Iranian Journal of Medical Education
Year:2006 | Volume:6 | Issue:2 (16)|Papers Count:28

Introduction: Nursing education has to be planned considering the community’s health needs based on the most recent criteria introduced by World Health Organization. The purpose of this study was to determine whether nursing curriculum conform to the burden of diseases as Disability Adjusted Life Years in Iran in 2003. Methods: In this comparative study, the etiology of burden of diseases based on Disability Adjusted Life Years was extracted from the World Health Report (2003). Then the number of credit hours in the baccalaureate nursing curriculum assigned to these etiologies was determined and reported as frequency. Results: The proportion of credit hours in nursing curriculum assigned to psychiatric, cardiovascular, respiratory, gastrointestinal and sensory disorders as well as intentional and non-intentional accidents, nutritional deficiencies, and congenital anomalies was less than the proportion of burden of diseases as Disability Adjusted Life Years related to these diseases. This proportion was more than optimum level concerning infectious diseases, maternal and antenatal problems, endocrine, genitourinary and dermatologic diseases, and at an optimum level for musculoskeletal disorders and malignant neoplasms. Conclusion: A more precise revision of baccalaureate nursing curriculum considering the above mentioned diseases is recommended.

Introduction: At the end of their education, nursing students have to acquire the minimum capabilities, essential for their professional job. The aim of this study was to determine the achievement of minimum learning requirements by midwifery students in School of Nursing and Midwifery of Isfahan University of Medical Sciences. Methods: A descriptive study as an educational evaluation based on CIPP (Context, Input, Process, and Product) model was performed. The study sample included 36 midwifery students from two educational periods who were prepared for their final practical exam. Data collection tool was a questionnaire which was developed through Delphi technique using experts’ views. The questionnaire assessed 12 courses including 61 units by asking about watching, listening, reading, and experiencing some tasks as well as their capability in doing those tasks. The data was analyzed by SPSS software as frequency distribution. Results: More than 90% of the courses were taught according to the outline approved by Cultural Revolution Committee. Concerning clinical education, the students did not have enough experience in uncommon cases such as breech delivery, using forceps and women’s cancer. In some cases such as neonate resuscitation, the student had no experience at all. Conclusion: In some cases, the students did not have enough experience in gaining the needed skills. It is suggested that teachers use new and active methods of teaching and take advantage of film, moulage and other audio-visual equipments for teaching unique cases.

Introduction: A Girl’s attitude towards menstruation has an important role in her future social compatibi-lity, and also her role as a mother and wife. The aim of this research was to compare three educational methods including training adolescents’ parents, adolescents via pamphlet and adolescents via discussion, in order to change their negative attitudes toward menstruation. Methods: This quasi-experimental study was performed on 256 high school girls aged between 12-14 years, in intermediate schools of Isfahan in 2004. Two intermediate schools from different districts of board of education were randomly selected for each educational method. The pre-test was administered before, and the post-test after the training. A 40 item questionnaire using 5 point Likert scale, measured their attitude. Paired t-test, ANOVA and ANCOVA were used for data analysis by SPSS software. Results: There was a significant difference between mean scores of pre and post- test in discussion group and parent education group but not in education via pamphlet. Discussion was the most efficient method among these three educational methods. Conclusion: Discussion method is the best way to improve the girls’ attitude towards menstruation. Parent education is also a useful method. But, educating by pamphlet which is the most used method has less efficiency. 

Introduction: In order to enhance e-learning, the first online educational course for teaching Medline, was established in Isfahan University of Medical Sciences. This study was designed to compare the effectiveness of online, face to face and combined educational methods presented for medical students. Methods: In an experimental study, Medline was taught to 40 medical students by three methods of online, face to face and combined educational methods and then, their knowledge, skills and satisfaction rate were measured and compared. The data collection tools included a questionnaire consisted of 10 multiple choice questions for measuring knowledge, a checklist for assessing participants’ skills in searching strategies, the appropriateness of the found articles for the subject and the time length for searching, and a ten item questionnaire with five point Likert scale for measuring their satisfaction. The data was analyzed by chi2, t-test, ANOVA and Kruskal–Wallis through SPSS software. Results: The mean and standard deviation of students’ knowledge in face to face, online and combined educational methods were 75 ±16, 70 ± 21 and 82.2±13 out of 100, respectively. The mean and standard deviation of their skills in face to face, online and combined educational methods were 76.9±25, 70±24 and 90.7±11 out of 100, respectively. There was no significant difference between the scores of knowledge and skills of the three groups. Also, students' satisfaction showed no significant difference in the three groups. Conclusion: It seems that, for expanding E-learning, a combination of online and face to face guidance can possibly have an acceptable effectiveness. Meanwhile, for achieving such combined method, the appropriate ground, containing related hardware and software must be provided in universities.

