommunication skills through holding training courses.Keywords: Communication; Teacher; Teaching

Improving continuing medical education by enhancing interactivity: lessons from Iran

SEYED ALIAKBAR FAGHIHI; HAMID REZA KHANKEH; SEYED JALIL HOSSEINI; SEYED KAMRAN SOLTANI ARABSHAHI; ZAHRA FAGHIH; SAGAR V. PARIKH; MANDANA SHIRAZI

Volume 4, Issue 2 , April 2016, , Pages 54-63

Abstract

Introduction: Continuing Medical Education (CME) has beenconsidered as a lifelong commitment for doctors to provide theoptimal care for patients. Despite a long history of creating ... Read More

Clinical procedural skills assessment during internship in ophthalmology

SUMITA SETHI; DINESH K BADYAL

Volume 7, Issue 2 , April 2019, , Pages 56-61

https://doi.org/10.30476/jamp.2019.44709

Abstract

Introduction: Directly observed procedural skills (DOPS) is aunique method for assessment since it tests the trainee’s abilityto apply his knowledge and skills in performing a ... Read More Introduction: Directly observed procedural skills (DOPS) is aunique method for assessment since it tests the trainee’s abilityto apply his knowledge and skills in performing a particularprocedure and provides an assessment of the practical workperformed by the trainee on a ‘real’ patient under supervisionof an experienced faculty. The study aims to make use of DOPSrating for assessment and further improvement in proceduralskills in interns in Ophthalmology rotational posting. Methods: A prospective study was planned and 15 interns on 2weeks’ rotational posting in the department of Ophthalmologywere included by purposive sampling over a duration of 2months. Four clinical procedural skills were identified and in thesecond week of posting, the interns were assessed by three DOPSencounters at an interval of 2 days for each clinical skill. TheDOPS ratings were analyzed quantitatively using R-statisticalsoftware by repeated measure ANOVA and Banfuroni test. Results: A total of 180 DOPS were undertaken for 15 internsin 4 core areas of ophthalmic examination. The mean overallDOPS rating for DOPS-1 was 3.70±0.82, DOPS-2, 3.83±1.82and DOPS-3, 4.93±1.65; the difference in DOPS rating betweenthe first and second encounter was not statistically significant(p=0.497), between the second and the third and between the firstand the third were statistically significant (p=0.000 in both cases)using Banfuroni test. The overall difference was also statisticallysignificant (p=0.000) using repeated measure ANOVA. Both theassessor and intern satisfaction increased significantly from thefirst to the third DOPS, but not statistically significant between thefirst and the second and between the second and the third DOPS. Conclusions: We found significant improvement in interns’clinical skills through repeated DOPS and the method waswell accepted by both the students and the faculty. Internshipperiod can be well utilized for improving clinical skills andnovel performance assessment methods like DOPS might proveto be highly beneficial in ensuring adequacy of learning duringinternship and also to assess their readiness for acceptingprofessional responsibilities in future.

Medical genetics teaching in Iranian medical schools, especially Ahvaz, south of Iran

MAHDI BIJANZADEH

Volume 2, Issue 2 , April 2014, , Pages 58-62

Abstract

Introduction: Physicians have to visit, diagnose and refer patients with genetic disorders, so they need to be familiar with the basics and indications of genetic tests. In other words, ... Read More

The educational effects of mobile learning on medical sciences students: A systematic review in experimental studies

HAMID REZA KOOHESTANI; SEYED KAMRAN SOLTANI ARABSHAHI; LADAN FATA; FAZLOLLAH AHMADI

Volume 6, Issue 2 , April 2018, , Pages 58-69

https://doi.org/10.30476/jamp.2018.41013

Abstract

Introduction: The demand for mobile learning in the medicalsciences educational program is increasing. The present reviewstudy gathers evidence highlighted by the experimental studieson ... Read More

