Shiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002Setting objectives for a competency-based undergraduate obstetrics and gynecology curriculum1471544102810.30476/jamp.2018.41028ENAJAYHALDERDepartment of Obstrtrics and Gynecology, All India Institute of Medical Sciences, Saket Nagar, Bhopal0000-0001-6725-0520ANKURJOSHIDepartment of Community Medicine, All india Institute of Medical Sciences, Rishikesh, UttarakhandRAGINIMEHROTRADepartment of Obstrtrics and Gynecology, All India Institute of Medical Sciences, Saket Nagar, BhopalBERTHARATHINAMDepartment of Anatomy, All India Institute of Medical Sciences, Saket Nagar, BhopalSUSHRUTASHRIVASTAVADepartment of Obstrtrics and Gynecology, All India Institute of Medical Sciences, Saket Nagar, BhopalJournal Article20181002Introduction: 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, CurriculumShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002Effectiveness of microteaching as a method of developing teaching competence among in-service medical teachers1551614102910.30476/jamp.2018.41029ENVIJAY KAUTILYADAYANINDHICoordinator Medical Education Unit, Department of Forensic Medicine & Toxicology, Shri Sathya Sai Medical College & Research
Institute, Ammapettai, Chennai, IndiaSHRUTI PRABHATHEGDEDepartment of Ophthalmology, Shri Sathya Sai Medical College & Research Institute,
Ammapettai, Chennai, IndiaJournal Article20170621Introduction: In spite of the fact that microteaching has beenpracticed extensively in most universities, its actual efficacyhas not been studied systematically. In this study, there was anattempt to quantify the efficacy of microteaching in inducingbehavioral change in teachers. We also aimed to determine theperceived utility and ease of this process in teacher training,using the feedback received from the participants. This feedbackalong with efficacy can collectively predict the effectiveness ofmicroteaching.Methods: A prospective experimental study was designed using aconvenient sample of 30 faculty volunteers. After the institutionalethics committee approval, the videos of pre-microteaching andpost-microteaching sessions from the 30 participants undergoing 5sessions of microteaching were graded with a seven point teachingcompetency scale and the participant’s perceived usefulness andperceived ease of use was studied using a validated questionnaire.Paired sample t-test was used to determine the efficacy of the study.Results: Microteaching showed a statistically significantimprovement among the behavior of the participants after fivesessions of microteaching. All the parameters in the scale showeda statistically significant improvement. Though the participantsfelt that this method was useful, the majority of them felt it is avery time consuming process requiring resources.Conclusion: Hence, the overall effectiveness in in-serviceteaching process was limited for microteaching in this currentscenario; though microteaching induced positive behaviourchange, it was time consuming and also it was difficult to arrangea peer group to enrole.Keywords: Microteaching, Efficacy, Usefulness, Effectiveness, Teacher trainingShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002Medical students’ occupational burnout and its relationship with professionalism1621674103210.30476/jamp.2018.41032ENSEDIGHEHEBRAHIMIDepartment of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-9933-9498FATEMEHATAZADEHShiraz University of Medical Sciences,Shiraz, IranJournal Article20180416Introduction: Occupational burnout is a prevalent syndromeamong medical students as well as other health professionals. Itmay be an important factor contributing to professional conducts.The aim of this study was to determine the prevalence of burnoutamong medical students of Shiraz University of Medical Sciencesat clinical level and its relationship with professionalism.Methods: In this cross-sectional study, all medical clinicalstudents who had spent a minimum of six months of the firstyear of clinical level and who were in their final year, in 2015-16were examined (using the census method). Data were gatheredusing demographics, educational background, and the dimensionsof professionalism questionnaires and Maslach Job BurnoutInventory. Data analysis was performed using descriptivestatistics, ANOVA and Pearson correlation test by SPSS, version14. A p-value ofShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002Medical student’s academic performance: The role of academic emotions and motivation1681754103410.30476/jamp.2018.41034ENALI ASGHARHAYATClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-4576-8828ASIEHSALEHIPublic Health School of Medicine, Griffith
University, AustraliaJAVADKOJURIClinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8909-897XJournal Article20180114Introduction: Identification of the factors that promote academicperformance is of importance in the success rate of medical students.This study aimed to find the relationship between emotions,motivation and academic performance of medical students.Methods: This descriptive-correlative study was conductedamong 370 medical students in Shiraz University of MedicalSciences using convenience sampling. Academic emotionsquestionnaire (AEQ) including 75 items and college studentversion of work preference inventory including 30 items were usedto collect the data. The Cronbach’s alpha for the eight types ofacademic emotions ranged from 0.73 to 0.86, and for the intrinsicand extrinsic motivation it was 0.81 and 0.87, respectively. Thedata were analyzed using Pearson correlation, multiple regression,independent t-test and one-way ANOVA through SPSS, 14.Results: Results indicated a positive and significant correlationbetween positive emotions (enjoyment, hope, pride) and students’academic performance (r=0.37, r=0.27 and r=0.39, respectively,with p<0.01). A negative and significant correlation was foundbetween negative emotions (anger, anxiety, hopelessness, shameand boredom) with students’ academic performance (r=-0.15, r=-0.24, r=-0.23, r=-0.215 and r=-0.21, respectively, with p<0.01).There was a positive and significant correlation between intrinsicand extrinsic motivation and academic performance (r=0.63, r=0.14,with p<0.01, p<0.05, respectively). Emotions related to enjoyment,hope, pride, hopelessness, boredom and intrinsic motivation wereshown as the key predictors of students’ academic performance.Conclusion: The results of this study showed the key role ofmotivation and positive emotions in increasing medical students’academic performance.Keywords: Academic emotions, Motivation, Academic performance, MedicalstudentsShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002A multiple-mini interview (MMI) for emergency medicine residency admissions: A brief report and qualitative analysis1761804102710.30476/jamp.2018.41027ENMEGANBOYSEN-OSBORNUniversity of California, Irvine, Department of Emergency Medicine, Orange, CA0000-0001-6676-6429ALISAWRAYUniversity of California, Irvine, Department of Emergency Medicine, Orange, CA0000000200594895WIRACHINHOONPONGSIMANONTUniversity of California, Irvine, Department of Emergency Medicine, Orange, CABHARATHCHAKRAVARTHYUniversity of California, Irvine, Department of Emergency Medicine, Orange, CAJEFFREY RSUCHARDUniversity of California, Irvine, Department of Emergency Medicine, Orange, CAWARRENWIECHMANNUniversity of California, Irvine, Department of Emergency Medicine, Orange, CASHANNONTOOHEYUniversity of California, Irvine, Department of Emergency Medicine, Orange, CAJournal Article20180327Introduction: A multiple-mini interview (MMI) is a type ofstructured interview, which may assess many non-cognitivedomains in residency applicants. There are few studies on MMIduring the emergency medicine (EM) residency admissionsprocess in the United States. We sought to determine the strengths,weaknesses, and acceptability of a pilot MMI for EM residencyadmissions.Methods: We piloted a five-station MMI with nine residencyapplicants. Following the MMI, we surveyed all participants,using 15 open- and closed-ended questions. Using groundedtheory analysis, we coded the responses to the post-interventionsurvey to uncover the strengths and weaknesses of the MMI forEM residency admissions.Results: All nine students completed the survey. A positivetheme that emerged from the survey was that the MMI wasa positive, unexpected experience (all respondents, n=9).Candidates felt they were able to showcase unique talents,which would not be observed during a traditional interview(n=3). A negative theme that emerged from the survey was thatthe experience was intimidating (n=3). Candidates felt that theMMI left out important aspects of a typical interview day (n=3),such as time for the candidate to become more familiar withthe program.Conclusion: An MMI may be a positive experience for candidates,but may also induce more anxiety. The MMI may omit animportant piece of the interview day: an opportunity for theapplicants to familiarize themselves with the residency program.Keywords: Internship, Residency, Interview, Medical studentsShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002The usefulness of crossword puzzle as a self-learning tool in pharmacology1811854103010.30476/jamp.2018.41030ENSHILPAPATRICKDepartment of Pharmacology, Teerthankar Mahaveer Medical College & Research Centre, TMU, Moradabad, Uttar Pradesh,
IndiaKIRTIVISHWAKARMADepartment of Pharmacology, Ananta Institute of Medical Sciences & Research Centre, Udaipur, RajasthanVISHAL PGIRIDepartment of Pharmacology, Shri Ram Murti Samarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, IndiaDEBRANJANDATTADepartment of Pharmacology, Teerthankar Mahaveer Medical College & Research Centre, TMU, Moradabad, Uttar Pradesh, IndiaPRIYANKAKUMAWATDepartment of Pharmacology, Teerthankar Mahaveer Medical College & Research Centre, TMU, Moradabad, Uttar Pradesh, IndiaPREETISINGHDepartment of Pharmacology, Teerthankar Mahaveer Medical College & Research Centre, TMU, Moradabad, Uttar Pradesh, IndiaPRITHPAL SMATREJADepartment of Pharmacology, Teerthankar Mahaveer Medical College & Research Centre, TMU, Moradabad, Uttar Pradesh, India0000-0002-9552-3642Journal Article20180409Introduction: Pharmacology is perceived as a volatile subject asit’s difficult to recall and recite the core of the subject. Enrichingthe learning environment through incorporation of a variety ofteaching and learning strategies and methods