Introduction: In nursing schools, lecture is usually used as the main teaching method. Cooperative learning is one of the common educational techniques. This study was conducted to compare the effect of Team Member Teaching Design (TMTD) versus lecture combined with question and answer, on nursing students' achievements. Methods: This pre-experimental study with two groups, pre and post-test design, was performed in Nursing School of Tabriz University of Medical Sciences in 2004-2005. All nursing students who were in their second semester including 27 students from day courses and 20 from night courses participated in the study. Some sections of community health course were taught to two groups, one using TMTD technique and the other lecture combined with asking question. Students’ achievements were measured by pre and post-test. SPSS software was used for data analysis and the groups were compared by paired t-test and independent t-test. Results: The mean and standard deviation of students’ scores in TMTD and lecture combined with question and answer groups were 13±2.5 and 14.44±3.2 out of the total score 22, respectively. Although the students’ scores of both groups significantly increased in post-test, the scores of combined method group were significantly more than TMTD group. Conclusion: Lecture combined with question and answer compared with TMTD, was more effective on students’ achievements, but TMTD as an active teaching method had positive effects on students’ learning as well. It is recommended to use both methods in teaching.

Introduction: In order to adjust medical students’ education with their professional needs, the educational managers in Isfahan Medical University decided to design a specific course for teaching Emergency Medicine. This study was done to determine the viewpoints of experts concerning minimum educational needs in emergency departments during general medical education. Methods: This cross-sectional study was performed in Medical University of Isfahan in 2003. The data was collected through three phases. In the first phase, the viewpoints of 30 interns, residents and general practitioners about minimum educational needs in emergency departments were gathered using open ended questions. Then a questionnaire was developed based on the results to be used in the second phase in which the viewpoints of 30 residents, faculty members and general practitioners were asked in order to delete unrelated topics. In the third phase, experts were invited and requested to discuss about each topic and choose the final topics according to the statistical results. The data was analyzed by SPSS software using mean and frequency. Results: During the first phase, 431 topics in 13 groups were defined. In the second phase, 132 topics were omitted, 146 were accepted, and 153 were remained to be taught in professional subgroups. Then, based on two introduced criteria the score of each topic was determined and the topics were ranked according to these scores. Abdominal emergencies and traumas had the most topics among all topics. Conclusion: The results of this study can be used as a base for designing a proper educational program. These minimum learning requirements for internal and surgical emergency wards can help in educational and managerial decision making.

Introduction: Medical students might face numerous problems during their educational period which makes them to seek proper ways for solving them. The aim of this study was to determine medical students’ viewpoints about the problems during their educational period and proper reference for solving them in Isfahan University of Medical Sciences. Methods: In this descriptive cross-sectional study, 400 medical students studying in 4 levels of basic sciences, introduction to clinical medicine, clerkship and internship, were selected randomly. The information was gathered through a researcher-made questionnaire including 16 questions about the problems of educational services, as well as psychological, personal, family, financial and welfare problems. The questionnaire also asked about the most appropriate reference for solving students’ problems. The data was analyzed by SPSS software using descriptive statistics and Chi2. Results: The frequency of psychological, financial-welfare, personal-family, and educational services problems were 43.7%, 30.8%, 30.2% and 29%, respectively. In educational services problems, the frequency of educational failure was 47.1% and of motivation decrease was 56.9%. Most students referred to personal experience for solving their problems. They also considered family as the most appropriate source for their financial-welfare and personal-family problems, and personal experience for their educational and psychological problems. Conclusion: The problems are very common in the course of study and need an organized counseling system in which faculty members act as the core and there is constant interaction with families. 

Introduction: The effect of educational interventions concerning the use of Evidence Based Medicine (EBM) on post graduate medical students has been assessed in many studies. But, there are few studies concerning these interventions in undergraduate medical education. This study was performed to determine the effect of an EBM workshop on under graduate medical students' skill in using EBM. Methods: In a pre-experimental study, 24 forth and fifth year medical students who had passed their internal medicine and surgery wards were selected through convenience sampling. A three session workshop about EBM, each session lasting for five hours was held for them. Students' attitude towards workshop was assessed using a questionnaire with Likert scale. Also, their abilities in formulating a clinical question and using effective search strategies were measured using pre-test/post-test and check list, respectively. Wilcoxon test was performed in order to compare pre and post tests by SPSS software. Results: Students had 23 mistakes in pre-test and 8 in post test, out of 40 questions about designing clinical question which showed a significant difference. The students’ score in search strategies was 40 in pretest and 100 in post test out of the total score 100, which had increased significantly. In general, the students’ attitude towards workshop was positive. Conclusion: This intervention improved clinical question development, and searching strategies. The students’ attitude was positive in total. More studies are recommended to assess the effects of early interventions such as workshop, on students, interns and residents.

