RESEARCH AND DEVELOPMENT IN MEDICAL EDUCATION
Year:2019 | Volume:8 | Issue:2|Papers Count:12

At the opening of the Association for Medical Education in Europe (AMEE) conference in Vienna on August 26, 2019, Anita Rieder used a phrase that was very interesting to me: “ Medical education is all about public health” . As this topic was discussed at various AMEE conference symposiums and plenaries this year, I was interested in discussing in detail these concepts of public health and the necessity of their application in medical education. . . .

In the field of medical education, conducting an effective large group teaching session is a major challenge for most teachers regardless of their teaching experience. 1 In order to clarify the issue and enhance the competence levels of teachers, the Medical Council of India has been conducting different faculty development programs through various nodal and regional centers for faculty development. The aim of these sessions has been to expose teachers to different ways in which a large group teaching session (and other types of teaching-learning sessions) can be made interactive and effective. . . .

The concept of the journal club is a time-tested collaborative learning activity to keep health professionals abreast of current literature and improve their confidence in reading literature. Being equipped with the skills to critically analyse a peer-reviewed scientific manuscript is equally as important as carrying out research and publishing papers. Most published literature related to the concept of journal club examines only the core critical appraisal skills and leaves behind potential factors which could significantly influence the effective pursuit of a journal club. In this practical advice paper, the author highlights 12 steps for conducting an effective journal club and the practical difficulties associated with each step.

Learning in any context involves acquisition, storage and utilization of information by the human memory system. Teaching and learning in health professions is a complex process since it demands learners interact with a number of novel information and concepts and critically analyze them to make important clinical decisions. Therefore, it is imperative for Instructional designers and instructors in health professions education to optimize learning content by considering the characteristics of memory and learning processes of students. This review explores stages of the human memory system, the process of learning, the various types of cognitive loads a learner experiences while learning, and the implications of these factors on instructional designs on the basis of a fairly new theory in educational psychology – the Cognitive Load Theory (CLT). By analyzing the unique features of the processing, storage and retrieval of information by human memory system, this article advocates for health professional educators to plan and design instructional strategies that facilitate student learning.

In response to the evolving needs and reports on medical education, many medical schools have been pursuing curricular integration. Contrary to Abraham Flexner who persuaded that teaching of medical sciences, from basic to clinical, should be a critical component of the discipline based curriculum, ‘ integration’ , in its purest sense unifies separate areas of knowledge which quenches the needs of adult learners. However, most medical schools struggle with integrating their curricula owing to the confusion derived from diverse definitions and multiple learning theories. A common criticism of integrated curriculum is that students will not see the relevance of basic sciences and this significantly minimizes the role of basic sciences in medical education. The crux of integration is achieving the balance of clinical and basic sciences in a manner that best serves the student to maximize student engagement and knowledge retention. In this paper, we made an attempt to address the contextual issues existing in medical schools, the changing role of basic sciences in present day medical education and the optimal strategy to achieve effective integration of basic sciences. We propose that a dynamic interconnectedness happening at various levels is more important to achieve effective integration rather than mere deliberate unification of individual disciplines.

Background: The routine method of measuring blood pressure (BP) is subject to numerous pitfalls. We evaluated the impact of a guidelines-based educational intervention on improvement of BP determination by fourth-year Iranian medical students. Methods: Using a consecutive sampling technique, 103 fourth-year medical students were recruited during their rotation in the Department of Community and Family Medicine at the Tabriz Medical School at the Tabriz University of Medical Sciences. All students attended a 3-hour training class covering accurate BP measurement. Using a valid checklist, sixteen elements of BP measurement skills were assessed among students before and after two weeks of training. McNemar’ s test, paired-sample t tests and Pearson’ s chi-square test were used to compare the data before and after training using SPSS version 23. Results: The study showed that before the training class most of the elements of BP measurement skills were not performed by most of the students, and 9 of 16 BP measurement skills were only performed by <20% of the students. Following the training class, however, 14 of 16 BP measurement skills were performed by >70% of the students. Before training, mean/SD of correctly-performed-skills out of 16 skills was 4. 76/2. 03. After training, the mean/SD was 13. 99/5. 19 (P < 0. 001). Conclusion: This study showed a significant improvement in medical students’ BP measurement skills after a 3-hour course of training. Thus, it appears that periodic training sessions of accurate BP measurement for medical students may be of great benefit and equal importance in medical schools.