A novel model of clinical reasoning: Cognitive zipper model

SHAHRAM YAZDANI; MARYAM HOSEINI ABARDEH

Volume 8, Issue 2 , April 2020, , Pages 61-71

https://doi.org/10.30476/jamp.2020.82230.1050

Abstract

Introduction: Clinical reasoning is a vital aspect of physician competence. It has been the subject of academic research for decades, and various models of clinical reasoning ... Read More Introduction: Clinical reasoning is a vital aspect of physician competence. It has been the subject of academic research for decades, and various models of clinical reasoning have been proposed. The aim of the present study was to develop a theoretical model of clinical reasoning.Methods: To conduct our study, we applied the process of theory synthesis in accordance with the Walker and Avant’s approach. First, we considered clinical reasoning as a focal concept of our study. Second, a search was carried out for the period 1984–2018, using the PubMed, Google Scholar, PsycINFO, ERIC, ScienceDirect and Web of Science databases to review the literature to identify factors related to the clinical reasoning and the nature of their relationships. Third, we organized clinical reasoning into an integrated and efficient representation of the clinical reasoning.Results: According to this study clinical reasoning is the iterative process of intermediation between the recalled clinical knowledge and the patient’s represented problem in the clinicians’ activememory. We analogize the process of clinical reasoning to the process of closure of a cognitive zipper. The recalled knowledge in clinician’s memory resembles to one side of zippers teeth and the evolving representation of the patient’s problem resembles the other side of zippers teeth. So, the results of this study are presented in three models: [1] multi-layer knowledge structure model, [2] problem representation model and [3] cognitive zipper model of diagnostic reasoning. Conclusion: We propose a developmental model of clinical reasoning. Several studies have tried to present models and theories to clarify clinical reasoning, but it seems that these theories and models could only explain part of this complex process and not the whole process. Cognitive zipper model, due to its developmental structure, can illustrate the clinical reasoning process in more details than other models do.

Educational needs assessment of managers working in teaching and private hospitals

VAHID KESHTKAR; NAHID HATAM; EHSANOLAH NIIKAEIN

Volume 1, Issue 3 , July 2013, , Pages 77-80

Abstract

Introduction: Hospital managers, as one of the most important health care workers, are the subject of continuous education. In some countries around the world, health management education ... Read More Introduction: Hospital managers, as one of the most important health care workers, are the subject of continuous education. In some countries around the world, health management education is an important part of health reforms. The aim of present research is to perform evidence-based studies based on assessing hospital managers’ needs. Therefore, it should be considered that educational need assessment regarding hospital managers is essential in today’s health care management. Methods: A total of 26 hospital managers were surveyed using a data gathering form (questionnaire) including 59 open questions designed in order to obtain data in 3 different areas. These included managers’ insight towards job duties and the capabilities required to fulfill their duty along with educational needs determined by managers. The next step involved presenting standard description of job duties to hospitals managers and asking them to document their educational needs regarding capabilities required to fulfill their duties. The standard description of job duties originated from ISO 9001 certified hospitals. For each manager, a score ranging from 0 to 19 was attained. For each correct matched statement, a positive point was considered and in the case of unmatched statements, managers received no points. Results: Out of 26 participating managers, only 20 did state the educational needs of hospitals managers. In describing job duties of hospital managers, the mean scores regarding hospital managers of public sector was 10.27 while it was 8 with private hospital managers. Conclusion: The findings of our study indicate that hospital managers as the leaders of the most sophisticated health care facilities delivering expensive complicated services need proper training regarding job competency. Therefore, it seems that continuous need assessment in this area should be carried out.Keywords: Health care, Hospital, Manager, Need assessment

Evidence-based medicine in pre-clinical years: a study of early introduction and usefulness

