Journal of Advances in Medical Education & Professionalism

Editorial

Designing a system of mentorship in Shiraz University of Medical Sciences

MITRA AMINI; JAVAD KOJURI; MOHAMMAD REZA DEHGHANI; ARASH MANI; PARISA NABEIEI; ROYA KHALILI; HOURI MUSAVI NEZHAD

Volume 5, Issue 2 , April 2017, Pages 49-50

Abstract

As you know, one of the new programs ofthe medical universities is to familiarizethe students to the medical atmosphere withthe help of compassionate and experienceduniversity professors. ... Read More As you know, one of the new programs ofthe medical universities is to familiarizethe students to the medical atmosphere withthe help of compassionate and experienceduniversity professors. The program is plannedand implemented under the title of mentorship,in which an experienced instructor takes theresponsibility of orientation, guidance and problemsolving of a number of students. The studentsat the time of admission face some problems,usually due to the young age, unfamiliarity withthe university context, the amount of the texts,etc.; therefore, they feel somehow defenselessin this atmosphere. In this program, which waslongitudinal and often causes a long-term andfriendly relationship between the professor andstudents during the education years, these problemsof students discuss with teachers (Mentor) andin this interact somewhat elevated. To do theappropriate implementation of this concept inthe university, the university was required to befamiliar with the concept of mentorship at the firststep (1). So, the Education Development Center ofShiraz University of Medical Sciences (EDC) hasimplemented this issue in a series of educationalfellowship workshops for the professors ofpostgraduate levels.In teaching this concept, the Jowhari model(Joseph Luft and Harry Ingham famous model)(2) has attracted the attention of authoritiesand professors of this period. In educating theconcept of mentoring, the development of selfgeneralizationwindow of the professors wasconsidered. Because this section covers theability of communication and flexibility in theleadership of the individuals, development ofthe window (area) decreases the incidence ofconflicts and misunderstandings and strugglesbetween individuals in this regard. To developthis area, there was an attempt in this period thatthe professors get familiar with the two methodsof self-openness and feedback. This educationalprogram was a pilot which was implementedin the country for the first time in one of thefellowship programs for the faculty members.Then, according to the results and positivefeedbacks, it was applied more extensively. Sofar, this subject has been trained in 5 differentfellowship training courses of the professors inthe form of diverse topics, such as the mentorshipconcept in educating the students, counseling andmentoring models and evaluation and feedbackprinciples. The results of the training showsachievement of the educational goals (85%),applicability of the educational materials (93%),and relevance of the educational environment (78%) in the universities. So, due to the newnessof this concept in the country and the necessityof its performance, doing more studies onthe improvement of this concept in the otherprofessor of this university seems necessary.

The impact of the teachers’ non-verbal communication on success in teaching

FATEMEH BAMBAEEROO; NASRIN SHOKRPOUR

Volume 5, Issue 2 , April 2017, Pages 51-59

Abstract

Introduction: Non-verbal communication skills, also called signlanguage or silent language, include all behaviors performed in thepresence of others or perceived either consciously ... Read More Introduction: Non-verbal communication skills, also called signlanguage or silent language, include all behaviors performed in thepresence of others or perceived either consciously or unconsciously.The main aim of this review article was to determine the effectof the teachers’ non-verbal communication on success in teachingusing the findings of the studies conducted on the relationshipbetween quality of teaching and the teachers’ use of non-verbalcommunication and also its impact on success in teaching.Methods: Considering the research method, i.e. a review article,we searched for all articles in this field using key words suchas success in teaching, verbal communication and non-verbalcommunication. In this study, we did not encode the articles.Results: The results of this revealed that there was a strongrelationship among the quality, amount and the method of usingnon-verbal communication by teachers while teaching. Based onthe findings of the studies reviewed, it was found that the morethe teachers used verbal and non-verbal communication, the moreefficacious their education and the students’ academic progresswere. Under non-verbal communication, some other patterns wereused. For example, emotive, team work, supportive, imaginative,purposive, and balanced communication using speech, body, andpictures all have been effective in students’ learning and academicsuccess. The teachers’ attention to the students’ non-verbalreactions and arranging the syllabus considering the students’mood and readiness have been emphasized in the studies reviewed.Conclusion: It was concluded that if this skill is practicedby teachers, it will have a positive and profound effect on thestudents’ mood. Non-verbal communication is highly reliable inthe communication process, so if the recipient of a message isbetween two contradictory verbal and nonverbal messages, logicdictates that we push him toward the non-verbal message and askhim to pay more attention to non-verbal than verbal messagesbecause non-verbal cues frequently reveal the intention of thesender of the information and reflect his/her emotional reactions.Based on the obtained results of this study, it is recommendedthat attention to non-verbal communication skills can make apositive change in the future of a student’s life. It seems necessaryfor the teachers to practice and learn effective communicationskills, especially for those who always interact with a largegroup of students. One of the factors contributing to the success or failure of students is the quality of the relationship and howthe teacher builds this relationship with students. Especially, itis more effective for students who are more responsive to humanrelations and communication skills. Finally, it is recommendedthat the teachers should improve their communication skills tohave better communication with their audience. The authoritiesare recommended to help improve the teachers’ level ofcommunication skills through holding training courses.Keywords: Communication; Teacher; Teaching

