Iranian Journal of Medical Education

fa صداهایی از کلاس درس: نگاه‌ دانشجویان و اعضای هیأت‌علمی درباره چالش‌های اجرای برنامه درسی بازنگری‌شده علوم پایه پزشکی Voices From the Classroom: Students’ and Faculty Members’ Perspectives on the Challenges of Implementing the Revised Basic Medical Sciences Curriculum ارزشيابي برنامه Program Evaluation پژوهشی اصیل Original research article مقدمه: برنامه درسی دوره پزشکی عمومی در ایران در سال 1396 بازنگری شد. هدف این مطالعه شناخت چالشهای اجرای برنامه درسی دوره علوم پایه پزشکی عمومی از دیدگاه دانشجویان و اعضای هیأتعلمی دانشگاه علوم پزشکی زابل بود. روش‌ها: در این مطالعه کیفی با رویکرد تحلیل محتوا، شرکت‌کنندگان شامل دو گروه دانشجویان پزشکی مقطع علوم پایه و اعضای هیأت‌علمی مشارکت کننده در این مقطع بودند که با نمونه‌گیری هدفمند انتخاب شدند. داده‌ها از طریق ۱۲ مصاحبه نیمه‌ساختاریافته (۹ مصاحبه فردی و ۳ مصاحبه گروهی) جمعآوری گردید. مصاحبه‌ها پس از اخذ رضایت آگاهانه، ضبط، پیاده‌سازی و با نرم‌افزار MAXQDA تحلیل شد. سپس در هر گروه جداگانه، کدگذاری به‌صورت باز انجام گرفت و کدهای مشابه تلفیق و در طبقات اصلی و فرعی سازماندهی صورت پذیرفت. معیارهای Lincoln & Guba برای اطمینان از دقت و صحت تحلیل استفاده شد. نتایج: از تحلیل متن مصاحبه‌ها ۳۹۶ کد اولیه (۱۸۶ مورد دانشجویان و 210 مورد اعضای هیأتعلمی) استخراج شد. پس از مقایسه، ادغام و تجمیع مفهومی کدهای مشابه، داده‌ها در قالب 17 زیرطبقه (11 مورد دانشجویان و 6 مورد اعضای هیأت‌علمی) و 10 طبقه اصلی (6 طبقه دانشجویان و 4 طبقه اعضای هیأت‌علمی) سازمان‌دهی شدند. دانشجویان بر تجربه یادگیری، روش تدریس و نظام ارزشیابی و اعضای هیأت علمی بر ساختار دوره، منابع انسانی و پویایی برنامه تمرکز داشتند. نقاط قوت شامل اکتساب درک کلی نسبت به پزشکی، درک اهمیت دروس پایه‌ای، مفید بودن کلاس‌های عملی و انگیزه بخش اساتید بود. چالش‌ها شامل حجم بالای محتوا، پراکندگی مباحث، کمبود منابع و ضعف روش‌های تدریس و ارزشیابی بود. ادغام علوم پایه و بالینی، تلاش برای ارتقاء و کاربرد فناوری آموزشی و تقویت تعامل استاد-دانشجو پیشنهاد شد. نتیجه‌گیری: اجرای برنامه درسی بازنگری‌شده علوم پایه پزشکی با چالش‌های محتوایی، آموزشی و ساختاری مواجه است. این نتایج ضرورت طراحی آموزشی سیستمی متناسب با شرایط اجرایی را برای بهبود اثربخشی برنامه درسی برجسته می‌سازد. Introduction: The curriculum provides the foundation for medical education by preparing competent and socially accountable graduates who can respond effectively to evolving community health needs. Rapid changes in healthcare systems, including the shift from treatment centered to health centered care, changing disease patterns, technological advances, increasing complexity in healthcare delivery, rapid expansion of medical knowledge, and rising healthcare costs, have underscored the need for continuous curriculum reform. However, even well-designed curricula may encounter substantial challenges during implementation because of barriers at individual, organizational, and structural levels. Engaging key stakeholders, particularly medical students and faculty members, is therefore important for identifying the strengths and shortcomings of revised curricula and informing their ongoing improvement. In Iran, the undergraduate medical curriculum underwent a major revision in the academic year 2017. This study explored the challenges of implementing the revised curriculum from the perspectives of medical students and faculty members at Zabol University of Medical Sciences. Methods: This qualitative study employed a conventional content analysis approach. Participants were purposively recruited from two groups: medical students in the basic sciences phase and faculty members involved in curriculum implementation. Data were collected through 12 semi structured interviews, including nine individual interviews with faculty members and three focus group interviews with medical students, and continued until data saturation was achieved. Separate interview guides, each comprising eight main questions, were developed for the two participant groups. Although the guides addressed comparable topics, the wording of the questions was tailored to the roles and experiences of each group. Probing questions were used when appropriate to explore participants’ responses in greater depth and clarify emerging concepts. With participants’ informed consent, all interviews were recorded and transcribed verbatim. The transcripts were analyzed using MAXQDA 2024 through an inductive coding process. Initial coding was conducted separately for each participant group. Similar codes