Journal of Advances in Medical Education & Professionalism

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, 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.

Abstract Introduction: Teaching medical professionalism is increasinglyacknowledged as an important aspect of medical education.The Professionalism Mini-Evaluation Exercise (P-MEX) is anassessment tool for evaluating medical professionalism, butno studies using it as a self-assessment instrument have beenreported. This paper reports on a preliminary investigation of theFinnish version of the P-MEX instrument as an assessment andself-assessment measure.Methods: The sample in the present cross-sectional studycomprised all 23 medical students and recent graduates (15 femalesand 8 males) participating in a summer school of psychiatryprogram in 2014. The two-month program combines clinicalwork with multifaceted teaching and intensive tutoring. At theend of the program, the participants’ medical professionalism wasassessed by the tutors and other members of the work communityas well as the students themselves using the Finnish version of theP-MEX instrument. The P-MEX scores were compared, using theFriedman test.Results: The mean values and SD for the P-MEX assessmentswere as follows: tutor assessment 3.26±0.21, work communityassessment 3.23±0.26 and self-assessment 3.01±0.07. Nosignificant gender differences were observed. The tutor and workcommunity assessments were significantly correlated (r=0.573,p=0.040), but the self-assessment scores did not correlate witheither of the other assessments. Overall, the students evaluatedtheir skills significantly poorer in comparison to the otherassessments.Conclusion: Although the small sample size limits thegeneralization of these preliminary results, the Finnish versionof the P-MEX instrument appears to be a feasible measure ofmedical professionalism. The instrument can also be used as aself-assessment instrument, but subjective evaluations should becomplemented with external assessments or feedback in order totake individual and cultural aspects into account.Keywords: Assessment; Medical students; Professionalism

Abstract Introduction: Leadership and management are two expected featuresand competencies for general practitioners (GPs). The purpose of thisstudy was leadership and management curriculum planning for GPswhich was performed based on Kern’s curriculum planning cycle.Methods: This study was conducted in 2011-2012 in Iran using anexplanatory mixed-methods approach. It was conducted throughan initial qualitative phase using two focus group discussions and28 semi-structured interviews with key informants to capture theirexperiences and viewpoints about the necessity of managementcourses for undergraduate medical students, goals, objectives, andeducational strategies according to Kern’s curriculum planning cycle.The data was used to develop a questionnaire to be used in a quantitativewritten survey. Results of these two phases and that of the review ofmedical curriculum in other countries and management curriculumof other medical disciplines in Iran were used in management andleadership curriculum planning. In the qualitative phase, purposefulsampling and content analysis with constant comparison based onStrauss and Corbin’s method were used; descriptive and analytic testswere used for quantitative data by SPSS version 14.Results: In the qualitatively stage of this research, 6 main categoriesincluding the necessity of management course, features and objectivesof management curriculum, proper educational setting, educationalmethods and strategies, evolutionary method and feedback resultwere determined. In the quantitatively stage of the research, fromthe viewpoints of 51.6% of 126 units of research who filled out thequestionnaire, ranked high necessary of management courses. Thecoordination of care and clinical leadership was determined asthe most important role for GPs with a mean of 6.2 from sampleviewpoint. Also, team working and group dynamics had the firstpriority related to the principles and basics of management with amean of 3.59. Other results were shown in the paper.Conclusion: Results of this study indicated the need to provideeducational programs for GPs; it led to a systematic curriculumtheory and clinical management using Kern cycle for generalpractitioner’s discipline. Implementation and evaluation of thisprogram is recommended.Keywords: Curriculum; Management; Medical education; General practitioner

Abstract Introduction: Shahid Motahari Annual Educational Festivalaims to improve the quality of medical education in the IslamicRepublic of Iran, and has held since 2008. The present study wasperformed to determine the satisfaction level of Iranian medicaluniversities’ faculty members about holding Shahid MotahariAnnual Educational Festival during the past six years, from 2008to 2014.Methods: This cross-sectional study was conducted on 473 facultymembers (FMs) including deputies and educational administrators,managers, and faculty members of medical education developmentcenters, members of scientific committees, and faculty memberswho participated in Shahid Motahari Festival from 42 medicalsciences universities in Iran. Data collection instruments weretwo reliable and valid questionnaires on the background and alsoparticipants’ satisfaction towards Shahid Motahari EducationalFestival. Data were analyzed using SPSS Software, version 14.Results: Among all participants, 30 FMs (6.3%) were educationaldeputies, 36 FMs (7.6%) managers of medical educationdevelopment centers, 226 FMs (56.2%) members of scientificcommittees, 29 FMs (6.1%) members of the national committees,343 FMs (27.5%) attendees, and 264 FMs (55.8%) had participatedfor retraining. The total satisfaction level of the participants was73.3% which shows a good satisfaction level.Conclusion: The results identified the main important strengthpoints such as “proposals’ review process at the country level”and weakness points such as “organizing the festival”.Keywords: Satisfaction; Attitudes; Education; Evaluation; Faculty members

