Iranian Journal of Medical Education
Year:2005 | Volume:5 | Issue:2 (14)|Papers Count:30

Introduction: In recent decades, medical education has been following new approaches to early clinical exposure. This study was designed to determine early clinical exposure (ECE) objectives and their availability and importance from the participants' viewpoint. Methods: In a descriptive study, 70 students who had participated in ECE at Isfahan Medical University were asked to complete a questionnaire based on ECE goals in other similar studies. The questionnaire included 22 items based on Likert scale and asking about two aspects of importance and availability of objectives. The total score for importance and availability and their relationship are reported. Items resulted in the greatest degree of agreement are presented as well. Results: Seventy two percent of the students took part in the study and Cronbach's alpha for the questionnaire was equal to 0.91. The median of all items indicating the importance of objectives was 4 and higher. The availability items had the median score equal to 3 in 7 items and equal or greater than 4 in the rest of items. The mean of total importance score was 3.98±0.7 and of total availability score was 3.51±0.53 out of 5. There was a small correlation between importance and availability of objectives. Conclusion: The determined goals were appropriate for our ECE program in the case of importance and availability but more attempts is needed to help students with basic sciences and clinical education integration. This study provided a good model to determine ECE objectives based on each university's specific needs. More studies are recommended to design these educational goals in an objective manner.

Introduction: Clinical education is a complicated process which is affected by many factors and variables. Since, recognizing the problems is the first step towards reducing them, a study was designed to determine the viewpoints of midwifery students about clinical education problems in Babol Medical University. Methods: In a cross sectional descriptive study, 55 last year midwifery students were selected by census sampling method. The data collection tool was a valid and reliable questionnaire containing 32 items asking about clinical education problems. The scale of the questionnaire was as yes, sometimes, and no. The data was analyzed by SPSS software using descriptive statistics and Chi2. Results: Eighty one point eight percent believed that clinical education in midwifery had some problems among which 40% were indicated as high and 41.8% as moderate. Seventy two point seven percent considered clinical education poor in facilities and environmental factors and faced with a lot of problems. Eighty seven point three percent related clinical education problems to trainers' problems, 83.6% indicated some problems in theoretical pre-clinical courses, 74.5% related the problems to hospital and health centers' personnel, and 83. 7% of subjects felt some problems in clinical evaluation. Conclusion: Lack of expert clinical trainers, and problems in pre-clinical courses and clinical evaluation were the most significant clinical education problems based on the view points of midwifery students in Babol Medical University.

Introduction: Lack of an evaluation tool with objective criteria is one of the problems in evaluation process specially in nursing management practicum. Considering the role of evaluation in assuring nursing students' management skills, this study was designed to develop a specific tool for measuring their management skills and determine the validity 'and reliability of this tool. Methods: At first, through literature review and expert panel sessions, the objectives of nursing management practicum were determined. Then, using Delphi technique, 56 important criteria were developed and the domains and criteria of evaluation were designed by Bars technique. A panel of experts was used to confirm content and face validity. Reliability was determined by a descriptive study in which 30 nursing students from one of Tehran's nursing schools were evaluated by this tool and the reliability was estimated by split half and inter-rater reliability. The data was analyzed by SPSS software, using Pearson Correlation Coefficient and reliability analysis. Result: A dual evaluation tool was provided for nursing instructors and head nurses. The face and content validity were confirmed by experts. The internal consistency and inter-rater reliability were confirmed by r>./8 as well. Conclusion: The designed tool with acceptable validity and reliability is appropriate to apply in clinical environment for evaluating the management skills of nursing students. Applying this instrument can improve the effectiveness of clinical education activities of nursing management instructors and students.