were then compared across groups, merged where appropriate, and organized into subcategories and overarching categories. The trustworthiness of the findings was assessed based on Lincoln and Guba’s criteria. Credibility was enhanced through prolonged engagement with the data, iterative review of transcripts, and member checking. Dependability was supported by comprehensive documentation of the research process and peer review of the analytical procedures. Confirmability was enhanced by maintaining an audit trail and using reflexive procedures to minimize researcher bias. Transferability was supported through rich descriptions of the research context and participant characteristics. Results: Analysis of the interview data yielded 396 initial codes, including 186 from medical students and 210 from faculty members. Through iterative comparison, integration, and abstraction, these codes were refined into 34 subcategories, comprising 22 from students and 12 from faculty members. The subcategories were subsequently consolidated into 10 overarching categories, with six reflecting students’ perspectives and four reflecting faculty members’ perspectives. Six overarching categories emerged from the medical students’ accounts: structural and operational challenges of the curriculum; educational and infrastructural constraints; challenges in teaching and learning; assessment and feedback; perceived strengths of the revised curriculum; and recommendations for its enhancement. Four categories emerged from the faculty members’ accounts: structural and implementation challenges; limitations in human and infrastructural resources; challenges related to teaching and assessment; and opportunities for further curriculum improvement. Medical students recognized both strengths and challenges in the revised curriculum. They valued the development of an integrated understanding of the basic sciences and their relevance to clinical practice, as well as opportunities for practical and applied learning. However, they reported concerns about curriculum overload, fragmented content, inadequate educational facilities, and continued reliance on traditional lectures, with limited opportunities for active learning. They also identified weaknesses in assessment, particularly limited continuous and constructive feedback, inadequate alignment between assessment and learning objectives, insufficient continuity across training phases, and delayed exposure to clinical settings. Students suggested greater integration of educational technologies, development of question banks, and provision of preparatory courses to strengthen curriculum implementation. Faculty members viewed the curriculum revision as a positive step toward greater coherence and interdisciplinary integration but reported several structural and operational challenges. These included weak interdepartmental coordination, limitations in scheduling and assessment planning, shortages of specialized faculty, and inadequate educational and research resources, despite the enthusiasm of younger educators. Faculty members also emphasized the need for professional development in contemporary instructional design and competency-based assessment, as well as stronger systems for monitoring and feedback. They further highlighted the importance of more coherent integration between the basic and clinical sciences and advocated systematic monitoring and evidence informed, incremental curriculum revision. Conclusion: Medical students and faculty members identified multiple structural, educational, and operational factors affecting the implementation of the revised medical curriculum. These findings highlight the importance of context responsive curriculum planning, adequate institutional resources, effective coordination, and continuous monitoring to support successful curriculum implementation.   دانشکده پزشکی, برنامه درسی, آموزش پزشکی, طراحی آموزشی سیستمی Faculty of Medicine, Medical Education Curriculum, Implementation Challenges, Systematic Instructional Design 98 110 http://ijme.mui.ac.ir/browse.php?a_code=A-10-5826-1&slc_lang=fa&sid=1 Elahe Haghighat Manesh الهه حقیقت منش haghighatmanesh@zbmu.ac.ir 7000319475328460097441 7000319475328460097441 Yes Department of Basic Sciences, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran. گروه علوم پایه، دانشکده پزشکی، دانشگاه علوم پزشکی زابل، زابل، ایران