Iranian Journal of Medical Education
Year:2011 | Volume:11 | Issue:5 (34)|Papers Count:19

Introduction: Pronouncing bad news is one of the most difficult duties of a physician. Lack of education in this field may negatively affect physician-patient relationship. These skills are not taught in our country vastly and effectively. The aim of this study was to assess knowledge and attitude of clinical teachers, family physicians and interns of Jahrom University of Medical Science about giving bad news.Methods: This study was conducted among a census sample of 40 clinical teachers, 22 family physicians, and 30 interns in 2009 in Jahrom University of Medical Sciences. A questionnaire was designed by the researcher, then its validity and reliability was determined. Data was analyzed by SPSS software using ANOVA and independent T test.Results: The average scores of knowledge and attitude were 15.96 (out of 25) and 34.43 (out of 52) among faculty members, 16.72 and 35.22 among family physicians, and 15.26 and 33.43 among interns group. Knowledge level in all 3 groups was medium and their attitudes toward training in these skills were positive. No significant difference was found between knowledge and attitude of these 3 groups (respectively: p=0.095 and p=0.548).Conclusion: According to the result of this study and considering the fact that these skills are currently learnt through inactive methods and via try & error technique, there is a real need for developing planned courses in Iranian medical universities.

Introduction: Community-Oriented Medical Education (COME) emphasizes on medical education based on community health needs. Medical teachers need to possess good knowledge of COME and also should have a positive attitude toward it and be able to successfully perform it. The aim of this study is investigating knowledge, attitude and performance of professors regarding COME.Methods: It is a cross-sectional study with non-random sampling conducted with a questionnaire after a pilot study in the educational year 2009-2010. We sent the questionnaires to educational hospitals for professors of medical school in Mashhad University of Medical Sciences. After collecting the questionnaires, data were analyzed using Student T and Pearson Correlation tests by SPSS 11.5 (p<0.05).Results: Out of 100 academic members, 37 (37%) were highly knowledgeable, 60 (60%) had an absolutely positive attitude and 53 (53%) had very good or good performances in community- oriented medical education. There also was a statistically significant correlation between knowledge, performance, and the academic rank.Conclusion: The attitude, knowledge, and performance of medical faculty members in Mashhad Medical Schools were satisfactory regarding community-oriented medical education. It may be suggested to run educational courses and plan managerial measures to raise knowledge, cultivate a more positive attitude, and improve performance of the academic members.

Introduction: With regard to the importance of students’ perspectives in the evaluation of Clinical Learning Environment (CLE), this study was performed to determine and analyze the differences in the perceptions of nursing students about actual and preferential CLE.Methods: In this analytic cross-sectional study, at the end of each clinical rotation, these 110 nursing students completed the actual and preferential versions of CLEI (Clinical Learning Environment Inventory). Three hundred forty actual forms and 110 preferential forms were completed. T-test was employed to analyze data.Results: The total score of preferential forms was higher than that of actual ones revealing a statistically significant difference. The highest and lowest mean scores for actual perspective version belonged to task orientation (21.01) and teaching innovation (13.33) respectively. The results indicated that satisfaction (25.82) and personalization (22.81) scored respectively, the highest and lowest mean in preferred form of CLEI.Conclusion: The outcome demonstrated that compared to the actual hospital environment, students prefer an environment enjoying higher levels of innovation in teaching and learning strategies, satisfaction, task orientation, interpersonal relationship, individualization, and involvement.

Introduction: Dentistry educational environment loads stress to the students.This can be harmful for educational system. The aim of this study was to investigate the stress perceived by the students in dentistry educational environment and the stress due to students' personality in Rafsanjan Dentistry School.Methods: In this cross- sectional study, the sample was selected from students of Refsanjan Dentistry school by census sampling in 2009. The Dental Environment Stress (DES) questionnaire was employed to assess perceived stress from dentistry environment, and the fourth part of Coudron stress questionnaire was used to investigate the stress due to students’ personality. Data were analyzed by ANOVA, Tukey post Hoc, T-test and Pearson's rank correlation.Results: Mean score of stress was 1.89±0.54 (out of 4). The highest and the lowest perceived stress means were for the third (2.53±0.25) and the first year students (1.54±0.29) respectively. Among stressful domains, clinical work (2.39±0.83) and personal factors (1.06±0.53) had the highest and the lowest means, respectively. The highest stress mean was for completing clinical requirements (2.95± 1.06). There was no significant difference in environmental perceived stress between male and female students (P>0.05). Stressful personality was seen in 84.8% of students .There was no association between the means of DES and the students' stressful personality (r=0.17, P=0.05).Conclusion: The level of stress in Dentistry school is moderate with the highest level for clinical work. Although majority of dentistry students have stressful personality, it doesn't seem to increase the stress perceived by them due to dentistry environment. According to the highest level of stress in third year students, special interventions are recommended for this critical study year.