Introduction: The possibility to use rural health technicians as instructors for on going education of Behvarzes, is an issue that should be considered. The effect of training by rural health technicians and Behvarzes' instructors on knowledge and practice of Behvarzes in Isfahan district were compared in this study. Methods: In an interventional study performed as field trial, 84 Behvarzes were selected and divided to two groups randomly. The knowledge and practice of Behvarzes were measured using a questionnaire and a checklist, respectively. Before starting the education, an educational course related to Acute Respiratory Infection including 12 hours lecture and group discussion was conducted for the health technicians. Then, the first group of Behvarzes was trained by instructors of Behvarz training center and the second group by health technicians using lecture, group discussion and practical education for 24 hours. The knowledge and practice of Behvarzes were measured after the education. The data was analyzed by SPSS software, using mean, standard deviation, paired t-test, independent t-test, covariance analyses and Pearson Correlation Coefficient. Results: Behvarzes' score in knowledge and practice increased significantly after education in both groups. The increased mean scores of knowledge were 3.9±2.59 and 2.73±2.67 in the groups trained by instructors and technicians, respectively. Also, the increased mean score of practice were 12.13±4.13 and 5.9±3.88 in the groups trained by instructors and technicians, respectively. There was no significant relationship between the score of Behvarzes' knowledge and practice with their experience. The increase in knowledge and practice scores of the group trained by instructors was significantly more than the group trained by technicians. Conclusion: The difference between the increased knowledge scores in the two groups is at an extent that shows we can use technicians instead of instructors for increasing Behvarzes ' knowledge. But, as far as Behvarzes' practice is concerned we should better not use technicians for improving their practice.

Introduction: Critical thinking has been always the subject of discussion by teachers and educational centers. Considering the extensive and serious approach to critical thinking, this study was performed to investigate the application of critical thinking by basic sciences students in facing scientific texts, in Isfahan University of Medical Sciences. Methods: In this experimental study medical, dentistry and pharmacy students in 3 different groups, received scientific texts or exam questions related to their course which contained conceptual-logical mistakes. The number of mistakes identified by students was considered as a criterion for their use of critical thinking skills. Results: In facing mistakes of exam questions, the students didn't use their critical thinking skills. But, concerning the mistakes in their texts, only 6.8 percent noticed some of the mistakes. Conclusion: Despite fostering different thinking skills as the most important goal of higher education in all universities of the world, the results of this study and other similar studies shows that in real situation, educational systems don't have any program for fostering thinking skills. This issue is a big concern for the present and future university graduates.

Introduction: Fear from dental work and other medical problems in dental patients can cause medical emergencies in dental office. Managing these emergencies depends on dentist's knowledge and their access to needed equipments. This study was performed to determine the knowledge of dentists about medical emergencies, and available equipments in Isfahan's dental offices. Methods: In this descriptive study performed in 2005, 150 dentists were selected by systematic random sampling. They were asked in person, using a valid and reliable questionnaire containing 10 multiple choice questions about medical emergencies, a list of 8 emergency medications and 5 emergency equipments. Data was analyzed by SPSS software using mean, frequency, and t-test. Results: From 139 dentists who completed the questionnaires, 74.8% were male and the rest were females. The mean score of their knowledge was 5.42 out of 10 and no significant difference was observed between male and female. The mean of available drugs was 5.28 from 8 drugs and the mean of available emergency equipments was 0.74 from 5 equipments. Conclusion: The Dentists' knowledge was at an average level and they had little access to emergency drugs and equipments. So, the correct management of medical emergencies in dental offices is difficult.

Introduction: Evidences show that current educational programs do not correspond to after graduation needs of physicians and occasionally cause problems for both physicians and recipients of services. Current study has determined the opinion of interns about achieving minimum learning requirements in ophthalmology ward. Methods: A descriptive study was done in the Medical School of Isfahan Medical University in 2004. All interns in ophthalmology ward (40), who were at least in their fourth month of internship period filled a valid and reliable questionnaire, composed of 15 questions. The data was analyzed by SPSS software using descriptive statistics. Result: The most learned skill, at the end of one month period, was physical examination (100%), and removing foreign bodies (92.5%). The least learned skill was estimation of visual field by methods of confrontation (12.5%) and using Schiotz tonometer (27.5%). Conclusion: It seems that the interns were not able to acquire the minimum learning requirements in ophthalmology ward. It is recommended that educational objectives be revised, defined more accurately, and adjusted according to the needs of learners and society. Also, designing appropriate evaluation methods is suggested to assess interns' acquired skills.