Analyzing the curriculum of the faculty of medicine, University of Gezira using Harden’s 10 questions framework

YASAR ALBUSHRA AHMED; SALMA ALNEEL

Volume 5, Issue 2 , April 2017, Pages 60-66

Abstract

Introduction: Despite the importance of curriculum analysisfor internal refinement of a programme, the approach for sucha step in under-described in the literature. This article describesthe ... Read More Introduction: Despite the importance of curriculum analysisfor internal refinement of a programme, the approach for sucha step in under-described in the literature. This article describesthe analysis of the medical curriculum at the Faculty of Medicine,University of Gezira (FMUG). This analysis is crucial in the eraof innovative medical education since introducing new curriculaand curricular changes has become a common occurrence inmedical education worldwide.Methods: The curriculum analysis was qualitatively approachedusing descriptive analysis and adopting Harden’s 10 Questionsof curriculum development framework approach. AnsweringHarden’s questions reflects the fundamental curricular componentsand how the different aspects of a curriculum framework fittogether. The key features highlighted in the curriculum-relatedmaterial and literature have been presented.Results: The analysis of the curriculum of FMUG revealsa curriculum with interactive components. Clear structuredobjectives and goals reflect the faculty’s vision. The approachfor needs assessment is based on a scientific ground, and thecurriculum integrated contents have been set to meet national andinternational requirements. Adopting SPICES strategies helpsFMUG and students achieve the objectives of the curriculum.Multiple motivated instructional methods are adopted, fosteringcoping with the programme objectives and outcomes. A widerange of assessment methods has been adopted to assess thelearning outcomes of the curriculum correctly, reliably, and inalignment with the intended outcomes. The prevailing conduciveeducational environment of FMUG is favourable for its operationand profoundly influences the outcome of the programme. Andthere is a well-defined policy for curriculum management,monitoring and evaluation.Conclusion: Harden’s 10 questions are satisfactorily addressedby the multi-disciplinary and well-developed FMUG curriculum.The current curriculum supports the well-written faculty missionsand educational objectives. It presents a structured, conceptualframework that supports the validity of the assumption behind thecurriculum. The curriculum enhances intellectual and academicpursuits and supports social accountability.Keywords: Curriculum; Education; Medical; Problem-based learning; Program evaluation

Comparison of the learning of two notations: A pilot study

ASHFAQ AKRAM; MAHER D FUADFUAD; ARSHAD MAHMOOD MALIK; BALSAM MAHDI NASIRALZURFI; MANAH CHANDRA CHANGMAI; MELINDA MADLENA

Volume 5, Issue 2 , April 2017, Pages 67-72

Abstract

Introduction: MICAP is a new notation in which the teeth areindicated by letters (I-incisor, C-canine, P-premolar, M-molar)and numbers [1,2,3] which are written superscript and subscripton ... Read More

Fourth year medical students’ reflective writing on “death of Ivan Ilych: a qualitative study

