Iranian Journal of Medical Education
Year:2012 | Volume:12 | Issue:1 (39)|Papers Count:14

Introduction: Lesson plan is one of the key factors in the education process. The main purpose of lesson plan is to facilitate teaching and learning by establishing a good communication platform. This study performed a content analysis of the lesson plans developed by faculty members of Ilam University of Medical Sciences.Methods: In this cross – sectional study, all 108 lesson plans developed by the faculty of Ilam University of Medical Sciences in the first and second semesters in 2009 were analyzed. The data was collected by a checklist covering 13 dimensions. Data analysis was done using t-test, and ANOVA.Results: Maximum and minimum ratios of the lesson plans belonged to schools of health (43.5%) and medicine (12%), respectively. The total average score of evaluation of the lesson plans developed was 67.94±16.57 (out of 100). The most common mistakes were related to objectives (45.4%), and evaluation methods (25.9%). The greatest shortcomings were related to dimensions of general and class regulations and policies (58.3%), preparation of learners before class sessions (55.6%), and assignments (40.7%). The dimensions of objectives in the lesson plans (89.9%), teaching methods (82.4%), and references recommended (82.4%) gained the highest scores. There was a significant relationship between faculty members’ academic ranks and evaluation scores of their lesson plans (p=0.03, CI95%=0.6-16.0).Conclusion: Based on the findings of the study, holding lesson plan workshops and using a standardized lesson plan templates could provide an appropriate basis for developing better lesson plans by the faculty.

Introduction: Oral anticoagulant therapies are intended for prevention of thrombotic adverse effects and to maintain the level of drug without bleeding. The probability of risk highly depends on the patient compliance after discharge from hospital. This study was designed to compare the effect of group and individual education on patients’ compliance and incidence of adverse effects of warfarin after cardiac valve replacement surgery.Methods: In this quasi experimental study, 76 inpatients older than 18 years, undergone valve replacement surgery in cardiovascular ward of Shaheed Rajaei Heart Center who met the inclusion criteria were selected randomly. After informed consent, they were randomly allocated to intervention or control groups. The patients in control group received individual education (the regular method) and intervention group was instructed in groups for three sessions each having one week interval. Up to six months, the results of the lab tests (PT, PTT, INR), the number of carried out lab tests, time interval between tests, and the incidence of complications were recorded, and finally compared statistically between the groups.Results: Comparing the compliance to therapy for two groups after six months, a significant difference was noticed (p=0.03). As 88.2% of intervention group vs. 61.2% in control groups had carried out their lab tests completely (p=0.02). Result of lab tests reported abnormal PT and INR in only 2 cases (5.9%) among patients of intervention group while 59.1% of patients in control group had the experience of once or more abnormal results (P=0.00). Three cases of deaths, two cases of hospitalization, and two cases of blood transfusions were reported in control group while none of the above was observed in the intervention group.Conclusion: Group education leads to the improvement of adherence to therapy which results in reduction of mortality among warfarin consumers after valve replacement surgery. Therefore it is highly recommended to nursing administrators to establish education units in hospital and conduct group education sessions for patients to reduce their problems. Simultaneously this leads to the reduction of hospital charges as well as financial and emotional loads on patients.

Introduction: Diabetes Prevention and Control has become among the nation's health system priorities in recent decade. Meanwhile, educational programs for executives have been designed and implemented. Tha aim of this study was to describe the situation of training of general practitioners who care diabetiv patients under National Diabetes Prevention and Control Program.Methods: This study is a qualitative content analysis (the conventional type). Data gathering was done through unstructured interviews with eight of diabetes management planners in the Ministry of Health and Medical Education as well as officials of the health system in Isfahan, and six general practitioners working in diabetes centers in Isfahan province. Observations and several field notes as well as existing records, documents, and technical notes were other sources of data collection. After manuscript analysis, meaning units, codes, categories, and key themes were achieved. The strategies for results validation included triangulation of data collection sources and methods, continuous observations in the field, and supervision and review of the analysis process by research team.Results: Three major themes and six sub-themes were emerged through qualitative data analysis. Major themes were (1) unstructured education including sub-themes of lack of continuous primary training among freshmen and lack of retraining for physicians; (2) inadequate physician's competence including sub-themes of inadequate knowledge, and lack of success in earning patients and colleagues' trust; (3) barriers to effective education including sub-themes of planning-related challenges, inadequate supervision on physician training process.Conclusion: Despite the importance of physician roles in diabetes management in health care centers, findings showed their education is faced with significant shortcomings.