Abstract Introduction: One of the most significant elements of entrepreneurshipcurriculum design is teaching-learning methods, which plays a key rolein studies and researches related to such a curriculum. It is the teachingmethod, and systematic, organized and logical ways of providing lessonsthat should be consistent with entrepreneurship goals and contents, andshould also be developed according to the learners’ needs. Therefore,the current study aimed to introduce appropriate, modern, and effectivemethods of teaching entrepreneurship and their validationMethods: This is a mixed method research of a sequential exploratorykind conducted through two stages: a) developing teaching methods ofentrepreneurship curriculum, and b) validating developed framework. Datawere collected through “triangulation” (study of documents, investigatingtheoretical basics and the literature, and semi-structured interviews withkey experts). Since the literature on this topic is very rich, and views ofthe key experts are vast, directed and summative content analysis wasused. In the second stage, qualitative credibility of research findings wasobtained using qualitative validation criteria (credibility, confirmability, andtransferability), and applying various techniques. Moreover, in order to makesure that the qualitative part is reliable, reliability test was used. Moreover,quantitative validation of the developed framework was conducted utilizingexploratory and confirmatory factor analysis methods and Cronbach’s alpha.The data were gathered through distributing a three-aspect questionnaire(direct presentation teaching methods, interactive, and practical-operationalaspects) with 29 items among 90 curriculum scholars. Target population wasselected by means of purposive sampling and representative sample.Results: Results obtained from exploratory factor analysis showedthat a three factor structure is an appropriate method for describingelements of teaching-learning methods of entrepreneurship curriculum.Moreover, the value for Kaiser Meyer Olkin measure of samplingadequacy equaled 0.72 and the value for Bartlett’s test of varianceshomogeneity was significant at the 0.0001 level. Except for internshipelement, the rest had a factor load of higher than 0.3. Also, the results ofconfirmatory factor analysis showed the model appropriateness, and thecriteria for qualitative accreditation were acceptable.Conclusion: Developed model can help instructors in selecting anappropriate method of entrepreneurship teaching, and it can also make surethat the teaching is on the right path. Moreover, the model is comprehensiveand includes all the effective teaching methods in entrepreneurshipeducation. It is also based on qualities, conditions, and requirements ofHigher Education Institutions in Iranian cultural environment.Keywords: Teaching; Learning; Curriculum

Abstract Introduction: Collaborative testing is a learning strategy thatprovides students with the opportunity to learn and practicecollaboration. This study aimed to determine the effect ofcollaborative testing on test performance and retention of coursecontent in nursing students of Shiraz University of MedicalSciences, Shiraz, Iran.Methods: This quasi-experimental study was carried out on 84students enrolled in the course of Medical-Surgical 2 in Spring2013 and Fall 2013 semesters. The control group consisting of 39students participated in the first mid-term exam in an individualformat. The intervention group, on the other hand, consisted of45 students who took the test in a two-stage process. The firststage included an individual testing, while the second stage wasa collaborative one given in groups of five individuals chosenrandomly. Four weeks later, in order to investigate retention ofthe course content, both groups took part in the second mid-termexam held individually.Results: The study findings showed significant differencebetween the mean scores in the intervention group in the Fall 2013semester (p=0.001). Besides, a statistically significant differencewas found between the two groups regarding the tests mean scores(p=0.001). Moreover, retention of course content improved in thecollaborative group (p=0.001).Conclusion: The results indicated an increase in test performanceand a long-term learning enhancement in collaborative testingcompared with the traditional method. Collaborative testing, as anactive learning technique and a valuable assessment method, canhelp nursing instructors provide the alumni with strong problemsolvingand critical thinking abilities at healthcare environments.Keywords: Collaborative; Nursing Education; Collaborative learning