MAHSHID ZOHOURI; MITRA AMINI; MOHAMMAD MEHDI SAGHEB

Volume 5, Issue 2 , April 2017, Pages 73-77

Abstract

Introduction: Medical students should be familiar with the endof life ethical issues and its considerations. For teaching end oflife care to medical students, literature is a source ... Read More Introduction: Medical students should be familiar with the endof life ethical issues and its considerations. For teaching end oflife care to medical students, literature is a source of excellentnarratives of patients with experiences of terminally ill conditionin their journey through suffering and one of the most favouritebioethics literature readings has been the death of Ivan Ilych byTolstoy. We used this novel to show medical students end of lifeevents and suffering and asked them to write a reflective essayon it. We aimed to find what students think about terminally illpatients and their journey to death.Methods: In an inductive qualitative content analysis model, 350essays, collected by homogenous sampling, were analyzed. Thefourth year medical students were provided with the Death of IvanIlych novel to read. They were asked to write a reflection essaybased on the reflective stages defined by Sandars. These essaysserved as the unit of analysis, each being read several times and acoding model was formed according to main topics. The relatedconcepts in each unit were named as themes and each theme wasabstracted to a code and the related codes were compared anddeveloped as categories.Results: Qualitative content analysis of 350 essays of fourth yearmedical students revealed three major categories in students’reflection on reading Death of Ivan Ilych as an end of life humanbody. These included: 1) Emotional experience, 2) Empathy andeffective communication, 3) Spirituality and dignity. Analysisof essays showed that this reflection activity may help medicalstudents have a deeper idea of the end of life situation and feelings.Conclusion: This project suggests that literature can be used asan example to introduce new ethical concepts to less experiencedmedical trainees. The students acquired the concept of the storyand reflected the major aspects of the suffering of a human beingin their essays. Having used and evaluated the effect of literatureon facilitating ethical insight in the teaching end of life care, westrongly recommend this method and specially the novella, Deathof Ivan Ilych.Keywords: Education; Death; Medical students; Qualitative study

Medical students’ academic emotions: the role of perceived learning environment

NAEIMEH KOHOULAT; ALI ASGHAR HAYAT; MOHAMMAD REZA DEHGHANI; JAVAD KOJURI; MITRA AMINI

Volume 5, Issue 2 , April 2017, Pages 78-83

Abstract

Introduction: Research shows that there is a relationship betweenstudents’ perceptions of classroom and learning environment andtheir cognitive, affective, emotional and behavioral ... Read More

Commentary

The impact of 3-option responses to multiple-choice questions on guessing strategies and cut score determinations

KENNETH D. ROYAL; MYRAH R. STOCKDALE

Volume 5, Issue 2 , April 2017, Pages 84-89

Abstract

Introduction: Research has asserted MCQ items using threeresponse options (one correct answer with two distractors) iscomparable to, and possibly preferable over, traditional MCQitem ... Read More Introduction: Research has asserted MCQ items using threeresponse options (one correct answer with two distractors) iscomparable to, and possibly preferable over, traditional MCQitem formats consisting of four response options (e.g., one correctanswer with three distractors), or five response options (e.g., onecorrect answer with four distractors). Some medical educatorshave also adopted the practice of using 3-option responseson MCQ exams as a response to the difficulty experienced ingenerating additional plausible distractors. To date, however,little work has explored how 3-option responses might impactvalidity threats stemming from random guessing strategies,and what impact 3-option responses might have on cut-scoredeterminations, particularly in the context of medical educationclassroom assessments. The purpose of this work is to furtherexplore these critically important considerations that largely havegone ignored in the medical education literature to this point.Methods: A cumulative binomial distribution formula was usedto calculate the probability that an examinee will answer atrandom a given number of items correctly on any exam (of anylength). By way of a demonstration, a variety of scenarios werepresented to illustrate how examination length and the number ofresponse options impact examinees’ chances of passing a givenexamination, and how subsequent cut-score decisions may beimpacted by these factors.Results: As a general rule, classroom assessments containingfewer items should utilize traditional 4-option or 5-optionresponses, whereas assessments of greater length are affordedgreater flexibility in potentially utilizing 3-option responses.Conclusions: More research on items with 3-option responses isneeded to better understand what value, if any, 3-option responsestruly add to classroom assessments, and in what contexts potentialbenefits might be discernible.Keywords: Medical education; Assessment; Evaluation; Psychometrics