yields enhancedlearning. Crossword puzzles provide expansion of vocabulary,stimulate thinking capacity, boost confidence, and fasten up thelearning capacity; hence, the present study was conducted toinvestigate the usefulness of crossword puzzle as an innovativeself-learning tool in pharmacology.Methods: This prospective study was conducted among 5thsemester students of the second professional MBBS course. A totalof 139 students participated in this study and were evaluated withformative examination and feedback questionnaire. Permissionwas taken from Institutional Ethics Committee for the study.A crossword puzzle consisting of 32 questions on endocrinepharmacology was prepared and divided into two sections: theacross section had 17 questions and the down section contained15 questions. The data were analyzed, using Graph Pad Softwareand presented as percentage of the responses.Results: On average, out of 32 questions, one mark each, thestudents scored 52.69% and all students responded correctly onquestions on the topic of hormonal contraceptives. 75.5% of thestudents had an enjoyable experience and the majority of themagreed that it helped them enhance their knowledge of drugs,remember diseases and drug names, and overall learning about thetopic. They were also of the opinion that this should be inculcatedin pharmacology curriculum.Conclusion: Incorporation of crossword puzzles, as an adjuncttool, was useful as majority of the students reported that thisimproved their attitude of learning, thereby improving theirperformance.Keywords: Endocrine system, Pharmacology, Self-learning, Lectures, FeedbackShiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002Academic nepotism – all that glitters is not gold1861874102610.30476/jamp.2018.41026ENDINESHKUMAR. VDepartment of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India0000-0001-8234-2829Journal Article20180511Dear Editor With increasing emphasis on publications forfaculty recruitment, career advancementand obtaining research grants, the issues relatedto author kinship and academic nepotism havegrown significantly and these probably reflectthe inflationary growth rather than the optimalgrowth warranted due to increasing researchcomplexity. Allesina S (1) measured the fullmagnitude of nepotism in the Italian academiaand found that this pervasive problem was ablemish that undercuts the quality of advancededucation over there. According to her, thisprocess of showing favouritism towards closerelatives incentivize illegal hiring practices andguarantees their career advancement regardlessof their merit. Even though the analysis ofshared last names cannot be considered a validtool for measuring the diffusion of nepotism inany organization (2), we cannot deny its sheerexistence.An analysis of 12,772 papers published in PLOSONE showed that 48% of the listed co-authors didnot fulfil the criteria for authorship, as their rolewas meagre or absent in drafting the manuscript(3). If we extrapolate these data to any settings,we could enunciate that a substantial amount ofpapers hoist the name of an expert (preferablythe kin of primary investigator) belonging to anentirely different specialty or giving an authorshipinstead of mere acknowledgement. Prosperi M etal. (4) analyzed more than 21 million MEDLINE/PubMed-indexed papers and documented that kinauthorship is a big menace for India, Italy andPoland. Measuring nepotism is highly unlikelyin India, owing to the facts that Indian women inacademia prefer to maintain their maiden namesand wide usage of surnames. Number of casesinvolving their spouses, lovers and domesticpartners would largely go underestimated,thereby causing the statistical models to fail.In the past, the recruitment and promotionmechanisms were tacit, which had measured theeducational and research qualities in an informalmanner. This, on one hand gave rise to negativeconnotations regarding nepotism and, on theother hand, led to the formation of “academicdynasties” in Indian medical academia. Sincethe evolution of “publish or perish” culture,the hiring/promotion process was replaced bya formal, explicit and individually measurableindex. The existing scenario can be crosssectionedby a participant’s comment in the studyconducted by Anderson et al. (5), “You can failto do everything else as long as you have lots andlots of papers.” In the process of conferring theaggregate output or research productivity, whichis a mere ‘pseudo-halo’, accomplished researchersor clinicians sometimes promulgate their spousesor get involved in reciprocal co-authorship, whichis yet another version of academic nepotism. Ina latest paper, Rivera H (6) proposes a 3 stepscheme for validating the genuine collaborationand calls for a focused evaluation of researchproductivity.In summary, I wish to address the leastsignified and unintended consequence of thepresent day evaluation/appraisal mechanismwhereby a scholar is potentially assessed by thenumber of publications he/she has. Consideringthe fact that history of research in global arenahad witnessed conjoint efforts from egalitariancouples, blanket recommendations are difficult tobe made. Nevertheless, we should not forget thefact that academic nepotism often