Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Lifelong learning along the education and career continuum: metaanalysis of studies in health professions
157
163
EN
OKSANA
BABENKO
Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Alberta, Canada
obabenko@ualberta.ca
SUDHA
KOPPULA
Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Alberta, Canada
skoppula@ualberta.ca
LIA
DANIELS
Department of Educational
Psychology, Faculty of Education, University of Alberta, Alberta, Canada;
lia1@ualberta.ca
LINDSEY
NADON
Department of Educational
Psychology, Faculty of Education, University of Alberta, Alberta, Canada;
lnadon@ualberta.ca
VIJAY
DANIELS
Department of Medicine, University of Alberta, Alberta, Canada
vdaniels@ualberta.ca
Introduction: Lifelong learning is an integral part of healthprofessionals’ maintenance of competence. Several studies haveexamined the orientation toward lifelong learning at variousstages of the education and career continuum; however, none haslooked at changes throughout training and practice. The objectiveof the present study was to determine if there are differencesbetween groups defined by their places on the education andcareer continuum.Methods: The authors performed a group-level meta-analysis onstudies that used the 14-item Jefferson Scale of Physician LifelongLearning or its variants. Eleven published articles, which reportedon studies with post-secondary health professions students,residents, and practicing health professionals met the inclusioncriteria. In total, there were 12 independent data sets, with fourdata sets per group.Results: In total, over seven thousand students, residents, andpracticing health professionals responded to the Jefferson Scale(N=7.269). Individual study means tendency to be high, suggestinga high orientation toward lifelong learning among the trainees(students and residents) and practicing health professionals. Metaanalysisresults indicated that the orientation toward lifelonglearning tended to increase gradually along the education andcareer continuum. Significant differences in the group means werefound between the trainees and practicing health professionals.Conclusions: In the reviewed studies, the orientation towardlifelong learning among students, residents, and practicingprofessionals was high. Nonetheless, although based on separatecohorts, it appears that the orientation toward lifelong learningcontinues to develop even after the completion of formal training.Keywords: Lifelong learning; Health professions; Meta-analysis
https://jamp.sums.ac.ir/article_41004.html
https://jamp.sums.ac.ir/article_41004_8b20ed179092215f45c39aecd9a502cc.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Interdisciplinary and inter-institutional differences in learning preferences among Malaysian medical and health sciences students
164
171
EN
REBECCA S.Y.
WONG
Faculty of Medicine, SEGi University, Malaysia
rebeccawongsy@gmail.com
HENG
LOKE
SIOW
School of Graduate studies, Asia e University, Malaysia
VINOTH
KUMARASAMY
Faculty of Medicine, SEGi University, Malaysia; Faculty of Medicine,
MAHSA University, Malaysia
vinothkumarasmay@segi.edu.my
NAZRILA
SHAHERAH FADHLULLAH
SUHAIMI
Faculty of Medicine, SEGi University, Malaysia
Introduction: The learner-centred approach in medical and healthsciences education makes the study of learning preferences relevant andimportant. This study aimed to investigate the interdisciplinary, interinstitutional, gender and racial differences in the preferred learningstyles among Malaysian medical and health sciences students in threeMalaysian universities, namely SEGi University (SEGi), University ofMalaya (UM) and Universiti Tunku Abdul Rahman (UTAR). It alsoinvestigated the differences in the preferred learning styles of thesestudents between high achievers and non-high achievers.Methods: This cross-sectional study was carried out on medical andhealth sciences students from three Malaysian universities following theapproval of the Research and Ethics Committee, SEGi University. Purposive sampling was used and the preferred learning styles were assessed using the VARK questionnaire. The questionnaire was validated prior to its use. Three disciplines (medicine, pharmacy and dentistry) were chosen based on their entry criteria and some similarities in their course structure. The three participating universities were Malaysian universities with a home-grown undergraduate entry medical program and students from a diverse cultural and socioeconomic background. The data were analysed using the Statistical Package for the Social Sciences (SPSS) software, version 22. VARK subscale scores were expressed as mean±standard deviation. Comparisons of the means were carried out using t-test or ANOVA. A p value of <0.05 was considered as statistically significant, and <0.001 as highly significant.Results: Both statistically significant interdisciplinary and inter-institutional differences in learning preferences were observed. Out of the 337 students, a majority of the participants were unimodal learners (n=263, 78.04%). The most common type of learners was the reading/writing type (n=92, 27.30%) while the kinesthetic subscale (M=6.98, SD=2.85) had the highest mean score. Female students (M=6.86, SD=2.86) scored significantly higher than male students (M=6.08, SD=2.41; t(249), p=0.014) in the auditory subscale, whereas Chinese students (M=5.87, SD=2.65) scored significantly higher than Malay students (M=4.70, SD=2.87; p=0.04) in the visual subscale.However, the mean VARK subscale scores did not differ significantlybetween high achievers and non-high achievers (p>0.05).Conclusion: This study gives an insight into the learner characteristicsof more than one medical school in Malaysia. Such multi-institutionalstudies are lacking in the published literature and this study gives abetter representation of the current situation in the learning preferencesamong medical students in Malaysia.Keywords: Learning; Medical students; Health sciences
