Journal of Advances in Medical Education & Professionalism

Abstract Introduction: The current literature supports the inclusion ofinter-professional education in healthcare education. Changes inthe structure and nature of the integrated medical education andhealthcare system provide some opportunities for interprofessionaleducation among various professions. This study is an attemptto determine the perceptions of students and faculty membersabout interprofessional education in the context of the medicaleducation and healthcare system.Methods: This qualitative content analysis study was conductedusing purposeful sampling in 2012. Thirteen semi-structuredinterviews were conducted with 6 faculty members and 7 studentsat Tehran and Iran Universities of Medical Sciences. Datacollection and analysis were concurrent.Results: Data analysis revealed four categories and ninesubcategories. The categories emerging from individualinterviews were “educational structure”, “mediating factors”,“conceptual understanding”, and “professional identity”. Thesecategories are explained using quotes derived from the data.Conclusion: Matching the existing educational context andstructure with IPE through removing barriers and planning toprepare the required resources and facilities can solve numerousproblems associated with implementation and design of interprofessionaltraining programs in Iran. In this way, promotingthe development of a cooperative rather than a competitivelearning and working atmosphere should be taken into account.The present findings will assist the managers and policy makersto consider IPE as a useful strategy in the integrated medicaleducation and healthcare system.Keywords: Interprofessional relations; Qualitative research; Medical education

Abstract Introduction: The integration of behavioral and social sciences(BSS) into the curriculum of medical students in order to equipthem with the necessary knowledge, skills and attitudes is anessential issue, emphasized in many researches. Our aim is toinvestigate the barriers to integrate BSS into the general medicinecurriculum as well as the recommended strategies to overcomesuch barriers through a systematic review of literature.Methods: PubMed, ERIC, Scopus, CINAHL, Google Scholar,and OPENGREY were searched for studies on the barriers tointegration of BSS into the general medicine curriculum as wellas the strategies employed to overcome them until August 28,2015.Results: Sixteen relevant studies were included and the relateddomains were categorized as barriers and some strategies wererecommended to overcome them. In addition, the quality of theincluded studies was assessed.Conclusion: Despite the prominent role of BSS in theeffectiveness of health care, these sciences have not beenincluded in the curriculum of medical students effectively. Theidentified barriers and the strategies used to overcome themshould be considered for all integration programs. Future studiesshould focus on the process of BSS integration in the medicalcurricula and should evaluate the efficacy of this integration inmore detail.Keywords: Integration; Social sciences; Behavioural sciences; Curriculum; Barriers

Abstract Introduction: Although nursing students spend a large partof their learning period in the clinical environment, clinicallearning has not been perceived by its nature yet. To develop aninstrument to measure effective factors on clinical learning innursing students.Methods: This is a mixed methods study performed in 2 steps.First, the researchers defined “clinical learning” in nursingstudents through qualitative content analysis and designeditems of the questionnaire based on semi-structured individualinterviews with nursing students. Then, as the second step,psychometric properties of the questionnaire were evaluated usingthe face validity, content validity, construct validity, and internalconsistency evaluated on 227 students from fourth or highersemesters. All the interviews were recorded and transcribed, andthen, they were analyzed using Max Qualitative Data Analysisand all of qualitative data were analyzed using SPSS 14.Results: To do the study, we constructed the preliminaryquestionnaire containing 102 expressions. After determinationof face and content validities by qualitative and quantitativeapproaches, the expressions of the questionnaire were reduced to45. To determine the construct validity, exploratory factor analysiswas applied. The results indicated that the maximum variancepercentage (40.55%) was defined by the first 3 factors while therest of the total variance percentage (59.45%) was determinedby the other 42 factors. Results of exploratory factor analysis ofthis questionnaire indicated the presence of 3 instructor-staff,students, and educational related factors. Finally, 41 expressionswere kept in 3 factor groups. The α-Cronbach coefficient (0.93)confirmed the high internal consistency of the questionnaire.Conclusion: Results indicated that the prepared questionnairewas an efficient instrument in the study of the effective factors onclinical learning as viewed by nursing students since it involves41 expressions and properties such as instrument design based onperception and experiences of the nursing students about effectivefactors on clinical learning, definition of facilitator and preventivefactors of the clinical learning, simple scoring, suitable validityand reliability, and applicability in different occasions.Keywords: Learning; Clinical; Teaching; Nursing student

Abstract Introduction: Several factors affect the academic performance ofcollege students and parenting style is one significant factor. Thecurrent study has been done with the purpose of investigating therelationship between parenting styles, academic achievement andcareer path of students at Shiraz University of Medical Sciences.Methods: This is a correlation study carried out at Shiraz Universityof Medical Sciences. Among 1600 students, 310 students wereselected randomly as the sample. Baumrind’s Parenting Style andMoqimi’s Career Path questionnaires were used and the obtainedscores were correlated with the students’ transcripts. To study therelation between variables Pearson correlation coefficient was used.Results: There was a significant relationship between authoritarianparenting style and educational success (p=0.03). Also findingsshowed a significant relationship between firm parenting styleand Career Path of the students, authoritarian parenting style andCareer Path of the students, educational success and Career Pathof the students (p=0.001).Conclusion: Parents have an important role in identifying children’stalent and guiding them. Mutual understanding and close relationshipbetween parents and children are recommended. Therefore, it isrecommended that the methods of correct interaction of parentsand children be more valued and parents familiarize their childrenwith roles of businesses in society and the need for employmentin legitimate businesses and this important affair should be moreemphasized through mass media and family training classes.Keywords: Parenting; Achievement; Career; Students