Introduction: Substantial changes in living trends of societies, promotion of health, and changes in environmental health officers' (EHOs) duties and responsibilities are the main reasons that educational programs in this field do not correspond with their job description in the real context and according to the real needs of the society. Therefore, the educational courses of this field should be revised. The goal of this study was to determine the job description and the educational needs of EHOs in order to coordinate their educational programs with their real job duties. Methods: In this descriptive study, a questionnaire was mailed to 383 graduates and personnel of environmental health in Isfahan Province, to declare their educational needs and job activities based on their frequency. The validity and reliability of the questionnaire was confirmed by content validity and test/re-test, respectively. The data analysis was performed by SPSS software using descriptive statistics. Results: The EHOs working in Isfahan province, with technician, bachelor and master degrees, declared 31, 38, 26 types of activities as their job duties, respectively. Their most common duties were residual chloride measurement in water, monitoring public places, and investigating complaints, which were the same as their educational needs. In postgraduate level, the most important duties included management, supervising environmental health affairs, teaching and research. Conclusion: Technicians and bachelors of environmental health are conducting similar job activities; which correspond with their mentioned educational needs. It is recommended that educational programs for environmental health be revised according to their real job activities and educational needs. It is also suggested to coordinate the educational programs with the needs of their future job such as continuing the education, and different job options, in order to increase their efficacy.

Introduction: The situation of clinical education should be always evaluated in order to improve its quality. This study was performed to determine the viewpoints of clinical instructors about obstacles of clinical teaching and strategies for improving its quality in Tehran Nursing Schools in 2005. Methods: In this cross-sectional survey 60 instructors of Tehran's nursing and midwifery schools were selected by census sampling method. The data collection tool was d valid and reliable questionnaire consisted of 5 domains including the performance of clinical instructors, curriculum design, clinical environment, students' characteristics, and educational and welfare facilities. Data was analyzed by SPSS software (13.0), using descriptive statistics, t-test and one-way ANOVA. Results: The instructors reported the quality of clinical education average in the domains of clinical environment and educational facilities, and weak in other domains. Lack of interest and motivation in students was the main obstacle for clinical education. Paying more attention to appropriate planning for clinical education was mentioned as the best strategy for quality improvement. Conclusion: The quality of clinical teaching was unsuitable. In order to overcome these challenges, the collaboration of instructors, staff, educational supervisors, head nurses, nursing managers and other managerial levels is recommended.

Introduction: One of the most important components of educational technology is educational needs assessment. This study tried to answer the question of, what the real needs of bachelor nursing students based on their experience? And what themes the refer to as their learning needs. Method: A phenomenology research was performed to study the experience of students regarding their learning needs using Colaizzi model. Twenty five male and 20 female nursing students were selected by purposive sampling and divided to 4 small groups. The data gathering was done through group discussion. Also, a face to face interview with 4 nursing instructors was performed and the interviews were recorded with their permission. Data was transcribed as soon as possible and analyzed by thematic analysis method. Results: The learner needs assessment model was obtained based of 5 main themes including: Nursing instructor, curriculum planning, educational management, social and environmental facilities and learner. According to this, learner-based need assessment model was developed in which, in addition to five main themes, there were three variables of responsibility taking, recognizing nursing profession and acquiring mental tranquility which were effective on increasing the learners' capabilities. Conclusion: Nursing instructor's need assessment lies in the center of learning. Curriculum, powerful educational management and providing the needed facilities for teaching and learning can assure the quality of bachelor nursing educational program.

Introduction: Considering the importance of educational services management and the quality of providing these services to post graduate students, this study was designed to investigate the satisfaction among students and faculty at graduate level in four educational, administrative, accountability and supervision domains. Method: In this descriptive study 78 master and doctoral students and 65 faculty members were selected through census sampling method in the period of 2001 till 2002. Data collection tools were two researchers made questionnaires whose validity and reliability were confirmed by experts and Cronbuch alpha, respectively. Data were analyzed using frequency and t-test. Results: Faculty members and graduate students were not satisfied with the services of any educational, administrative, accountability and supervision domains. No significant difference was observed between the viewpoints of male and female faculty members and students. Conclusion: Dissatisfaction of graduate studies faculty members and students from educational services management is considered as a weakness at the managerial level of the university. It is recommended that the university managers take necessary actions to improve the quality of educational services management.