https://jamp.sums.ac.ir/article_41005.html
https://jamp.sums.ac.ir/article_41005_5f983c042c05ec15cbfa4843302a18d0.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Early clinical exposure program in learning renal physiology
172
176
EN
ARMAN
DEHGHAN
Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
MITRA
AMINI
0000-0003-3761-1801
Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
mitraamini51@yahoo.com
MOHAMMAD
MAHDI
SAGHEB
Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
SEYED MOSTAFA
SHIDMOOSAVI
Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
PARISA
NABEIEI
Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Introduction: Teaching renal physiology for undergraduatemedical students in an understandable way using methods whichimprove their deep learning has always been a problem. In thisstudy, Early Clinical Exposure (ECE) was used in teaching renalphysiology for the second year medical students in Shiraz MedicalSchool. This article aims to introduce and develop this programand also measure the attitude of medical students toward ECE inlearning renal physiology.Methods: This is a mixed method study conducted on 120 secondyear undergraduate students. After performing the course, bothqualitative and quantitative methods were used for measuring theviewpoints of the students. In the qualitative part, 10 high rankmedical students were selected. These students participated inbrain storming sessions to express their opinion about the programbased on the strengths and weaknesses. For trustworthiness of thequalitative part, member check and peer check were done. In thequantitative part, a researcher-made questionnaire was used basedon the objectives of the program in a 4 point Likert scale. Thevalidity of questionnaire was determined by medical educationexperts and reliability was determined after a pilot study.Results: Based on the results of the quantitative part of the study,98 percent of the students stated that the ECE program wasgenerally a useful program. In the qualitative part, the students’comments were obtained. The benefits of the program weresummarized in 4 main themes. These themes are “understandingof renal physiology”, “Integration of basic and clinical knowledge”,“Improvement of attitude toward importance of physiology”, and“encouragement to study”. In response to the questions aboutnegetive aspects of this program in qualitative part, the two mainthemes were insufficient time and large grup size.Conclusion: Students reported that ECE was useful, but theystated that they needed to have more encounter with patientsand more hospital teaching. The results also reveal that this ECEprogram is an excellent approach to strengthen learning in adifficult subject like renal physiology. This approach is adjustableto other basic science topics and subjects as well.Keywords: Early clinical exposure; Integration; Learning
https://jamp.sums.ac.ir/article_41006.html
https://jamp.sums.ac.ir/article_41006_e804c09bc6926af6ef2c125ef7f1122a.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Models of clinical reasoning with a focus on general practice: a critical review
177
184
EN
SHAHRAM
YAZDANI
0000-0002-9193-7557
School of Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
sh_yaz@yahoo.com
MOHAMMAD
HOSSEINZADEH
School of Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
drmhosseinzadeh@yahoo.com
FAKHROLSADAT
HOSSEINI
School of Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
fakhrihosseini@outlook.com
Introduction: Diagnosis lies at the heart of general practice.Every day general practitioners (GPs) visit patients with awide variety of complaints and concerns, with often minor butsometimes serious symptoms. General practice has many featureswhich differentiate it from specialty care setting, but during thelast four decades little attention was paid to clinical reasoningin general practice. Therefore, we aimed to critically review theclinical reasoning models with a focus on the clinical reasoningin general practice or clinical reasoning of general practitionersto find out to what extent the existing models explain the clinicalreasoning specially in primary care and also identity the gaps ofthe model for use in primary care settingsMethods: A systematic search to find models of clinical reasoningwere performed. To have more precision, we excluded the studiesthat focused on neurobiological aspects of reasoning, reasoningin disciplines other than medicine decision making or decisionanalysis on treatment or management plan. All the articles anddocuments were first scanned to see whether they include importantrelevant contents or any models. The selected studies whichdescribed a model of clinical reasoning in general practitioners orwith a focus on general practice were then reviewed and appraisalor critics of other authors on these models were included. Thereviewed documents on the model were synthesizedResults: Six models of clinical reasoning were identified includinghypothetic-deductive model, pattern recognition, a dual processdiagnostic reasoning model, pathway for clinical reasoning, anintegrative model of clinical reasoning, and model of diagnosticreasoning strategies in primary care. Only one model hadspecifically focused on general practitioners reasoning.Conclusion: A Model of clinical reasoning that included specificfeatures of general practice to better help the general practitionerswith the difficulties of clinical reasoning in this setting is needed.Keywords: Problem solving, General practitioners, Diagnosis
