Journal of Advances in Medical Education & Professionalism

Abstract Introduction: The supervision of academic theses at theUniversities of Medical Sciences is one of the most importantissues with several challenges. The aim of the present studyis to discover the nature of problems and challenges of thesissupervision in Iranian universities of medical sciences.Methods: The study was conducted with a qualitative methodusing conventional content analysis approach. Nineteen facultymembers, using purposive sampling, and 11 postgraduate medicalsciences students (PhD students and residents) were selected onthe basis of theoretical sampling. The data were gathered throughsemi-structured interviews and field observations in Shiraz andIsfahan universities of medical sciences from September 2012 toDecember 2014. The qualitative content analysis was used with aconventional approach to analyze the data.Results: While experiencing the nature of research supervisionprocess, faculties and the students faced some complexities andchallenges in the research supervision process. The obtained codeswere categorized under 4 themes based on the characteristics;included “Conceptual problem”, “Role ambiguity in thesissupervision”, “Poor reflection in supervision” and “Ethicalproblems”.Conclusion: The result of this study revealed that there is a needfor more attention to planning and defining the supervisory,and research supervision. Also, improvement of the quality ofsupervisor and students relationship must be considered behindthe research context improvement in research supervisory area.Keywords: Research; Complexity; Medical students; Grounded theory

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 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

Abstract Introduction: Many studies have focused on the need of healthsystems to educated physicians in the clinical prevention, researchmethodology, epidemiology and health care management andemphasize the important role of this training in the public healthpromotion. On this basis, Shiraz University of Medical Sciences(SUMS) has established MD/MPH dual degree program since theyear 2012.Methods: In the current study, Delphi technique was used. Bothqualitative and quantitative methods were applied in the Delphiprocess. The Delphi team members including experts withextensive experience in teaching, research and administration inthe field of educational management and health/medical educationreached consensus in almost 86% of the questionnaire itemsthrough three Delphi rounds. MD/MPH program for SUMS wasdesigned based on the items agreed and thematic analysis used inthese rounds.Results: The goals, values, mission and program requirementsincluding the period, the entrance condition, and the number ofunits, and certification were determined. Accordingly, the coursesof the program are presented in parallel with the MD educationperiod. MPH courses consist of 35 units including 16 obligatoryand 15 voluntary ones.Conclusion: Designing MD/MPH program in SUMS based onthe existent models in the universities in different countries,compatible with educational program of this university and needsof national health system in Iran, can be a beneficial measuretowards promoting the students’ knowledge and theoretical/practical skills in both individual and social level. Performingsome additional research to assess the MD/MPH program andsome cohort studies to evaluate the effect of this program on thestudents’ future professional life is recommended.Keywords: Medical education; Public health; Organization; Administration

Abstract Introduction: Today, development of professionalism is acritical aim of medical schools. Studies have demonstrated thatmedical students’ perceived level of professionalism is inadequateworldwide. This study aimed to investigate the medical students’perceptions of their colleagues’ professional behavior.Methods: This study is a cross-sectional study with 280 medicalstudents at Shiraz University of Medical Sciences in their fifthto seventh year of study as the sample. The study was performedduring one month in 2013, using stratified random samplingmethod. The instrument of the study was the Persian version ofthe questionnaire of the American Board of Internal Medicine(ABIM).The questionnaire includes demographic information,questions about the meaning of the professionalism, history ofmedical ethics education programs and 12 behavioral questions.The data were analyzed using student t-test and Pearson correlationtest. The significance level was set as 0.05.Results: Forty percent of respondents did not know the meaning ofprofessionalism. The mean±SD score of behavioral questions was5.91±1.2 on a scale from 0 to 10. The mean±SD score of excellencequestions was 4.94±1.7. It was 7.05±1.9 for ‘honor/integrity’, and6.07±2.1 for ‘altruism/respect’ questions. There was a significantassociation between gender and excellence score (p=0.007).Conclusion: Medical students assessed their colleagues’professional behavior as poor. They did not have properinformation about professionalism. Medical students are futuregeneral practitioners and respecting medical ethics by them is veryimportant in a perfect health system. Universities should emphasizethe importance of teaching professionalism to medical studentsand faculty members, using innovative education methods.Keywords: Professionalism; Excellence; Respect; Medical students

Abstract Introduction: The application of organizational ethics in hospitalsis one of the novel ways to improve medical ethics. Nowadaysachieving efficient and sufficient ethical hospital indicators seemsto be inevitable. In this connection, the present study aims todetermine the best indicators in hospital accreditation.Methods: 69 indicators in 11 fields to evaluate hospital ethicswere achieved through a five-step qualitative and quantitativestudy including literature review, expert focus group, Likert scalesurvey, 3 rounded Delphi, and content validity measurement.Expert focus group meeting was conducted, employing NominalGroup Technique (NGT). After running NGT, a three roundedDelphi and parallel to Delphi and a Likert scale survey wereperformed to obtain objective indicators for each domain. Theexperts were all healthcare professionals who were also medicalethics researchers, teachers, or Ph.D students. Content validitymeasurements were computed, using the viewpoints of twodifferent expert groups, some ethicists, and some health careprofessionals (n=46).Results: survey, 11 main domains were listed including:Informed consent, Medical confidentiality, Physician-patienteconomic relations, Ethics consultation policy in the hospital,Ethical charter of hospital, Breaking bad medical news protocol,Respect for the patients’ rights, Clinical ethics committee,Spiritual and palliative care unit programs in the hospitals,Healthcare professionals’ communication skills, and Equitableaccess to the healthcare. Also 71 objective indicators for these 11domains were listed in 11 tables with 5 to 8 indicators per table.Content Validity Ratio (CVR) measurements were done and 69indicators were highlighted.Conclusion: The domains listed in this study seem to be themost important ones for evaluating hospital ethics programsand services. Healthcare organizations’ accreditation andranking are crucial for the improvement of healthcare services.Ethics programs would also motivate hospitals to improvetheir services and move towards patients’ satisfaction. In thisregard, more involvement of bioethicists can help healthcareorganizations to develop ethics programs and ensure ethicsbasedpractice in hospitals.Keywords: Hospital; Ethics; Accreditation; Evaluation