depresses thehealth care professionals and adversely affectstheir morale. I wish to conclude that academicnepotism is yet another ethical dilemma,which every administrator/selection committeemember needs to face and at times of makingcrucial decisions (like hiring for a job) it is theresponsibility of them to uphold the legitimateinterests of the organization, more than personalaffiliations.Shiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002Vertical integration in the teaching of final year medical students1881894103110.30476/jamp.2018.41031ENMARIAKOSHYDepartment of Medicine, Christian Medical College, Vellore0000-0002-3228-5270SELVIN SUNDAR RAJMANIDepartment of Medicine, Christian Medical College, Vellore0000-0003-4141-1175SUDHA JASMINERAJANDepartment of Medicine, Christian Medical College, VelloreRAMYAIYYADURAIDepartment of Medicine, Christian Medical College, VelloreSOWMYASATHYENDRADepartment of Medicine, Christian Medical College, VelloreJournal Article20171112Dear Editor, The traditional approach to medical educationhas been dichotomous, with a lack ofintegration between basic sciences and clinicalmedicine (1). Recent reforms have called forindividualizing the learning process, integratingknowledge with practice, and cultivating a spiritof lifelong learning (2). Vertical integrationbreaks the traditional division between clinicaland pre-clinical sciences, resulting in betterunderstanding and application of concepts (3).We did an exercise to integrate basic sciencesand clinical medicine in the teaching of medicalstudents. After obtaining informed consentand ethical clearance, a group of final yearundergraduate students underwent verticallyintegrated, small group, problem-based trainingon tuberculosis. We studied the effect of theintegration on the students’ understanding of thesubject and acceptance of this method. Studentswere divided into intervention and control armsof 10 students each, based on the medical unitsin which they were posted. The control armunderwent standard clinical teaching (lecturesand practical sessions), as per the institutionaleducation policy. The intervention group wasgiven three case scenarios which highlightedthe various presentations of tuberculosis, withrelevant questions regarding the pathogenesis,clinical course, and management. These werediscussed in a multidisciplinary interactivesession, with input from the faculty taken fromthe departments of Pathology, Microbiology andInternal medicine. Triangulation of data frompre- and post-test scores, focus group discussionand feedback scores was done.When compared to the mean pre-test score,the mean post-test score in the interventiongroup significantly improved (6.7 vs. 12.44, meandifference: 5.74; 95% CI 2.71-8.95; p=0.003).There was a significant difference in the meanpost-test scores between the intervention andcontrol groups (12.44 vs 7.55, mean difference:4.89; 95% CI 3.89-5.84; p<0.001). On qualitativeassessment by focus group discussion, the studentsstressed on the usefulness of the session and feltthat vertical integration facilitated “integrationand application of knowledge”. They were able to“recognize how diverse processes are inter-related”.The problem-based approach motivated them to doself-directed learning and facilitated formulationof research ideas. In their own words, “The onusof the learning was in our hands, so we learntbetter”, “I had never heard of Quantiferon gold,but because of the session, I read that in detail”,and “I searched Pub Med to look for articles fromIndia which might be more relevant”. The sessionstimulated “team building” with their peers. Thesmall group teaching was well accepted and foundto be more useful than lectures. Overall, there was afavorable perception regarding vertical integration.On discussion with the faculty, aspects of greatercommitment in terms of time and resources,and cooperation among faculty members werehighlighted. The faculty was motivated to readin greater detail to clarify the students’ queries.Feedback scores from the students were positive,confirming the themes which emerged from thefocus group discussion. Tuberculosis is a majorpublic health problem in India and it is importantfor students to have a deep understanding of thetopic (4). Case-based teaching on a disease of highprevalence has been shown to improve applicationof knowledge (5). Our study has highlighted thatsuch sessions help the students to form cross-linksand connections, resulting in a smoother transitioninto clinical practice.Shiraz University of Medical SciencesJournal of Advances in Medical Education & Professionalism2322-22206420181002Professionalism ethics in pharmacy education: Do students have acceptable knowledge or it is a white paper in pharmacy education curriculum?1901914103310.30476/jamp.2018.41033ENHOSSEINKHOLGHIPOURFaculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-5985-4399ALIDEHSHAHRIDepartment of Biotechnology, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranHOSSEINMAHMOODIANDepartment of Medical Ethics and Philosophy of Health, Faculty of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran0000-0001-7296-136xJournal Article20180404Dear 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.