https://jamp.sums.ac.ir/article_41007.html
https://jamp.sums.ac.ir/article_41007_51f4b8d8bc49a0452af2a0881413fdcd.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Learning style preferences: A study of Pre-clinical Medical Students in Barbados
185
194
EN
NKEMCHO
OJEH
Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados, West Indies
nkemcho.ojeh@cavehill.uwi.edu
NATASHA
SOBERS-GRANNUM
Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados, West Indies
UMA
GAUR
0000-0001-7532-1229
Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados, West Indies
uma.gaur@cavehill.uwi.edu
MD. ANWARUL
AZIM
MAJUMDER
Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados, West Indies
Introduction: Educators need to be aware of different learningstyles to effectively tailor instructional strategies and methodsto cater to the students’ learning needs and support a conductivelearning environment. The VARK [an acronym for visual (V),aural (A), read/write (R) and kinesthetic (K)] instrument isa useful model to assess learning styles. The aim of this studywas to use the VARK questionnaire to determine the learningstyles of pre-clinical medical students in order to compare theperceived and assessed learning style preferences, assess genderdifferences in learning style preferences, and determine whetherany relationships exists between awareness of learning styles andacademic grades, age, gender and learning modality.Methods: The VARK questionnaire was administered to preclinicalstudents taking a variety of courses in the first three yearsof the undergraduate MB BS degree programme at the Faculty ofMedical Sciences, The University of the West Indies, Cave HillCampus, Barbados in 2014.Results: The majority of the students were multimodal learnerswith no differences observed between males (59.5%) and females(60.0%), with tetramodal being the most common. Read/write(33.8%) followed by kinesthetic (32.5%) were the most commonlearning style preferences. The sensory modality preference forfemales was read/write (34.2%) and for males it was kinesthetic(40.5%). Significant differences were observed between theperceived and assessed learning style preferences with amajority of visual and read/write learners correctly matchingtheir perceived to their actual learning styles. Awareness oflearning styles was associated with learning modality but notwith academic performance, age or gender. Overall, 60.7% ofhigh achievers used multimodal learning compared to 56.9%low achievers.Conclusion: The findings from this study indicated that theVARK tool was useful in gathering information about differentlearning styles, and might assist educators in designing blendedteaching strategies to cater to the students’ needs as well as helpthe students in becoming aware of their learning style preferencesto enhance learning.Keywords: Education; Learning; Teaching; Medical students
https://jamp.sums.ac.ir/article_41008.html
https://jamp.sums.ac.ir/article_41008_962fbd00b1456e4204ffd14c53b81143.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Presenting the students’ academic achievement causal model based on goal orientation
195
202
EN
EBRAHIM
NASIRI
Anatomy Department, Medical School, Guilan University of Medical Sciences, Rasht, Iran
mahdokht_taheri@gmail.com
ALI
POUR-SAFAR
Faculty of Literature and Humanities,
Department of Educational Sciences, Guilan University, Rasht, Iran
ali.poursafar@yahoo.com
MAHDOKHT
TAHERI
0000-0002-8970-9336
Medical Education Research Center, Education Development
Center, Guilan University of Medical Sciences, Rasht, Iran
taheri1049@gmail.com
ABDULLAH
SEDIGHI PASHAKY
Faculty of Literature and Humanities,
Department of Educational Sciences, Guilan University, Rasht, Iran
abdolah.sedighi@yahoo.com
ATAOLLAH
ASADI LOUYEH
Department of Nursing, School of Nursing and Midwifery, Guilan University
of Medical Sciences, Rasht, Iran
Introduction: Several factors play a role in academic achievement,individual’s excellence and capability to do actions and tasks thatthe learner is in charge of in learning areas. The main goal of thisstudy was to present academic achievement causal model basedon the dimensions of goal orientation and learning approachesamong the students of Medical Science and Dentistry courses inGuilan University of Medical Sciences in 2013.Methods: This study is based on a cross-sectional model. Theparticipants included 175 first and second year students of theMedical and Dentistry schools in Guilan University of MedicalSciences selected by random cluster sampling [121 persons(69%) Medical Basic Science students and 54 (30.9%) Dentistrystudents]. The measurement tool included the Goal OrientationScale of Bouffard and Study Process Questionnaire of Biggs andthe students’ Grade Point Average. The study data were analyzedusing Pearson correlation coefficient and structural equationsmodeling. SPSS 14 and Amos were used to analyze the data.Results: The results indicated a significant relationship betweengoal orientation and learning strategies (P<0.05). In addition,the results revealed that a significant relationship exists betweenlearning strategies [Deep Learning (r=0.37, P<0.05), SurfaceLearning (r=-0.21, P<0.05)], and academic achievement. Thesuggested model of research is fitted to the data of the research.Conclusion: Results showed that the students’ academicachievement model fits with experimental data, so it can be used inlearning principles which lead to students’ achievement in learning.Keywords: Goal, Orientation, Learning, Strategies, Academic achievement