Introduction: Good communication between doctor and patient is one of the fundamental skills which can lead to getting adequate information from the patient, correct diagnosis, gaining patients’ trust, and at the end, proper care and treatment. The aim of this study was to investigate interns’ communication with patients from the observer and patient’s view. Methods: In this cross-sectional study performed in 2004, the communication skill of 72 interns of Kerman Medical University, during interview with patients was studied. The research tools included a checklist filled through direct observation and a questionnaire which was completed through interview with patient. The data was analyzed by descriptive statistics, Spearman and Kappa coefficients using SPSS software. Results: In total, the performance of interns in communicating with patient during history taking was at an intermediate level, from both the observer and patients’ views. Also, according to their views, the most areas of deficit were at the end, during conducting and beginning of the interview, respectively. In most parts, there was no agreement between observer’s and patient’s views. With increasing patients’ age, the scores given to interns’ communication skills increased significantly. Conclusion: There are some deficiencies in interns’ communication skills during history taking. Considering the importance of communication skills, teaching them in Clinical Skills Learning Center before confronting real patients is necessary. It is recommended to perform interventional studies in order to find proper content and teaching methods for the education of communication skills. 

Introduction: Hypertension can accelerate other complications of diabetes mellitus, particularly cardiovas-cular disease and nephropathy. This study was carried out in order to determine the effect of applying Continuous Care Model on diabetic patients’ blood pressure. Methods: This clinical trial was performed as time series on 74 patients with diabetes mellitus type II, in Orumieh in the years 2003-2004. After matching the study variables, the patients were divided equally and with random allocation to two experiment and control groups. The Continuous Care Model which included 4 main steps of orientation, sensitization, performing and evaluation was performed for the experiment group through 10 sessions of education concerning self care in diabetes, each session lasting for 2 hours. The blood pressure of both groups was measured at the beginning and every month, for three times. The data was analyzed by SPSS software using repeated measure ANOVA. Results: There wasn’t any difference between the mean of systolic blood pressure in both study groups, but comparing the mean of diastolic blood pressure of the two groups showed a significant difference. Conclusion: Applying Continuous Care Model can reduce diastolic blood pressure in type 2 diabetic patients. Therefore, it is recommended to use this model on diabetic patients in order to control diabetes complications.

Introduction: The instructors’ clinical teaching behaviors need to be monitored and improved during educational process. The purpose of this study was to determine the effect of a three day educational workshop about clinical teaching and evaluation on effective clinical teaching behaviors of clinical instructors at faculty of Nursing and Midwifery in Shiraz. Methods: All clinical nursing instructor who had been involved in clinical teaching at least for four months (n=39), participated in this quasi-experimental research with two group post-test only design. They were divided randomly into two experiment (n=19) and control (n=20) groups. The experiment group participated in a pre-planned three day educational workshop about clinical teaching and evaluation. Two months later, all of the students who were involved in clinical experiences (n=588) were asked to evaluate their clinical teachers using a questionnaire consisting of 21 items about effective clinical teaching behaviors. The mean scores for teaching behaviors were compared by independent t-test using SPSS software. Results: The mean scores of the experiment group were significantly higher than the control group. Furthermore, the experiment group significantly differed from the control group in six educational behaviors including conducting effective clinical conferences, providing positive feedback and reinforcement, encouraging students to think, analyzing and rational criticizing, being flexible, facilitating students’ self-evaluation, and asking stimulating questions. But no significant difference was observed in other 15 educational behaviors. Conclusion: Participation in clinical education workshop had a positive effect on instructors’ effective clinical teaching behaviors, and made them to apply some educational principles. To improve other effective clinical teaching behaviors, program organizers and directors should provide appropriate situations in order to facilitate the application of instructors’ knowledge and skills in clinical teaching.

Introduction: Most of previous studies have focused on factors affecting learning during nursing educational program, and a few researches have been conducted on students’ achievements. The present research aimed to determine nursing students’ and instructors’ viewpoints regarding the level of skills gained by students during internship in Tabriz University of Medical Sciences. Methods: In this descriptive study conducted in 2003, 74 bachelor nursing students attending internship program and 33 instructors were selected using census method of sampling. A researcher made questionnaire with five point Likert scale and including 96 questions was distributed as self-administered. The questionnaire covered a variety of dimensions such as providing services for patients, patient care, patient safety, management skills, quality improvement, and patient education. The data was analyzed by SPSS software using frequency distribution, and Chi2. Results: The achieved professional abilities in all dimensions were not satisfactory. There was a significant difference between students’ and instructors’ viewpoints, on the level of professional skills in patients’ services, patient care, management skills, quality improvement, and patient education. Conclusion: Students’ professional abilities during internship program were not optimum. The gap is probably due to the absence of good, supportive and incentive environment, or due to the lack of appropriate stewardship and management mechanisms.