Introduction: Several approaches are introduced to facilitate anatomy learning. One of them is to present practical course before the theoretical one. This study compared the effect of presentation of practical class before lecture on enhancement of learning among dental students of Babol University of Medical Sciences.Methods: Thirty eight students of first semester in school of dentistry of Babol University of Medical Sciences, whom were admitted in year 2009, were randomly divided into three groups to pass the course of Head and Neck anatomy. One group (N=13) received new method of education and 2 groups (N=13 &N=12) were taught using traditional method. Having the instruction finished the midterm examination was held for the three groups. After midterm examination, both groups were instructed using traditional method. Midterm examination scores achieved by experiment and control groups were compared. At the end of the semester, students of experiment group were given a questionnaire containing attitude questions in order to assess their attitude toward traditional and new method of education in comparison and considering their role in facilitating learning of anatomy. Data was analyzed using descriptive statistics and paired t test.Results: There was no statistically significant difference between the mean of midterm scores achieved by experiment and control groups (P<0.05). Assessing students’ viewpoints toward the two educational approaches, showed that they believed presentation of practical course before the lecture leads to a better feeling (69.2%) about anatomy course, facilitates and deepens the understanding (92.3%), and results in more learning (84.6%) as well.Conclusion: Based on the results of current study, despite of no significant differences between mean scores of students taught via two different methods, students showed a better attitude toward the presentation of practical course before the lecture compared to traditional method. Therefore it may be suggested to present practical course for anatomy before the lecture.

Introduction: Inappropriate performance of delivery care team is one of the most important causes of maternal mortality. Lack of objective tools, reduces the opportunity for a systematic valid evaluation in clinical examinations. Therefore, this study investigated the reliability and validity of assessment tools in comprehensive final examination of midwifery students at the end of their education (at the time of graduation).Methods: In this correlational study, founded on existing evaluation tools for final comprehensive exam in Mashhad School of Nursing and Midwifery, students’ skills in 4 areas of examination (delivery room, gynecological unit, pregnancy care, and maternal and child’s health) were assessed (July 2010). Thirty one students (22 students of 8th and 9 students of 6th semester of midwifery BSc program) were evaluated within 5 consecutive days by 2 examiners. Content validity was determined by field experts. Mean scores achieved in each area of examination were compared in order to appraise construct validity as well as total mean score of students of senior and junior semesters (8 and 6). Alpha Cronbach coefficient was used for reliability analysis.Results: A significant difference of 26 percent between total mean score of students studying at 8th semester with that of students studying at 6th semester in comprehensive final examination, proved the construct validity in evaluation forms of midwifery students based on Royal College of Gynecology and Midwifery Definition in this examination (p=0.01). There was an average to high Cronbach’s Alpha coefficient (0.83 -0.51) in each area of examination which reveals an internal consistency within the evaluation tools. Content validity was also high (0.8). The lowest and highest reliability of evaluators determined to be 0.82% and 73.5% respectively, according to definitions characterized by Cincinnati University.Conclusion: The tools used for evaluating midwifery students at the final examination in Mashhad School of Nursing and Midwifery met reliability and construct validity criteria and are recommended to be used for evaluationg midwifery students for graduation.

Introduction: Continuous evaluation of Islamic Thoughts courses and revising the course delivery methods are necessary to make the courses more efficient to meet the needs of the youth, and to transmit the Islamic values to the students. Due to the necessity of curriculum evaluation, this study aimed at determining the students’ attitude about the Islamic Thought courses.Methods: In a descriptive study, the population of students studying in Mazandaran University of Medical Sciences in 2008-2009 was involved. Through census sampling, 549 students who had enrolled in Islamic Thoughts courses I and II, took part in the study and filled out a researcher made questionnaire. To analyze the data, in addition to descriptive statistics, chi-square, Kruskal Wallis, and Mann-Whitney U tests were employed to compare subjects’ viewpoints based on qualitative variables (nominative and ordinal).Results: The mean age of participants was 20.79±2.59, and 68.9% (378) of the subjects were female. Findings indicated that 87.3% (479) of the students were satisfied with the Islamic Thoughts books, the related instructors, their positive effects on the students, and the university educational planning for these courses. Also, there was no significant difference between students’ opinions regarding their gender and study major.Conclusion: In spite of positive viewpoints of students toward various aspects of these courses, the negative points should also be acknowledged to eliminate the defects. Since students’ needs are changing, the books and educational methods should be also revised accordingly.