Background: The knowledge and experience sharing of faculty and staff at universities and research institutes with their communities is a key element of success in achieving the organizational goals. Faculty members play a key role in universities. Accordingly, recognizing the importance of this capability in faculty members, this study aimed to investigate the status of knowledge and experience sharing based on the Ajzen model in faculty members at the Shahid Beheshti University of Medical Sciences in 2018. Methods: This descriptive-analytical study was conducted with 300 faculty members at the Shahid Beheshti University of Medical Sciences using stratified random sampling and simple random sampling. Data was gathered using a researcher created questionnaire and the analysis was conducted using SPSS 25 and LISREL 8. 8. Results: The results showed that the significance level of a test for the relationship between knowledge and experience sharing components was less than α = 0. 05, and there was a positive and significant correlation between knowledge and experience sharing components in faculty members at the Shahid Beheshti University of Medical Sciences. Most of the respondents’ agreement regarding “ knowledge and experience sharing” were related to behavioral control (mean=3. 87; SD=0. 353), behavior (mean=3. 56; SD=0. 328), attitude (mean=3. 30; SD=0. 344) subjective norm (mean=3. 16; SD=0. 435) and intention (mean=2. 76; SD=0. 284). Conclusion: This tool can be used by managers and university presidents to manage and translate knowledge in medical sciences universities.

Background: This study aimed to evaluate the effectiveness of debate as a learning tool for changing audiences’ views regarding the use of clinical guidelines in routine clinical practice. Methods: A debate scenario including different rationales for and against using guidelines in clinical practice, presented by the student section of Iranian Evidence Based Medicine Center of Excellence, was held at the first International Student Congress of Research Integrity and Evidence-Based Practice (Kish Island, Iran, December, 2015). The audience was first asked to check the papers given to them, and if they agreed to the terms, they were asked to choose, “ Yes” , “ No” , or “ I don’ t know” . Results: Of the 400 individuals participating in the congress, 100 were present during the scheduled debate time. Among the 71 people completing pretest questionnaires, 73% (52) answered “ yes” to the question, “ Should we use guidelines? ” About 7% (5) claimed that we shouldn’ t use guidelines, and 20% (14) had no opinion about using them. Following the debate, the participants who chose “ yes” to the guidelines remained in favor of their use in clinical practice. Of the 14 who did not have an opinion for guideline use, all agreed to use guidelines in clinical practice. Surprisingly, the five participants who were against guideline implementation remained fixed in their view, continuing to disagree regarding their use in clinical encounters. Conclusion: Although we were unable to change the attitudes of physicians who were against the use of guidelines in clinical practice, the debate caused a positive shift among participants who did not have an opinion regarding their use in clinical scenarios.

Background: Futures study is a science that, given changes in society, identifies future trends for making appropriate and practical decisions. Universities benefit from futures study research to improve their efficiency and make effective decisions. This is increasingly seen in medical sciences universities, which are responsible for public and specialized health education, and their quality development should be addressed. The purpose of this study was to identify components and key indicators of the qualitative development of medical sciences education and writing scenarios based on these. Methods: The present study is a mixed methods study carried out in the medical universities of Iran in 2018-2019. In this qualitative approach, the components and indicators of qualitative development of medical sciences education were identified by the classical Delphi method according to targeted sampling from 10 experts with content analysis that was identified and coded. Following the qualitative portion, a quantitative approach using Scenario Wizards software was used to design robust scenarios. Results: In all, 13 components and 48 indicators were identified in the qualitative development of medical sciences education from which robust scenarios can be considered for futures study, including optimistic, intermediary, and pessimistic scenarios. Conclusion: These results indicate how using each of the medical sciences education’ s qualitative development components and indicators can lead medical sciences universities to consider favorable and unfavorable futures for planning and direction. Recognizing correct components and drawing scenarios for desired futures is essential.