https://jamp.sums.ac.ir/article_41009.html
https://jamp.sums.ac.ir/article_41009_32710901a3f33f8f89c0083dd11dca80.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Experiences of nursing students of evidence-based practice education according to rogers’ diffusion of innovation model: a directed content analysis
203
208
EN
SHAHZAD
PASHAEYPOOR
Department of Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
sh-pashaeipour@tums.ac.ir
TAHEREH
ASHKTORAB
Department of Nursing,
School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
t_ashktorab@sbmu.ac.ir
MARYAM
RASSOULI
Department of Nursing,
School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
rassouli.m@gmail.com
HAMID
ALAVI_MAJD
Department of Biostatistics, School of
Paramedics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Introduction: Evidence based practice (EBP) education isessential in promoting of clinical care, but an effective educationalstrategy for teaching EBP in nursing faculties is not available.The aim of this study was to explore the experiences of nursingstudents of EBP Education according to Rogers’ Diffusion ofInnovation Model.Methods: This qualitative study was carried out using a directedcontent analysis method and purposeful sampling. Data werecollected until saturation by fourteen semi-structured face-tofaceindividual interviews and two focus group discussions withnursing students from two nursing faculties in Tehran, Iran.Rogers’ Model was used in this study.Results: Data were classified into five themes and 11 categoriesaccording to the Rogers’s Model. Themes and main categorieswere knowledge (educational enrichment, new strategyfor education), persuasion (internalization of education,improvement of motivation), decision (acceptance, use in thefuture), implementation (objectivity, consolidation of learning)and confirmation (learning and teaching, achieving a goal, selfconfidence).Conclusions: EBP Education, based on the teaching strategyof Rogers’s Model, leads to an improved EBP learning. All thenecessary steps for a better education of it are included in thiseducational approach which can be used to teach any new subjectlike EBP.Keywords: Evidence based practice; Education; Nursing; Baccalaureate
https://jamp.sums.ac.ir/article_41010.html
https://jamp.sums.ac.ir/article_41010_0dafe24ac788bb8d3388bedc7f45778b.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
Addressing the physicians’ shortage in developing countries by accelerating and reforming the medical education: Is it possible?
209
212
EN
MUSTAFA
AL-SHAMSI
Department of Public Health & Continuous Medical Education, Ministry of Health, Basra, Iraq
mustafatalibb@yahoo.com
Introduction: Doctors’ shortage has remained a concernworldwide. The developed countries started aids to recruitinternational medical graduates (IMG) to cope with the defectsthat the health care system suffers from; however, this solution maynot work in developing countries that have a limited resource andpoor budget to spend on the health care system. This study aimsto present an alternative way to approach the physicians’ shortageby accelerating undergraduate medical education and reform somepost-graduate courses in order to cope with this problem.Methods: The literature in PubMed/Medline and Google scholarwere searched using such keywords as undergraduate medicaleducation, physician shortage, health care reform, physicians’performance, medical curriculum.Results: The finding revealed that performance duringundergraduate medical school does not have a relationship withthe physician’s performance post-graduation. Moreover, theoverloaded curriculum and the years spent in undergraduateeducation have a negative impact on the students in terms ofburn out, lack of competency, and loss of motivation in medicine.The method of education was found to have a positive effect onpreparing good students and ultimately good physicians.Conclusion: Since performance in undergraduate years does nothave an impact on the practice post-graduation, the developingcountries may consider the option of changing the context, andabbreviating undergraduate medical education as a solution forphysicians’ shortage dilemma. Moreover, modifying some postgraduatemajors such as family physician, and general practitionerto allow the physicians enter the practice in areas of need isrecommended.Keywords: Medical education; Physicians; Developing countries
https://jamp.sums.ac.ir/article_41003.html
https://jamp.sums.ac.ir/article_41003_01ea2fb91c0265b71d4ed386774ca1aa.pdf
Shiraz University of Medical Sciences
Journal of Advances in Medical Education & Professionalism
2322-2220
2322-3561
5
4
2017
10
01
PhD supervisor-student relationship
213
214
EN
FILIPE
PRAZERES
0000-0002-2849-5194
Faculdade de Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, Portugal; Family Health Unit Beira Ria, 3830-596 Gafanha da Nazaré, Portugal
filipeprazeresmd@gmail.com
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.
https://jamp.sums.ac.ir/article_41002.html
https://jamp.sums.ac.ir/article_41002_7ad762f0bba37f9226a80ffca02fa850.pdf