Journal of Advances in Medical Education & Professionalism

Abstract Introduction: There are two popular methods of clinical skills teaching. One is Peyton’s method, and the other one is Robert Gagne’s method. A hybrid model which is a combination of both teaching methods is developed and implemented at Avalon University School of Medicine in Clinical Skills. The aim of the study was to evaluate the hybrid model of clinical skills teaching.
Methods: This is a quasi-experimental study where a control group with a sample size of 26 was compared with two study groups; one group included 24 participants, and as the other one consisting of 16 subjects selected without randomization. All students in the class were included in the study, except for those withdrew voluntarily. The quantitative data were gathered in the form of a questionnaire on the Likert scale which was collected as the end of course evaluations. The quantitative data for the responses on the Likert scale was analyzed for descriptive statistics: Mean, Median, and Mode. The quantitative data also included the students’ performance on assessments of clinical skills which was analyzed using ANOVA test. The qualitative data were gathered in the form of open-ended questions in the end of course evaluations. The qualitative data were also collected from the faculty members who were the examiners for the clinical skills course as the feedback taken from them.
Results: There was a significant improvement in the feedback of students (end of course evaluations) after implementing the hybrid model of clinical skills teaching which was shown by increased Mean, Median, Mode for the most pointers on the Likert scale. Also, there was a notable improvement in the performance of students with a significant p-value (p<0.05) on ANOVA test.
Conclusion: The hybrid model is very effective in teaching clinical skills. This teaching method can be evaluated by replicating this study at larger institutions with more number of students. 

Abstract Introduction: Ever-expanding medical literature demands successful amalgamation of huge information and clinical practice for budding doctors. This study aimed to find the effectiveness
of the concept map, a novel method of teaching to improve performance among undergraduate pharmacology students.
Methods: The undergraduate medical students pursuing pharmacology in 2017-18 in our institute was divided into two groups after stratified randomization based on the last semester grades. After a session of didactic lecture on ‘Drugs affecting Calcium Metabolism’ and a pre-test, one group was taught using traditional tutorial methods and another group using the concept map method. Finally, a post-test was taken and feedback received from the intervention group.
Results: A significant improvement of student performance was found in both groups using validated questionnaire from pre-test to post-test. There was no significant difference in the percentage
of improvement between the groups. This finding was consistent in both Low scorers and High scorers of the previous semester examination. Students found the new method better in terms of
understanding the concept and interactivity.
Conclusion: Concept mapping encourages the students to actively participate and get a comprehensive and accurate overview of the topic, but the improvement in performance in the test was not evident.

Abstract Introduction: Hidden curriculum plays a main role in professional learning, formation of professional identity, socialization, moral development and learning values, attitudes, beliefs, and knowledge in learners, so it needs to be managed. Although the majority of the theorists believe in the existence of a hidden curriculum and its greater effect and sustainability compared to the formal curriculum; none has proposed a comprehensive model or approach for its management. This study aimed to design a hidden curriculum management model in medical education.
Methods: In this study, the authors used the theory or model construction methodology to synthesize a hidden curriculum management model in medical education. According to Walker and Avant; this methodology includes the following three steps for synthesizing the model: specifying focal concepts, reviewing the literature, and organizing concepts into an integrated and efficient representation.
Results: The results of the study showed that numerous factors affected the hidden curriculum including environmental factors (professional, organizational), human factors (teachers, peers and
staff), and formal curriculum and learner’s influenceability filter which bear important messages for learners, staff and teachers. To manage the hidden curriculum, in addition to the above factors,
it is necessary to manage knowledge and the learners’ learning in an educational institution.
Conclusion: This study revealed that to achieve the desired performance in students, the formal curriculum reform is not sufficient. Moreover, other factors such as environmental factors, human factors, learner’s influenceability filter, and knowledge management should also be taken into account. The hidden curriculum management model can be used for training and educating the staff and students with the desired performance in any educational institution.

Abstract Introduction: In the test-enhanced spaced learning, educational contents are presented in small packages of well-developed test questions with a defined frequency to the learners. It is not clear that applying this educational style might have a positive impact on the summative assessment. Therefore, in this study we assessed the effect of the test-enhanced spaced learning on the otolaryngology board and annual examinations of residency training.
Methods: In a quasi-experimental study with consecutive sampling, all forty-four residents of otolaryngology in four levels of training in 2016 at Tehran University of Medical Sciences
(TUMS) received daily-standardized multiple-choice questions with a twice-repeated frequency of 10 days. Individual feedback according to one’s response to each test was provided. The results of national board and annual exam were compared with the same results of all residents of other universities and previous year TUMS’ residents for whom spaced learning were not applied and they were considered as the control groups. The board exam had two parts, multiple-choice questions, and computer-based clinical examination. The annual exam format was multiple-choice questions. The total score for each one was 150. Student’s t-test and Mann-Whitney U test were used for comparative analyses.
Results: The mean of the board exam results showed statistically significant improvement compared to other medical schools (113.6±10.7 vs. 102.9±13.4 in multiple-choice questions, p=0.048, 118.7±12.5 vs. 54.1±60.0 in the computer-based clinical examination, p<0.001), while similar comparison results in the previous year did not show any significant difference.
Conclusion: Spaced learning with testing effect may be useful in the clinical education setting to improve the learning outcomes. 