Background: The competence of faculty in conducting e-learning is one of the preconditions for e-learning implementation in a university. This study aimed at investigating the readiness of the faculty members of Ardabil University of Medical Sciences (ARUMS) to have e-learning. Methods: To fulfil this purpose, a triangulation method has been used. In the quantitative section, based on the Technological Pedagogical Content Knowledge (TPACK) model, the faculty competence in conducting e-learning has been measured in four areas: pedagogical knowledge, technological knowledge, content knowledge, and finally the skill of combining pedagogical knowledge, technological knowledge, and content knowledge. Subsequently, with the qualitative data of the semi-structured interview, the findings of the research have been explained. Finally, the strategies for improving the readiness of ARUMS faculty have been identified in e-learning. Results: One-sample t test with a significant level (P ≤ 0. 5) showed that the faculty e-learning of ARUMS had the highest mean of pedagogical knowledge, content knowledge and contentpedagogical knowledge respectively. In other words, the faculty had a high level of pedagogical, content and content-pedagogical knowledge, but they need to improve their technological, technological-content, technological-pedagogical and ultimately, technological-pedagogicalcontent knowledge. Conclusion: That is why, in order to have effective e-learning at ARUMS, the faculty has to improve their technological, technological-content, technological-pedagogical and technological-pedagogical-content knowledge. In this regard, several solutions have been proposed in this paper.

Background: The content of courses in English for specific purposes (ESP) has been largely determined on the basis of the intuitive judgments and personal preferences of syllabus designers and teachers rather than a standard needs analysis. The present study was an attempt at assessing the current English language abilities of undergraduate students majoring in the medical sciences and identifying their target needs for academic success through quantitative and qualitative methods. Methods: The participants included 197 undergraduate students, 12 Teaching English as a Foreign Language (TEFL) teachers, and 15 content teachers from the Tabriz University of Medical Sciences, Iran. Data were collected through a target needs analysis, self-assessment questionnaires, and semi-structured interviews. Results: Pronunciation, technical and general vocabulary knowledge, and use of bilingual dictionaries were regarded as ‘ important’ and ‘ very important’ target needs by the participants, though some significant differences in perceptions were found between content teachers and students. Writing skill, listening comprehension, and speaking were perceived as the weakest points in the students’ current level of ability. There was also a significant difference between the perception of TEFL teachers and students in assessing the students’ linguistic abilities. Furthermore, both students and TEFL teachers voiced their dissatisfaction with certain areas of ESP courses, such as an inadequate number of credits and heterogeneity of classes. Conclusion: To improve the outcome of ESP courses, they should be designed on the basis of a realistic appreciation of all stakeholders’ perceptions in the field, and they should be taught through the cooperation of both TEFL teachers and content teachers working together.

Background: Residency programs generally carry out various educational interventions to improve residents’ publication records. Since an intervention may not produce the same effect in different locations, evaluating the effectiveness of individual interventions is essential for examining progress in this field of study. Authorities at the Tabriz University of Medical Science (TUOMS) proposed a research training program targeting a rise in residents’ scholarly activity and publications; this study aimed to evaluate the program and share the findings and experiences. Methods: Questionnaires were sent to 182 residents and the heads of all clinical departments. Evaluators used Kirkpatrick’ s four-level model and Stufflebeam’ s Context, Input, Process and Product model for data gathering and analyzing. Focus group discussions (FGDs) and in-depth semi-structured interviews were done with faculty members, executive staff, and residents to complement the survey results. Data were summarized and categorized using quantitative and qualitative analysis. Results: The participation rate for residents and heads of departments were 76 (41. 7%) and 14 (70%), respectively. At the end of the course, residents assessed their knowledge and research skills as weak or medium in most of the subjects. A total of 182 (100 %) residents prepared thesis proposals. Only 82 (49. 1%) residents completed their thesis, and 19 (11. 3%) published papers. Generally, participants were not satisfied with the course. Barriers noted were: mandatory topics for theses, an intensive course with a one-month duration, a lack of consideration of practical subjects, high cost of the course, and failure to achieve an increase in publications. Conclusion: The self-assessment results of increased knowledge and research skills did not indicate improvement. Mandatory participation in the course did not result in the expected publication increase.