Abstract Introduction: Accreditation assesses performance, or capacity toperform, against predetermined standards. It typically combinesexternal quality assurance, through a process of peers review,with elements of self-regulation through internal and selfdirectedassessment. This study is an attempt to identify thequality of pediatrics residency educational programs regardingpredetermined standards.Methods: This descriptive-analytical evaluation study of appliedtype was conducted during 2010 and 2011 in the pediatrics departmentof Shiraz Medical School, Iran. The assessment process occurredin several phases; at first an assessment model for a residencyeducational development and a series of educational criteria andindices were created based on WFME Standards. Multiple methodsincluding a self-assessment questionnaire and several checklistswere used to collect data, whereas systematic site visit, peer reviewand document reviewing were conducted with survey team. Due tolimitation of the statistical society, all faculty members (n=34) andresidents (n=41) of the pediatric department were asked to completethe survey. At last, descriptive and deductive statistics data analysiswas performed using SPSS version 14.Results: According to the records available in assessing programquality, it seems that the input criteria were desirable for theprogram based on the residents’ viewpoints (86.6%).There wereproper physical facilities for them to meet the residency programgoals. The study indicated that the learning environment neededto be revised for the educational needs (Likert scale: 2.96±1.05).The peer evaluation team demonstrated achievement of missionfulfillment in the context of the objectives and indicators bymeeting the desired themes. In spite of some weaknesses inthe process criteria, the criteria for output indicators were goodaccording to the report (more than desired level of 75-80%).Conclusion: Accreditation is an important step towards strengtheningthe quality of educational programs. According to this study thecurrent status of the pediatrics department of Shiraz Universityof Medical Sciences was desirable leading to a satisfactory levelin general. However, additional educational development will beneeded in order to achieve a widespread change and improvement.Keywords: Accreditation; Standard; Pediatric

Abstract Introduction: The importance of medical profession and therole of the physician in society is no secret to anyone. Skills andcompetencies in clinical practice are necessary for the medicalprofession. In fact, in patient care, doctors require practical skillsin addition to scientific knowledge. This study examines thepotentials of medical school students in three areas of doing theright thing, doing the right thing in an intermediate range, anddoing the right thing by the right person.Methods: This study was done in a descriptive-analytical andsectional model. The population of this study was all internsof Shiraz University of Medical Sciences who were passinginternship at Internal Medicine, Surgery, Pediatrics, Obstetrics andEmergency wards. About 100 persons were selected were selectedby simple randomization. In order to collect data, a questionnairewith 12 questions was designed in two parts. The questionnairewas approved by 7 Faculty members of Clinical Medicine andMedical Education, and its reliability was approved by test-retestmethod on 20 medical students in the form of a pilot study andthrough Cronbach’s alpha (82%). Collected data were analyzed bySPSS software version 14 using descriptive statistical methods.Results: Results showed that within the inner circle, internsevaluated their skills in surgery, internal medicine, andgynecology wards, intermediate and at other wards as weak. Alsowithin the center circle, interns evaluated adequate educationalevidence-based training in the field of medicine, and sufficiencyof educational training in the field of clinical decision making andclinical care as suitable.Conclusion: According to the results, it seems that medicalinterns’ skills in performing most medical skills are moderate.So teaching students by new educational methods and workshoptechniques, using experienced teachers will be effective. Theuse of clinical skills training centers and objective assessmentmethods for the students’ skills, especially before entering theclinical departments, is very important.Keywords: Student; Assessment; Clinical skills

Abstract Introduction: Pervasive beliefs regarding curricular reformand integration have flourished among medical students, facultymembers and medical school administrators. These conceptshave extensively impacted the reform process, sometimes byresisting the reforms and sometimes by diverting the curriculumfrom its planned objectives. In the current paper, we have tried toaddress the challenges of integration in MD program by lookingat the existing literature and the experience of the internationaluniversities.Methods: We collected the questions frequently asked duringthe curricular reform process. We, then, evaluated them, andselected 5 main ideas. In order to find their answers, we searchedthe literature using these keywords: integration, reform, andundergraduate medical curriculum.Results: The findings are discussed in five sections: 1) Reform isnot equivalent to integration, 2) Integration can be implementedin both high school and graduate programs, 3) Organ-systembased integration is not the only method available for integration,4) Integration of two phases (basic sciences and physiopathology)can be considered but it is not mandatory, 5) Integration does notfade basic sciences in favor of clinical courses.Conclusions: It seems that medical education literature and priorexperience of the leading universities do not support most of theusual concepts about integration. Therefore, it is important toconsider informed decision making based on best evidence ratherthan personal opinions during the curricular reform process.Keywords: Medical education; Curriculum; Reform; Integration