Abstract Introduction: Emotional intelligence is a social skill that controls stress and affects one’s ability to cope with the demands and environmental pressures; it so can improve professional competence in health care providers such as nursing students. Training on emotional intelligence increases the mental health and influences the mutual relationships, stress, depression and aggression. This study aimed to determine the effect of emotional intelligence skills training program on the stress and academic success of nursing students in a higher education health complex.
Methods: This study is a quasi-experimental study with an educational intervention. The participants included 100 students of nursing selected by stratified random sampling from both genders. They were randomly categorized into two intervention and control groups including 50 subjects, respectively. We used Meyer and Salvia model in Emotional Intelligence training in the intervention group. During the training sessions in the intervention group, the control group did not receive any intervention. Academic stress and professional competence in both groups were measured before and two weeks after the experiment. SPSS version 21 was used to analyze the data, using Paired t-test, independent t-test, Wilcoxon, Mann-Whitney and Chi-Square tests.
Results: The mean age of the participants was 20±2.14 years old. According to the results, the mean difference of the changes in the professional competence (p<0.001), total academic stress
(p<0.001), and the four areas of academic stress such as emotional response (p<0.001), physical response (p<0.001) and physiological response (p<0.001) were significant. The intervention group, as compared with the control group, showed no significant effect on the other factors of academic stress such as frustration, conflict, academic pressure, changes and self-imposed stress.
Conclusion: The education of emotional intelligence components can improve the efficiency of nursing care services and professional competence due to deceased stress.

Abstract Introduction: A cricothyroidotomy is an emergency procedure that few emergency medicine residents see or perform during their training. Therefore, there is a need for low cost, high fidelity models for training. In this study, we explore a new training model for cricothyroidotomies (the bleeding CRIC [cost-effective realistic interactive cricothyroidotomy]) to determine if this new tasktrainer is non-inferior compared to the current standard of training.
Methods: Authors conducted a randomized control noninferiority study. There were seventeen residents and medical students enrolled by convenience sample to partake in the study. The participants were randomized by block randomization to be taught how to perform a ricothyroidotomy on either the new task trainer or the current standard task trainer and then were
asked to perform the procedure on a pig trachea model. Primary outcome measures were scores on a previously validated objective assessment tool and secondary outcomes were comfort levels and
realism scores based on pre and post survey results which were analyzed with ANOVA.
Results: There was found to be no statistically significant difference between the groups in assessment scores, time to completion, or comfort levels pre- and post-intervention. There was a statistically significant difference in that the participants gave higher realism scores in post-test analysis to the Bleeding CRIC compared to the SimMan. Both groups demonstrated that they had significantly improved comfort levels from baseline post-intervention.
Conclusion: Overall, the new task trainer was rated by learners to feel more realistic than the current standard. This study demonstrates non-inferiority of the new task trainer and further studies with larger sample sizes should be conducted to determine its true efficacy.

Abstract There has been a paradigm shift in the teaching strategies from didactic or teacher-centered to more vibrant student centered approaches. For the last five decades, small group teaching (SGT) has been a hallmark of this reorientation of educational strategies especially in medical schools, which use problem-based learning as a core educational tool. The key strength of SGT is the continuous and active participation by learners which fosters lifelong learning skills. SGT has had a profound influence on the motivation levels of students, self-confidence, self-directed learning and fabric of teamwork. The role of the tutor as a facilitator rather than knowledge provider is of paramount importance in this process. However, there are challenges that ensue as a result of heterogeneous teaching skills and attitudes of faculty members from diverse backgrounds. Some of the tutors from traditional backgrounds find it difficult to adjust to switching roles from a conventional teacher to a facilitator and inadvertently defeat the very philosophy of student-centered SGT. This article has been
composed with this background in mind and ten general basic and practical guidelines are offered which are expected to be useful for the successful transition from a traditional teacher to a SGT
facilitator.

Abstract N/A

Abstract Mentoring involves two-way communication, learning and progress. Students participating in this process receive guidance from senior students and professors on how to deal with challenges more effectively and yield suitable methods as to progress. Shiraz University of Medical Sciences (SUMS) is one of the leading universities in the field of Mentoring. The main objectives of the Mentoring program include: providing educational and emotional support for mentees. Considering the successes of the Mentoring program in Shiraz University of Medical Sciences over the past three years, we have decided to account of some of the activities carried out by Mentoring teams of this university briefly and share this experience with the other Medical schools, through this short report.