Introduction: Multiple choice exams are one of the most common objective exams used in medical education. So, it is important to find ways to improve the quality of these exams, especially in residency programs. Thus the aim of this study was to investigate the effect of education on quality improvement of Multiple Choice Questions (MSQ) designed in Annual Residency Exams of Dental Faculty.Methods: In this experimental study, the structure and taxonomy in all MCQs designed by dental faculty for annual residency exams in 2008 were analyzed through valid and reliable checklist. Checklist items were based on Millman’s principles and several other resources. The same process was repeated for MCQs after running a workshop for question designers. The pre- and post- workshop data were compared using Z test.Results: From 1239 questions, 63.1% and 76.3% of the questions developed in 2008 and 2009 had no structural flaw, which revealed a significant difference between the two years (P<0.001). Regarding high taxonomy questions, a significant increase was observed in the year 2009 (P=0.039).Conclusion: Considering the results of this study, designing and running training workshop for question designers improved quality of MCQs and these workshops can lead to improvement of MCQ exams in other universities.

Introduction: Society needs are constantly changing. As a result, it seems to be necessary to make changes in education as well. The viewpoints of faculty members as the educators and the most authentic group involved in medical education system are of significant influence. This study was conducted to investigate the determinants of effective teaching from non-clinical teachers' viewpoint in Kurdistan University of Medical Sciences.Methods: In this descriptive cross-sectional study, the entire 72 non-clinical teachers in academic year 2009 were selected for investigation. Data collection tool was a questionnaire made by researcher which was validated and reliable. Faculties’ viewpoints toward determinants of effective teaching were collected via this questionnaire. After completion of the questionnaire, data was codified and analyzed using descriptive statistics.Results: Nonclinical teachers believed that: having scientific capability (97.2%), public speaking competency (97.2%), communication skills (95.9%), the capability to develop critical thinking in the students (91.6%), professional degree (88.8%), and the ability to motivate students for problem solving (84.7%) are respectively the most important factors determining effective teaching. Meanwhile, 68.1% of the respondents believed that the teacher’s research activity is considered significant in his educational success.Conclusion: The results of the study revealed that several factors may influence the effective teaching of non-clinical teachers. Considering these factors at the time of planning and running training workshops for teachers may help these programs to be more effective and successful. Our results may also emphasize on the necessity of including courses like the principles and methods of teaching in the curricula of master and PhD programs.

Introduction: Distinguished work force is a major factor for growth and development of all countries and training programs should be designed based on their needs. Interviews with students provide an insight into the challenges of learning environment. This study investigated the educational problems from the viewpoint of talented students of Shahid Sadoughi University of Medical Sciences.Methods: In this qualitative study, 55 talented university students expressed their educational problems during three focus group sessions. At the end of each session, the data were classified and organized and findings were sorted, categorized and tabulated, based on the frequency of statements in group discussions.Results: Most problems were related to the areas of educational objectives, planning, and management. The main reported problems were inclusion of a number of unnecessary content materials in the syllabi, low emphasis on research, unrealistic teacher evaluations, and inharmonious educational departments.Conclusion: Except for a few problems such as changing some parts of curricula that must be resolved at country level, there are many less important problems that influence the effectiveness of the educational outcomes. These problems do not need much effort to eradicate, as more cooperation of teachers, students, and managers can remove them.