Introduction: Gathering students' viewpoints about teacher evaluation, its effective factors and its process, can identify the strength and weaknesses of teacher evaluation and provide the possibility to improve its quality. The aim of this study was to determine the viewpoints of students about the factors affecting evaluation of teaching in Jondishapour Medical University. Method: In a descriptive study 423 students were studied using a valid and reliable questionnaire including 64 closed questions. The questionnaires were distributed and gathered at the schools of Medical University. The data was analyzed by SPSS software using frequency distribution, mean, chi2 and Pearson correlation coefficient. Results: Sixty five point eight percent of students believed that students were a valid and reliable source for teacher evaluation and they were truthful in their opinions. The verbal skills and teaching methods of the faculty member were introduced as the most important factors of effective teaching with the mean of 4.05. With a little difference, scientific ability, ethical issue, and behavior with students were in next priorities. No significant difference was observed between male and female students and between high mean score and low mean score students in regard to effective factors in teaching evaluation. Conclusion: The three professional, scientific and personal characteristics of faculty members were considered important with some small differences. A study on different researches on teacher evaluation is recommended to use the results for designing a more appropriate questionnaire and evaluation process. This can make a considerable help regarding the improvement of teacher evaluation system.

Introduction: One of the challenges of medical universities is to deliver medical and health instructions and the related concepts from the higher university levels to the basic levels of the society. The absolute need to have a communicating bridge between the universities and the urban society, has led to more attention to community health volunteers as the potential source for such a link. This study attempted to determine the effect of female health volunteer education on the knowledge and attitude towards mental health in urban society of Isfahan. Methods: This was a quasi-experimental study with two group/pre and post-test design carried out in 2003. Four hundred people of Falavarjan city as well as the same number of people in Khomeini-Shahr city were randomly assigned to complete a valid and reliable questionnaire for knowledge & Attitude as the pretest. Then after a one year period of mental health educational interventions by health volunteers in Falavarjan, the post-test was accomplished in both cities. The data was analyzed by SPSS software using t-test and Ch2. Results: The pre-interventional scores of knowledge and attitude in the experiment group were 40.5% and 54.5%, respectively which increased significantly to 64.2% and 80.2%, respectively, after intervention. In the control group, the pre- and post-interventional scores of knowledge were 41.5 and 41.9 respectively which had no significant difference. The respective rates for attitude were 63.1 and 49.9 which showed no significant difference before and after intervention. The post interventional scores of knowledge and attitude were significantly higher in the experiment group, compared to the control group.Conclusion: For promoting mental health in urban areas, we can rely on the efficacy of the stepwise knowledge transfer from the higher health levels (third level mental health physician) to health-educating volunteers and from them to community health volunteers and finally to urban families.

Introduction: One of the main criteria for a complete care system in mental health is using evaluation data to identify and focus on potential capacities for future planning. The goal of this study was to evaluate educational programs of center for mental health education and consultation in Isfahan University of Medical Sciences. Methods: In this evaluation study, the participants of educational programs of this center, from March 2001 until August 2003 were investigated. A researcher made questionnaire was used to study the knowledge, attitude and practice of people referring to this center, in 11 educational subjects presented in the educational programs. The demographic characteristics were also asked along with the main questionnaire. The data analysis was made using descriptive and inferential statistics, t-test, and ANOVA by SPSS software. Results: Center for consultation and education of mental health, has had a successful performance regarding identifying mild mental problems. Based on the designed criteria for evaluating educational programs in this center, these programs were relatively successful in promoting the knowledge and practice of referred people. Conclusion: Considering the increasing complications of societies and the necessity to educate people for the purpose of preventing acute mental disorders, it seems that implementing and developing such centers is one of the priorities of health system and medical education in the country.