Abstract Introduction: Feedback cards are recommended as a feasible toolfor structured written feedback delivery in clinical education whileeffectiveness of this tool on the medical students’ performanceis still questionable. The purpose of this study was to comparethe effects of structured written feedback by cards as well asverbal feedback versus verbal feedback alone on the clinicalperformance of medical students at the Mini Clinical EvaluationExercise (Mini-CEX) test in an outpatient clinic.Methods: This is a quasi-experimental study with pre- and posttestcomprising four groups in two terms of medical students’externship. The students’ performance was assessed throughthe Mini-Clinical Evaluation Exercise (Mini-CEX) as a clinicalperformance evaluation tool. Structured written feedbacks weregiven to two experimental groups by designed feedback cards aswell as verbal feedback, while in the two control groups feedbackwas delivered verbally as a routine approach in clinical education.Results: By consecutive sampling method, 62 externship studentswere enrolled in this study and seven students were excluded fromthe final analysis due to their absence for three days. Accordingto the ANOVA analysis and Post Hoc Tukey test, no statisticallysignificant difference was observed among the four groups atthe pre-test, whereas a statistically significant difference wasobserved between the experimental and control groups at thepost-test (F=4.023, p=0.012). The effect size of the structuredwritten feedbacks on clinical performance was 0.19.Conclusion: Structured written feedback by cards could improvethe performance of medical students in a statistical sense. Furtherstudies must be conducted in other clinical courses with longerdurations.Keywords: Feedback; Medical education; Ambulatory care; Outpatient clinics

Abstract Introduction: Triage is a response to the problem of overcrowdingin Emergency Departments (EDs) and accuracy of decisions madeby the triage unit affects the ultimate outcome of EDs. This studywas conducted to evaluate the knowledge of triage among lastyear medical students in Shiraz University of Medical Sciences.Methods: This is a cross-sectional analytical study whose subjectswere all the senior students of medicine (62) in the last year ofmedicine from January to June 2013 who attended emergencymedicine course in the screen room of 2 University Hospitals. Thisquestionnaire was designed in 3 sections including personal data,15 questions on knowledge of triage and 10 case scenarios fortriage decision making and completed by the students. Statisticalanalysis was performed in SPSS statistical software (version 14)using independent sample t-test, one way ANOVA, and Pearsoncorrelation coefficient (p≤0.001).Results: The total mean score of the participants was 10.6±1.5,ranging from 7 to 13. 58(93.5%) students had poor triageknowledge. In the scenario’s section, the percentage of correcttriage by students was 49.2% and those of over and under triagewere 28.1% and 22.7%, respectively. There was a significantrelationship between the triage accuracy and level of triage (ESI4) (p≤0.001).Conclusion: The level of knowledge of triage in the last yearmedical students was poor, although most of them had passeda course in the screen room. It is recommended that medicalstudents’ educational courses should include sections on theknowledge of triage in emergency rooms.Keywords: Emergency; Triage; Medical students

Abstract Introduction: Note taking while attending a PPT requires highactivity of memory and writing process which ultimately leadsto what is called “death by power point” referring to boredomand fatigue. To overcome this we planned to evaluate the impactof utilisation of uncompleted handouts given prior to PPTpresentations.Methods: Final year MBBS students were divided in 2 batches,batch A and batch B. For a set of lectures one batch was providedwith handouts before lecture while the other batch was givenlectures only. Crossover was done to avoid bias, all the lecturesbeing given by the same presenter. At the end of each lecture, ashort questionnaire of 10 Multiple Choice Question (MCQ) wasprovided to the students. Mean scores were calculated for lectureswith handouts and without handouts.Results: For a set of lectures, when batch A was provided withhandouts, the mean score was 28.2; for batch B to which nohandouts were given the mean score was 23.4. Similarly, forbatch B when provided with handouts the mean score was 29.1,for batch A which was not provided with handouts the meanscore was 24. There was an average increase of 4.2 marks.Actual gain when handouts were provided was 1.2 marksper lecture. It was more for the batch comprising of repeaterstudents as compared to the batch of fresher students. Increasein attendance was also noted.Conclusion: Providing uncompleted handouts before a didacticlecture definitely results in increase in knowledge gain; repeaterstudents benefit more with uncompleted handouts.Keywords: Education; Medical education; Undergraduate; Lecture; Lecture notes

Abstract Introduction: For some time now the field of medical educationhas been criticized by many of its stakeholders. Countless debateshave been presented in the literature regarding the quality ofmedical education research, adequacy of methodological rigor,and other concerns.Methods: At present, the views expressed have largely come fromphysicians and individuals with less familiarity with educationscience.Results: As prolific educational researchers with Ph.Ds inEducation and Psychology, we offer a critique of medicaleducation’s apparent identity crisis and address what we believeare some of the most significant problems continuing to impedethe field of medical education from catching up with the broaderfield of education. We close with specific recommendations forimproving the overall state of medical education.Conclusion: Finally, both editors and reviewers for medicaleducation journals need to abandon the hegemonic viewsregarding research design. Thus, research designs that many in theclinical sciences often perceive as ‘weak’ are entirely appropriatein education research fields.Keywords: Medical education; Education; Medicine; Education research; Quality; Research design