YOGESH ACHARYA; M.V. RAGHAVENDRA RAO; SATEESH ARJA

Volume 5, Issue 3 , July 2017, , Pages 95-100

Abstract

Introduction: Evidence Based Medicine (EBM) has establisheditself as a strong predictor of future medical practice by medicalstudents. The purpose of this study was to determine theeffectiveness ... Read More Introduction: Evidence Based Medicine (EBM) has establisheditself as a strong predictor of future medical practice by medicalstudents. The purpose of this study was to determine theeffectiveness of EBM in pre-clinical years and reflect on selfassessmentskill of 4th semester medical students regarding theunderstanding of EBM and its various determinants.Methods: All of the 4th semester (MD4) medical students at theAvalon University of Medical School, Curacao who had completedtheir EBM curriculum were asked to voluntarily participatein a cross sectional student survey containing qualitative andquantitative questionnaires in a 10-point scale. The students’responses were analyzed statistically and the results reported.Results: Twenty-three students participated in the survey. 91%of them reported that EBM had helped them to better understandresearch process and 95% believed that EBM was necessary todevelop clinical skills in the future. 78% of the students agreedthat they were provided with enough resources for effectiveimplementation of EBM in the university. All participants(100%) self reported that they could appraise the research articleseffectively (mean score 8.26, S.D-1.45).Conclusions: EBM is an integrative and comprehensive way tosuccessfully adopt concepts of acquired medical knowledge foreffective medical practice. Early introduction of EBM in preclinicalyears proved favorable in students and better equipped them withthe ability to critically apprehend and appraise new research andinnovations in medicine for optimal learning experience. Thereis a definitive need for scientific and systematic design of thecurriculum for early introduction of EBM in pre-clinical years,best suited for the students. The principles should be directedtowards further research for the effective implementation of EBMto enhance clinical skills.Keywords: Evidence-based medicine; Medical education; Medical students; Curriculum; Evaluation

A study of the professional development needs of Shiraz high schools’ principals in the area of educational leadership

ALIASGHAR HAYAT; BIJAN ABDOLLAHI; HASAN REZA ZAINABADI; HAMID REZA ARASTEH

Volume 3, Issue 3 , July 2015, , Pages 99-104

Abstract

Introduction: The increased emphasis on standards-based schoolaccountability since the passage of the no child left behind act of2001 is focusing critical attention on the professional ... Read More Introduction: The increased emphasis on standards-based schoolaccountability since the passage of the no child left behind act of2001 is focusing critical attention on the professional developmentof school principals and their ability to meet the challenges ofimproving the student outcomes. Due to this subject, the currentstudy examined professional development needs of Shiraz highschools principals.Methods: The statistical population consisted of 343 principalsof Shiraz high schools, of whom 250 subjects were selected usingKrejcie and Morgan (1978) sample size determination table. Tocollect the data, a questionnaire developed by Salazar (2007) wasadministered. This questionnaire was designed for professionaldevelopment in the leadership skills/competencies and consisted of25 items in each leadership performance domain using five-pointLikert-type scales. The content validity of the questionnaire wasconfirmed and the Cronbach’s Alpha coefficient was (α=0.78). Toanalyze the data, descriptive statistics and Paired-Samples t-testwere used. Also, the data was analyzed through SPSS14 software.Results: The findings showed that principals’ “Importance” ratingswere always higher than their “Actual proficiency” ratings. Themean score of the difference between “Importance” and “Actualproficiency” pair on “Organizing resources” was 2.11, making itthe highest “need” area. The lowest need area was “Managingthe organization and operational procedures” at 0.81. Also, theresults showed that there was a statistically significant differencebetween the means of the “Importance” and the correspondingmeans on the “Actual proficiency” (Difference of means=1.48,t=49.38, p<0.001).Conclusion: Based on the obtained results, the most importantprofessional development needs of the principals includedorganizing resources, resolving complex problems, understandingstudent development and learning, developing the vision and themission, building team commitment, understanding measurements,evaluation and assessment strategies, facilitating the changeprocess, solving problems and making decisions. In other words,the principals had statistically significant professional developmentneeds in all areas of the educational leadership. Also, the resultssuggested that today’s school principals need to grow and learnthroughout their careers by ongoing professional development.Keywords: Professional; Development; Need assessment; Educational leadership

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)

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