Introduction: Problem solving is an important skill for living in nowadays world. Due to their professional responsibility and occupation in a complicated therapeutic environment, nurses should be skillful enough for problem solving in order to handle them. Therefore, this study was performed to determine the effect of problem solving course on nursing students' emotional intelligence of Shiraz University of Medical Sciences in year 2008.Methods: This quasi-experimental study was performed on 43 senior nursing students of Shiraz University of Medical Sciences. Primarily students were asked to complete questionnaires of demographic data and “Bar-On" test for emotional intelligence evaluation. Then, they were randomly divided into two groups of experimental (N=20) and control (N=23). Six sessions of problem solving course based on D'zurilla and Goldfride social problem solving protocol, was performed for students of experimental group. Emotional intelligence assessment repeated for both groups immediately and 2 months after training. Data was analyzed through statistical tests of Mann Whitney, Wilcoxon, Repeated Measure ANOVA, and Pearson correlation Coefficient.Results: Standardization of emotional intelligence scores among students of experiment group showed a statistically significant difference for these scores achieved immediately (105.87±9.82) and 2 months after intervention (109.44±9.56) compared to the one before (101.22±10.93) intervention (p<0.01). The mean score of problem solving skill among students of experiment group showed also a statistically significant difference comparing the scores achieved immediately after intervention (8.31±77.75) and 2 months after that (8.00±78.75) to that of before intervention (11.95±71.35) (p<0.01). This is while control group showed no statistically significant difference considering these variables. Only 20 percent of students enjoyed a high emotional intelligence before intervention, while this increased to 40 percent of high intelligence and 10 percent of very high emotional intelligence 2 months after intervention.Conclusion: Problem solving skills lead to promotion of emotional intelligence among students of experiment group compared to control group. This result was stable not only immediately after intervention but also after two months. Therefore problem solving education in various nursing domains such as education, research, management and clinic, is recommended.

Introduction: A pleasing communication and interaction between physician and patient can be effective in patients’ satisfaction, treatment outcome, medical charges, clinical services quality, and even claim against physicians. This study was performed to evaluate patients’ satisfaction with physicians’ manners with them in Ghods Clinic of Tehran in year 2010.Methods: Totally 392 patients were surveyed in this descriptive cross-sectional study. Satisfaction among patients referred to Ghods Clinic (affiliated to Social Insurance Organization) of Tehran in year 2010 was measured considering several aspects including physicians’ behavior, physical examination and interview, communication and instruction to the patient, follow-up, responsibility to questions, and giving information. These data was gathered using Patient Satisfaction Questionnaire and the effect of variables such as gender, marital status, job, and academic level on satisfaction score was investigated. Data was analyzed using T test, ANOVA, and Pearson correlation coefficient.Results: The highest satisfaction scores were obtained from physicians’ instruction (mean: 55.8±24.1) and answering to questions (mean: 49.2±6.58) and the lowest was from physical examination skills (mean: 31.25±22.76). Satisfaction mean score among patients with a higher level of education (p=0.002), was more than others. Also, patients who were government employee, compared to business people, had higher satisfaction scores (p=0.006).Conclusion: It seems that the physicians should try more to satisfy people with lower educational levels and different social positions by spending more time and employing appropriate communication skills. Education and emphasis on improvement of these skills leads to promotion in health services.

Introduction: Studies indicate that using interventions including education may improve medical record documentation and decrease incomplete files. Since, physicians play a crucial role in medical record documentation, the researchers aimed to examine the effect of educational intervention on observing principles of medical diagnosis recording among residents in Kashan University of Medical Sciences.Methods: This quasi-experimental study was conducted in 2010 on 19 specialty residents (from internal medicine, obstetrics and gynecology, and surgery) in Kashan University. During a 5-hour workshop, guidelines for recording diagnostic information related to surgery, obstetrics and internal medicine were taught. Before and after the intervention, five medical records from each resident were assessed using a checklist which was designed based on diagnostic information related to each discipline. Data were analyzed through paired t and Wilkoxson test.Results: There was no improvement in recording obstetric diagnoses (type of delivery, place of delivery, outcome of delivery, complication of delivery) after the training. Also training did not have any effect on documentation of underlying cause and clinical manifestations of diseases by internal medicine residents and surgery residents (P=0.285 and P=0.584).Conclusion: Administering an educational intervention alone did not improve recording of diagnosis among residents. It seems that to have complete, accurate and high quality medical recording requires interaction we should consider other solutions, including three main key components, namely, management, health information management professionals and health care providers. Therefore, developing such an interaction is recommended.