Journal of Advances in Medical Education & Professionalism

Abstract As the chief editor of JAMP, I have been confronted with duplicate articles or those with a high level of overlap in the last few years. This is an unethical approach to publishing manuscripts and is not in the same line with Cope principles.

Abstract Introduction: Human resources development, especially faculty members who play a substantial role in education, is of great importance and can lead to enhanced competence and participation of employees in university affairs. Mentoring is one of the programs that have attracted the attention of activists in this field today. This review aims to integrate the evidence about the goals, methods, implementation steps, and consequences of the mentoring methods for faculty member development in higher education institutions.
Methods: We used a systematic review in this study. Keywords related to the mentoring program were searched in gateways and databases such as PubMed, Scopus, Web of Science, and ERIC from 2000 to 2021. In the initial search, 638 articles were found, and 16 studies were reviewed after excluding those unrelated to the research objective.
Results: The results showed that the mentoring program included three stages: “Targeting and Familiarization with the Implementation of the Mentoring Program”, “Mentoring Program Implementation”, and “Evaluation of the Mentoring Program”. The implementation approaches included Traditional One-toone Mentoring Program, Peer Mentoring Program, and Distance Education Mentoring Program.
Conclusion: This study identified the stages and types of mentoring programs and revealed that their employment, especially the distance education mentoring program, led to the advancement of faculty members in various fields. A mixed-method approach to program evaluation can provide more appropriate views of the effects of these programs.

Abstract Introduction: Medical institutions worldwide faced an unprecedented situation during COVID-19 of identifying alternative strategies to sustain the continuum of learning process. This led to several innovations in the traditional medical curriculum. This study explored the effectiveness and feasibility of using the Peyton’s framework modified for a virtual platform (Microsoft Teams) for teaching clinical skills to first and second-year medical students at The Aga Khan University, Karachi, Pakistan.
Methods: In 2020-2021, the modified Peyton’s framework was integrated in the clinical skills (CS) curriculum for all first- and second-year students (N=200). For evaluation, a mixed-method design was used, with pre-and post-session questionnaires. Students’satisfaction was obtained through the standard session evaluation tool of the university. For the qualitative arm, to explore the instructors’experiences, purposive sampling was used (n=8) and a focused group discussion (FGD) was conducted. Finally, performance of the students at the end of year summative Objective Structured Clinical Examination (OSCE) was compared with the students of previous year. Quantitative data were analysed using STATA® version 15.1, using paired t-test to compare the differences in OSCE scores in selected CS stations. A p-value of <0.05 was considered significant for all tests. The FGD was transcribed and analysed through manual content analysis.
Results: Nine clinical skills (that included history and examination skills) were taught using the virtual platform. There was a significant improvement in post-session questionnaires in seven of these skills (P<0.01). Session evaluations showed that most students were satisfied with the learning experience. The instructors showed that the online teaching offered a promising platform for teaching history taking skills. The OSCE scores showed mixed results, with significant improvement in two out of four repeated stations by using paired t-test [abdominal exam (87.33±8.99, <0.001); and precordial examination (88.45±8.36, 0.001)].
Conclusions: Modifying Peyton’s framework to a virtual platform allowed us to sustain the continuum of clinical education during the COVID-19 pandemic. The results support the use of a blended learning environment for teaching clinical skills.

Abstract Introduction: Concept mapping is a multidimensional tool that has been put to little use in India. We designed this study to check its applicability for assessing higher-order thinking in the subject of Physiology.
Methods: This interventional analytical study was carried out among 65 students of Phase I of MBBS in the year 2021. The students were sensitized to the technique and were given a practice session. On a pre-informed date, an assessment of a topic taught to them was done using concept mapping and a multiple-choice question (MCQ) based test. Feedback on the technique was taken from the students. The statistical tests used were test of normality – Kolmogorov-Smirnov Test, significance of association - Wilcoxon Signed Rank test, correlation - Spearman’s correlation, and agreement - Bland Altman Analysis. The discrimination index was calculated for both concept mapping and MCQ based tests, separately. Percentages were calculated for feedback questionnaire items. The data were analysed using Microsoft Excel (2019) and an online calculator. P values <0.05 were considered statistically significant.
Results: Students scored more in concept mapping. There was a significant difference in the scores of the students on the two tests (Wilcoxon Signed-Rank test, Z=-2.66, P=0.008) and a weakly positive non-significant correlation between them (Spearman’s correlation coefficient, rs=0.07, P=0.60). Bland Altman’s Analysis showed agreement in the scores of the students in the two tests. The mean score of the students in the two tests increased, so did the difference in the scores in the two tests. The discrimination index of concept mapping (0.28) was higher than that of the MCQ based test (0.18). Most of the students agreed on the advantages of concept mapping in the feedback.
Conclusion: The assessment result of concept mapping is better than that of MCQ-based test and it may be included as a teaching learning and assessment strategy in the context of Indian medical education in the subject of Physiology.