Abstract Introduction: Recognizing the determinants of behavior plays amajor role in identification and application of effective strategiesfor encouraging individuals to follow the intended pattern ofbehavior. The present study aimed to analyze the universitystudents’ behaviors regarding the amenability to dress code, usingthe theory of reasoned action (TRA).Methods: In this cross sectional study, 472 students were selectedthrough multi-stage random sampling. The data were collectedusing a researcher-made questionnaire whose validity wasconfirmed by specialists. Besides, its reliability was confirmed byconducting a pilot study revealing Cronbach’s alpha coefficientsof 0.93 for attitude, 0.83 for subjective norms, 0.94 for behavioralintention and 0.77 for behavior. The data were entered into the SPSSstatistical software and analyzed using descriptive and inferentialstatistics (Mann-Whitney, correlation and regression analysis).Results: Based on the students’ self-reports, conformity of clothesto the university’s dress code was below the expected level in28.87% of the female students and 28.55% of the male ones. Themean scores of attitude, subjective norms, and behavioral intentionto comply with dress code policy were 28.78±10.08, 28.51±8.25and 11.12±3.84, respectively. The students of different collegeswere different from each other concerning TRA constructs. Yet,subjective norms played a more critical role in explaining thevariance of dress code behavior among the students.Conclusion: Theory of reasoned action explained the students’dress code behaviors relatively well. The study results suggestpaying attention to appropriate approaches in educational, culturalactivities, including promotion of student-teacher communication.Keywords: Dress code, Adherence, Behavior

Abstract of higher education into focus in the past few years. They havetried to improve the quality of their own higher education. Thestudies show that Iranian Universities are not at an accepted levelin terms of quality. They have encountered several problemswhich have diminished their quality level. This study aimed atassessing the quality of medical education program as viewed bygeneral practitioners graduated from Shiraz, Fasa and JahromMedical Universities.Methods: This is a cross-sectional study. 215 subjects wereselected based on a census of all the general practitionersgraduated from Shiraz, Fasa and Jahrom Universities during 2011-2013. The questionnaire used for collecting the data was that ofthe Association of Graduates from American Medical Colleges.The collected data were then analyzed using SPSS 14 throughwhich such descriptive and bivariate statistics as percentage,means, Standard Deviation and ANOVA were used. The level ofsignificance was set to 0.05.Results: The questionnaire return rate was 97%. As to thegraduates’ preclinical experiences, five indices were studiedwhich were assessed as “average” in graduates’ views. However,with respect to their clinical experiences five indices wereequally studied, among which such indices as “Communication”were evaluated as “desirable” in view of the graduates from thevery three universities. On the contrary, the quality of clinicalexperiences and technological skills was evaluated as “almostweak”; furthermore, the integration of basic science with requiredclinical experience was also considered “weak”.Conclusion: It seems essential to set up an annual assessmentof general practitioner education program and a review of themedical education program in Iran based on the global medicaladvancement and international standards.Keywords: Quality; Evaluation; General practitioners; Medical students

Abstract Dear Editor Program directors need to evaluate educationalprograms to ensure their quality (1). The resultsof a survey conducted in Tehran University ofMedical Sciences (TUMS) in early 2012 showedthat program evaluation was not an establishedprocess in the majority of schools. It was at besta stand-alone project focusing on a single courseor a particular component of it with no structuredfollow-up (2). Hence, we decided to promoteand organize course evaluation practices in ouruniversity by development of general guidelines.TUMS has eleven affiliated schools of varioussizes and scope of activities. It was importantto propose guidelines that were general enoughto provide acceptable degree of consistency andcoherence among evaluation activities in schools,and yet specific enough to enable schools to havetheir own evaluation plan tailored to their needs.In this regard, the project taskforce decided toconsider the related literature on the existingprogram evaluation standards and guidelinesas the starting point and formulate guidelinesaligned with TUMS condition.After generating the draft for the guidelinesby taskforce, it was distributed among decisionmakers in all schools and their comments wereobtained. Once the guideline was revised basedon the suggestions, it was approved by theuniversity Education Council in November 2012.In total, 22 guidelines categorized in 3 domainsincluding course evaluation “infrastructures”,“design and implementation”, and “reporting andutilization of the results” were developed (2).After sending the guidelines to schools, acomprehensive program evaluation workshop wasconducted for the schools’ delegates. Afterwards,each school designed its own course evaluationplan based on the university guidelines. Courseevaluation plans were appraised by taskforce and,if necessary, feedback was provided through aformal letter, face to face meeting or telephoneconversation.Development of guidelines was a valuableapproach to reach a common understanding of courseevaluation between stakeholders in our university.There is usually an inadequate understandingof what course evaluation is and the concept isfrequently reduced to teacher evaluation or studentassessment (3). In spite of creating consistency ofevaluation activities in our institution, the guidelineswere not prescriptive and the schools were allowedto design their own plans adapted to their context,which is vital for a large institution such as TUMSwith diverse cultural contexts.We believe our approach has made changes in individuals’ thinking as well as the culture ofschools involved in the process of developmentof course evaluation guidelines. The next step isbuilding the evaluation capacity in our universityby sustainable evaluation practices based on theevaluation guidelines.