Introduction: Developing a fair and organized evaluation system with faculty members’ own participation, could lead to faculty members’ more satisfaction with evaluation. The goal of this study was to determine the effects of a participatory model of evaluation on faculty members’ perspective toward this model. Methods: In this pre-experimental study as one shot case study, 55 faculty members from School of Medicine were selected randomly. They were provided with a database through designed software by which they could make their own evaluation forms. Then, their viewpoints toward this intervention were asked using a 21 item questionnaire with Likert scale. The data was analyzed by SPSS software, 11.5 edition using mean, standard deviation and also t-test, ANOVA and Pearson correlation coefficient. Results: Eighty four percent of the selected sample participated in the study and designed their individualized questionnaires. The mean and standard deviation of faculty members’ viewpoints towards this model were 4.02±.5 out of the total score 5. The most scores belonged to faculty members’ viewpoints about a sense of participation and satisfaction from the presented model. Conclusion: It seems that using this model which requires faculty members’ most cooperation in the evaluation process can help to reduce their resistance against evaluation, increase their satisfaction and improve their responses towards evaluation feedback.

Introduction: Different evaluation methods have been introduced for evaluating clinical skills. Using checklist and logbook are common methods in clinical units. The purpose of this study was to compare logbook and checklist as the means for evaluating midwifery students in labor and delivery training. Methods: This pre-experimental study was performed in Hazrat Zaynab Nursing and Midwifery School affiliated to Gilan University of Medical Sciences in the first semester of 2005. The study sample included all midwifery senior students (n=21). In order to record students’ daily scores, the students and their instructors were provided with a logbook including all the skills they were supposed to acquire. The instructors checked all students’ activities using a checklist at the end of semester, while at the same time, the instructors and students had to evaluate and mark any daily activity, using the logbook. The data was analyzed by SPSS software using frequency distribution, mean, standard deviation and t-test. Results: The mean and standard deviation of the scores recorded using the logbook and checklist were 16.33±.77 and 17.88±.41, respectively, which had a significant difference. At the beginning, all students were completely satisfied with the new method of evaluation, but after receiving the results, their satisfaction rate decreased to 85.71%. The students had significantly more satisfaction with logbook. Conclusion: Using logbook provided a more objective evaluation and led to more students’ satisfaction. However, using logbook requires more studies and revisions in other university centers. 

Introduction: The continuous examination of the current situation, and recognizing the strengths and improving the weaknesses are necessary for promoting the quality of clinical education. This study was designed to determine the problems of clinical education from the viewpoints of nursing and midwifery students of Shahrekord University of Medical Sciences. Methods: In this descriptive study performed in 2004-2005, all bachelor nursing and midwifery students who were in their last semester (n=133) were asked to complete a 36 item questionnaire as self-administered. The data was analyzed by SPSS software using frequency distribution. Results: The most important strength of clinical education were proper encounter with trainees, on time presence of trainees and trainers, respecting the pre-requisite courses, respecting the stages of clinical education, full support of trainees, and complete supervision over clinical education. The weaknesses included not using audiovisual aids, lack of welfare facilities, not evaluating trainers by the students, and lack of coordination between theory and practice. Conclusion: Most subjects concerning educational objectives and trainers were confirmed while the situation of educational environment, supervising and evaluation were not optimal. There were also some problems in encountering with students. It is recommended to improve the facilities and equipments of clinical education and revise the evaluation tools and process.

Introduction: Identifying effective factors in learning is one of the important issues considered by researchers. The aim of this study was to determine nursing and midwifery students’ learning styles in Tabriz University of Medical Sciences. Methods: In a descriptive study performed in 2005, 250 nursing and midwifery students were selected by census sampling method. The research tool was David A. Kolb's Learning Style Inventory including 12 questions which was distributed and collected as group administered. The analysis of data based on LSI guide was done by SPSS. Results: The majority of nursing and midwifery students were converger (54.2%). Also, 32.1, 7.5 and 6.2 percent of them were assimilator, accommodator, and diverger, respectively. Conclusion: Considering the use of converger and assimilator learning styles among students, it is recommended that faculty members use visual methods, diagrams, teacher’s handouts, lecture and self-learning methods.