Introduction: General physicians (GPs) and dentists have to acquire reasonable research capability during academic education in Iran. For this purpose, various educational programs such as: statistics and research methodology course, Health System Research (HSR) workshop and research thesis have been planned in their curriculum. The purpose of this study was to determine knowledge, attitude and research ability of general practitioners and dentists graduated from Hamadan University of Medical Science (HUMS). Methods: In a descriptive study 60 general physicians and dentists, who had been graduated in the previous 2 years, were selected randomly and asked to design a research proposal. They were also asked to complete a valid and reliable questionnaire containing 22 questions regarding their knowledge and attitude. The data was analyzed by SPSS software using frequency, mean, standard deviation, frequency and t-test. Results: The mean and standard deviation for knowledge and attitude were 12.5±2.72 (out of 22), and 55.25±6.49 (out of 80), respectively. The mean and standard deviation of research capability was 15±7.27 (out of 34). In total, 27.5% of GPs and dentists had low knowledge, while, only 3% had negative attitude towards research. There was no significant relationship between HSR workshop participation and research capability. Conclusion: The majority of medical doctors and dentists graduated from Hamadan University of Medical Sciences had low but acceptable knowledge about research methodology. More than 50% of them had low research capability, but more than 95% had a positive attitude towards research. In total their research capability was far from optimal situation.

Introduction: In order to achieve clinical education objectives, it is necessary to evaluate the educational situation continuously and identify its strength and weaknesses. The aim of this study was to determine dentists' opinion about their professional capability graduated from Babol Dental School. Methods: In a cross-sectional descriptive study, all dental students who had entered the university in 1997 and 1998 (n=45) filled a valid and reliable questionnaire including 97 questions about clinical training objectives. The data were analyzed by SPSS software using t-test and Pearson correlation coefficient. Findings: The total mean score was 132.2±20.11 out of 180. The lowest and highest scores belonged to periodontology and fixed prosthetics, respectively. The mean score of professional capability in males was more than females. There was no significant relationship between the mean score of capability and the year of entrance to the university, marriage status and quota of acceptance to the university. Conclusion: The students' opinion about their professional capabilities showed their dissatisfaction from their acquired capabilities which in turn reveal the existence of some weaknesses in clinical educational methods.

Introduction: Teaching problems solving skills is not formally included in educational programs of nursing students. On the other hand, fostering self-concept in nurses is an issue which has to be considered. This study was performed to determine the effect of a short problem solving course on nursing students' self concept in Shiraz Nursing and Midwifery School. Methods: In this quasi-experimental study, 54 volunteer nursing students were randomly divided into two experiment and control groups and their self-concept was measured by "Carl Rogers self-concept inventory". The experiment group was divided into 3 small groups to participate in group discussions based on D'zurilla and Goldried problem solving methods. The control group received the routine theoretical and practical training. One month later, self-concept of the two groups was measured again. Results: One month after completing the course, comparing the self-concept of the two groups, , showed a significant difference. There was a significant difference between the mean score of self-concept, in the experiment group, before and one month after the intervention; this difference was not significant in the control group. Conclusion: In general, implementation of the problem-solving course was a successful experience that resulted in the improvement of self-concept. Therefore, this kind of problem solving education is recommended in nursing educational programs.

Introduction: It seems that graduated physicians have not acquired some of the necessary skills, while interns are supposed to have the required knowledge and skills to start their internship. In this study, interns' opinions about their readiness for entering internship period in Isfahan Medical University were determined. Methods: In a descriptive, cross sectional study, 4 domains of interns' readiness were measured by a valid and reliable questionnaire consisting of 20 items. The study group included 75 interns at their first 4 months of internship in the year 2005. The data was analyzed by SPSS software using frequency, Chi2, and Pearson correlation coefficient. Results: In the domain of theoretical knowledge, most interns evaluated themselves at an average level, while in the domain of skills they considered themselves at the levels of average and good. In hospitalization and discharge process, most of them evaluated themselves, average to weak. They considered themselves good to average in self confidence and interaction with nursing and medical staff, and patients. There was a significant correlation between pre-internship exam score and the score of knowledge domain. Conclusion: It seems that, interns do not have the required readiness for starting internship, especially in the domains of knowledge and skills. Pre-internship examination does not cover all the requirements for internship period. More extended planning is needed to improve some domains such as skills and familiarity with hospitalization and discharge process.