Abstract Introduction: Inadequate prescription communication skills of the medical graduates lead to poor therapeutic outcome and increased burden on the healthcare system. This gap has to be addressed through effective methods for teaching prescription communication skills to medical students. This study compared the effectiveness of Role play and Small Group Discussion (SGD) in teaching prescription communication skills to students of Phase Two of the Bachelor of Medicine and Bachelor of Surgery (MBBS) course.
Methods: This was a prospective interventional study done in the Department of Pharmacology affiliated to the Department of Surgery at a Tertiary Care Centre in North Kerala for a period of 3 months from March 2021 to May 2021. After obtaining ethical clearance and informed consent, students of Phase Two of the MBBS course students (n=60) were selected by convenience sampling and divided into 2 groups by simple randomisation. The groups were taught prescription communication skills by Role play and SGD, respectively. Each group received six independent interventions on different topics. An Objective Structured Clinical Examination (OSCE) was conducted 1 week after each session for both groups. At the end of six sessions, feedback on the sessions was collected through a perception questionnaire. Quantitative data were compared using independent t-test. Ordinal data were expressed as percentages. Statistical analysis was done using online statistical calculators. P<0.05 was considered statistically significant.
Results: Mean OSCE scores for each session was significantly higher in the Role play group than the SGD group. Mean total OSCE score of the Role play group was significantly higher than the SGD group (60.39±6.33, 47.79±4.27, P<0.001).
Conclusion: Role play is more effective than SGD in teaching prescription communication skills to MBBS students. Students have shown more favourable perception towards Role play than SGD for teaching prescription communication skills.

Abstract Introduction: Professionalism, as one of the core competencies of physicians, is essential for providing the patients with higher quality care. It is an abstract concept and its education and assessment need objective and operational methods. The present study aimed at teaching the concepts of professionalism based on a scenario-based approach using role-playing and reflection.
Methods: This is a pre-experimental study (one-group pretest-posttest design) with a mixed method approach. The study was conducted on 18 medical students (by voluntary sampling method) who had enrolled in the Medical Ethics Course at Kashan University of Medical Sciences in 2020. Twelve scenarios were designed about the most prevalent issues of medical professionalism. In each session, one group of students played out their scenarios and then, the participants and instructors discussed their role-playing. Participants’ knowledge about professionalism was assessed at the beginning and end of each session, and they completed a satisfaction questionnaire and a reflection form. T-tests (one-sample and paired T-test) were applied for statistical analysis. Quantitative and qualitative data were analyzed using SPSS software (version 26), and P<0.05 was considered statistically significant. Conventional content analysis was used to analyze the qualitative data.
Results: The mean scores of the participants’ knowledge in posttest were significantly higher than those in the pre-test (P=0.042, t=-2.074). The mean scores of the participants’ role-playing quality (P<0.001) and satisfaction (P=0.001) were significantly higher than their corresponding test values. Qualitative analysis of the participants’ reflections revealed their satisfaction with the study intervention.
Conclusion: The scenarios, role-playing, and reflection could provide an opportunity for operationalizing the concepts of professionalism and deep learning of students. Medical instructors need to improve their knowledge and skills of using active methods in teaching professionalism to medical students.

Abstract Introduction: Game in education aims to enhance human motivation and performance in a given activity. Gamification experts and health researchers are still unsure about the status of progress of game for health. So, to fill in this gap, the present study aimed to analyze scientific productions to identify production trends, subject areas, countries, institutes, and authors in these three areas on gamification, game-based learning, and serious games in medical education, as well as to determine coauthorship patterns.
Methods: The present descriptive quantitative research was conducted through scientometric analysis by using co-authorship networks in gamification, game-based learning, and serious games. First, an advanced search was performed from 1990 to 2020 and the studies were retrieved from Web of sciences, on Aug 17, 2021 The plain text format of data was inputted to Microsoft Excel, CiteSpace and Gephi to analyze scientometric maps for the three domains. Subsequently, the required indicators to review co-authorship networks were obtained: Degree centrality, Betweenness centrality, Closeness centrality, Density, Clustering coefficient, collaboration index and collaboration coefficient.
Results: There were 466 documents in gamification, 155 documents in game-based learning, and 295 documents in serious games. The results indicated the rising trend of scientific publications on the three domains. US was a prolific country in all three domains. Author collaboration has remarkably increased, although the number of single-author  articles is still high.
Conclusion: Due to the increasing growth of publications on these three domains, research can be continued by forming specialized groups and supporting joint publications. Also, research policymakers should promote author collaborations on the national and international scale.

Abstract Introduction: Medical errors are a serious problem in providing medical care and ensuring the health of society, and discovering the causes of errors to minimize the possibility of their occurrence is one of the main challenges in the field of treating patients. This study aimed to determine the relationship between professional identity, performance and attitude to self-reported medical errors among medical interns of Ardabil University of Medical Sciences.
Methods: This cross-sectional analytical study was conducted on 187 medical interns with census method in five Ardabil educational hospitals in the second semester of 2020-2021. Data collection tool was a questionnaire consisting of 3 parts (demographic, self-reported attitude towards medical errors and professional identity). The validity of the questionnaire was evaluated using Content validity index (CVI) and Content validity ratio (CVR). The reliability of the attitude section was 0.78 and 0.86 for professional identity section. Data analyses were performed using the IBM SPSS Statistics, version 21 by descriptive statistics, such as mean and standard deviation and independent T-test, chisquare and one-way ANOVA. P-values<0.05 were considered statistically significant.
Results: The mean scores of students’ attitudes towards selfreport and professional identity were 55.6±8.8 and 60.4±9.8. Less than 50% of the students declared the possibility of reporting their medical errors. There were no significant differences in the mean scores of self-reported attitude, medical error and professional identity according to grade point average, type of faculty and students’ gender (P>0.05).
Conclusion: The attitude and performance of students regarding the self-disclosure of medical errors was not satisfactory, and it seems that the analysis of the educational programs in the education of medical errors and the legal and ethical aspects of errors needs serious attention.