Introduction: Acquiring clinical skills is an important issue in nursing education. This study aimed to determine senior nursing students’ opinion toward their achievement level of clinical skills in Ahvaz Jundishapur University of Medical Sciences in 2008-2009 academic years.Methods: In this descriptive cross-sectional study, sixty students who were selected by census from those who were passing the last semester of the Nursing BSc program. Data collecting tool was a questionnaire on ordinal scale. It included 190 items on clinical skills regarding medical-surgical nursing in areas of caring patients with common medical–surgical diseases, nursing (care) procedures, performing and interpreting diagnostic tests, care before, during, and after diagnostic procedures, recording, medication administration, working with therapeutics equipments, and students' demographic information. Data was analyzed by SPSS software using descriptive statistical analysis.Results: Most students believed that clinical skills of medical surgical nursing were 18.3%, 63.3%, 18.3% respectively as excellent, good, and average. Total mean score of clinical skills was 365.51±79.08 out of 570 and was reported as good. The best clinical competence reported to be in medication administration and nursing procedures, and the lowest competence reported to be in care before, during and after diagnostic procedures.Conclusion: Most students reported their own clinical skills of medical surgical nursing as excellent and good. Since in some areas clinical skills reported as moderate to poor, or in some cases as not performed, it seems that an accurate evaluation of students’ clinical performance prior to graduation is highly needed. Clinical training programs also should be revised along with putting emphasis on its strength points.

Introduction: Identifying educational needs and implementing appropriate courses is one of the important steps to empower managers and experts. It also has an important role in improving organizational performance. In this study we aimed to determine the educational needs of managers and top administrators of health vice-chancelleries in Iranian universities of medical sciences.Methods: This cross- sectional study was conducted in spring 2010. The research sample was selected through systematic and stratified randomization from among the staff working in health vice-chancelleries of 13 medical universities. All available managers and top administrators in the selected universities were interviewed by using census approach. The questionnaire included individual and organizational variables and 28 management topics.Results: Interviews of 293 managers and top administrators revealed that 26 (92.9%) out of 28 topics had been rated 3.5 and above (out of 5). There were significant correlations between the mean scores of some needs and the type of universities, sex, age, work experience, educational level, passing MPH courses, work place and the current position of the participants (P<0.05).Conclusion: Based on the high rate of topics with considerable mean scores, it is suggested to have short and long term management training courses.

Introduction: Community health nursing education in filed is one of the main courses of Iranian nursing education curriculum; however, little scientific attention has been paid to the evaluation of community health nursing process so far. Therefore, the present study was conducted to explore nursing students' comprehension of community health nursing in field education.Methods: A qualitative study was employed using content analysis approach with 19 bachelor degree nursing students. Data were gathered through unstructured interview technique.Results: The data analysis resulted in emerging 2 main categories as ‘suitable learning aspects for students’ and ‘learning inhibitor aspects’. The participants mentioned the education in filed with its specific conditions as a way to personality development, employing theory in practice, in-depth learning, learning from various human resources, and achieving skill to teach patients. Inhibitor aspects were related to ineffective clinical instructors, inefficiency of management of training, and theory-practice gap.Conclusion: Clinical education of nursing students should cover active learning and personal/professional growth. It also should be compatible with community requirements. The study participants pointed out to factors which nursing education policy makers and nursing faculties should pay attention to in order to improve the quality of training community health nursing in filed.

Introduction: Educational system is a set of plans, approaches, and materials which coordinately facilitate learners’ access to pedagogical objectives. With regard to the fact that each step of knowledge acquisition calls for a particular learning method or a specific approach, it might be possible to ease students’ achievement of learning objectives by using a blend of learning strategies. This study aimed to determine the effects of blended teaching models on learning of vital signs among nursing and operation room students.Methods: This was a quasi-experimental, with before and after-research design performed on two groups. All first semester nursing and operation room students (N=52) were selected for the study. They were randomly allocated into two groups of experiment and control and were instructed using blended and traditional education methods. Before and after each session of education, academic achievement tests were applied to evaluate students’ cognitive learning in three levels of knowledge, comprehension, and application regarding the topic of vital signs. Data was analyzed using t-test, Wilcoxon, Mann Whitney, and Fisher’s exact test.Results: Both teaching methods improved students’ learning in knowledge, comprehension, and application levels. Mean differences before and after education in both groups were statistically significant in all levels. The mean of increase in scores in all exams and sessions were significantly higher in the blended teaching group compared to the traditional one. The mean score of students’ satisfaction in experiment group (66.2±19.5) was significantly (p<.001) different from the control (38.9±21.4).Conclusion: The used blend of teaching methods was more effective than the traditional one, on the improvement of knowledge, comprehension and application of vital signs topic. It also satisfied students more. Of course, the traditional method was also effective, so both approaches may be used according to the situation.