Introduction: On time diagnosis and appropriate treatment of hypertension are highly important especially in preventing the complications of this disease. The present study was designed to determine the knowledge of medical interns about different aspects of hypertension in Shiraz University of Medical Sciences. Methods: In a cross-sectional descriptive study all interns in educational hospitals of Shiraz Medical University (n=111) were studied using a valid and reliable questionnaire in the year 2004. The questionnaire included 50 multiple choice questions about diagnosis, treatment and complications of hypertension and also the side effects of the anti-hypertensive drugs. The data was analyzed by SPSS software using mean, standard deviation, Chi2, t-test, ANOVA and Spearman. Results: The total mean score was 27.6±8.35 out of 50. The mean score for male and female interns were 28.30±7.65 and 26.29±9.52, respectively. In total, 23% of interns had poor, 59% had moderate and 18% had good knowledge about hypertension. Conclusion: Most interns participating in the study had poor to moderate knowledge regarding hypertension. More studies are recommended to investigate the causes of interns' inadequate knowledge about hypertension and provide strategies to improve their knowledge.

Introduction: Evaluation of clinical education in nursing is necessary to improve effective methods, and identify and solve the problems. The aim of this study was to determine the viewpoints of nursing students about clinical education in Yasuj Medical University in the year 2002. Methods: This cross sectional-descriptive study was performed on all nursing students who were in their third semester or higher (n=100). A valid and reliable questionnaire which assessed four domains of instructor, environment and facilities, educational programs and student, using ordinal scale, was applied. Data was analyzed by SPSS software using descriptive statistics, t-test, and ANOVA. Results: Most of the students (55%) evaluated clinical education as good. Also, they evaluated the domains of instructor (51%), educational programs (52%) and student (53%) in a good level. While the situation of clinical environment (60%), and educational facilities (42%) were reported as moderate, and welfare facilities (70%) as poor. Conclusion: According to the nursing students, the situation of clinical education especially in the fields of instructor, student and educational programs was good but in clinical environment, and educational and welfare facilities was poor. It is recommended to take proper action to provide the needed facilities and equipments for nursing students in clinical environments.

Introduction: Students are the main source of information regarding teaching quality and effectiveness. This study was designed to investigate the view points of Rafsanjan Medical University students at clinical settings towards the role of anatomy courses in achieving clinical objectives. Methods: A descriptive study was performed in the year 2005 in which 97 clerkship and internship students were selected by census sampling method. They filled in a valid and reliable questionnaire using a five point scale from very high to very low. The data was analyzed by SPSS software using descriptive statistics. Results: Based on the students, trunk anatomy had the most application and head and neck anatomy had the least application in achieving clinical objectives. Moreover the students believed that more attention has to be paid to anatomy of abdomen in trunk anatomy and neuroanatomy in head and neck anatomy. Conclusion: Considering the importance of trunk anatomy and specially anatomy of abdomen, it is recommended to pay more attention to teaching these courses in a more applied manner.

Introduction: Universities as one of the main sources for producing scientific information, play an important role in the development of the society. So, it is necessary to monitor their research activities. This study investigates the situation of producing scientific information by faculty members of Kermanshah University of Medical sciences during 1993-2002. Methods: In this descriptive study, a valid and reliable questionnaire and related documents were used for gathering the data. All full time faculty members (210) were studied through census sampling method. The data was analyzed by descriptive statistics and SPSS software. Results: The total number of scientific products, in all forms, produced by faculty members was 2956. The most produced scientific information was in the form of thesis (42.82%) and the highest percentage of scientific information production was done in 2001 (16.05%). School of Medicine had the highest percentage in scientific information production (82.8%). Articles published in foreign journals (73) as the most creditable products were done by 31 of faculty members (15.2%) and the majority of internal articles produced by 131 of them (64.5%). Only 20% of research projects were presented as scientific articles. Conclusion: Translating and compiling books are performed in a very small number and publishing the results of research projects is very limited also. It is recommended to provide more facilities for publishing scientific articles.