Letter to Editor

“Excellence” and “equity”: key elements in medical education

MEHDI ALOOSH

Volume 5, Issue 2 , April 2017, Pages 90-91

Abstract

In Iran, similar to most countries, medicineis a prestigious and high income profession.Moreover, traditionally “best and the brightest”candidates have been considered suitable ... Read More In Iran, similar to most countries, medicineis a prestigious and high income profession.Moreover, traditionally “best and the brightest”candidates have been considered suitable toenter medical schools. In fact, the excellencyof the applicants has been measured in a highlycompetitive national competition, by a multiplechoice knowledge test of high school materials.Accordingly, the national exam would provideequal chances for all candidates to enter medicalschools based on their knowledge excellence;in addition, the test provides an “objective”assessment, which would be supported by socialaccountability. Moreover, using this tool isrelatively feasible among about half a millionapplicants per year. However, a study in 2012showed that the national exam alone or evenin combination with high school Grade PointAverage (GPA) has limited predictive value formedical school exams and GPA (1). Similarly,other studies have supported inadequacy ofthese knowledge scores in predicting success inmedical training and even practicing medicine (2,3). In fact, being a “good doctor” is required tobe competent not only in knowledge acquisition,but also in non-knowledge competencies, suchas communication. Therefore, it seems thatthe current method of candidate selection hasnarrowed the definition of "excellence" byfocusing on theoretical knowledge. Furthermore,this method does not examine higher levels ofknowledge dimension, such as metacognition andhigher cognitive processes, such as creativity.In order to achieve more equity in access toeducation, a quota has been defined for differentgeographical areas of the country (central vs.marginal provinces). This would balance thechance of acceptance in medical schools forlower scored students in remote areas competingnumerous high scored applicants in big cities.In the United States, since five decades ago, aquota policy has been implemented entitled“affirmative action”, to address race diversity inmedicine. Such diversity has shown to improvehealth care and medical practice in underservedareas (3) without any adverse effect on residencytraining (4).In Iran, despite of implementation of the quotapolicy for more than half a century for selectingmedical students, it seems that advantageouspopulation -upper and middle socioeconomicgroups- have a higher chance to enter medicalschools even in remote areas. Indeed, they havemore resources to invest on the training requiredfor being excellent in the national knowledgeexam. Therefore, equity, which addresses socialjustice, would not be satisfied.Moreover, it has been shown that patients oflower socioeconomic level have limited accessto care and receive less medical care comparedto advantageous patients (5). It can be partiallybecause of communication problems caused bysocial class differences between physician and patient (6). In poorer patients' perspective, themost important criterion to choose a physicianis psychosocial aspect of the patient–physicianrelationship (7). In addition, physicians reportless interest and comfort and more anxiety invisiting patients with low socioeconomic status(8). As a result, there is a correlation betweenphysicians’ social class and communities theyserve (9). It seems that recruiting more medicalstudents from lower socioeconomic originmight raise awareness through the socializationprocess (10). Therefore, the equity in access tomedical education is considered as a tool for morejustice in the delivery of health care rather thana means for individual social advancement (11).In other words, if just some social groups entermedical profession, specific social groups wouldbe underrepresented in the profession and theirhealth care needs would be undermined.In summary, it seems that meaning ofexcellence and various excellences, whichare required to provide the best care for thepopulation, should be revisited. Accordingly, areliable and valid measurement tool for thoseexcellences is required to be designed. Finally,revision of policies in selecting medical studentswould satisfy health care needs of all socialgroups.

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Volume & Issue: Volume 5, Issue 2, April 2017 (23)

Designing a system of mentorship in Shiraz University of Medical Sciences

Abstract

The impact of the teachers’ non-verbal communication on success in teaching

Abstract

Analyzing the curriculum of the faculty of medicine, University of Gezira using Harden’s 10 questions framework

Abstract

Comparison of the learning of two notations: A pilot study

Abstract

Fourth year medical students’ reflective writing on “death of Ivan Ilych: a qualitative study

Abstract

Medical students’ academic emotions: the role of perceived learning environment

Abstract

The impact of 3-option responses to multiple-choice questions on guessing strategies and cut score determinations

Abstract

“Excellence” and “equity”: key elements in medical education

Abstract