Iranian Journal of Medical Education

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Clinical reasoning is not only a critical skill in medicine, but also central to the clinical practice. Considering that there is no method of assessing clinical reasoning based on the theoretical framework of medical expertise research, we could approach assessment in an innovative way taking the model of clinical reasoning as a guide. In this model three major components of clinical reasoning (i.e. information gathering, hypothesis formation and hypothesis evaluation) have been measured, treating them collectively as a single score that reflects clinical reasoning competency. This battery permits the inclusion of different formats of clinical reasoning tests that cannot be administered simultaneously and assesses different aspects of clinical reasoning. This article explains the process of designing and implementing the battery of clinical reasoning in the first Olympiad for medical sciences students using action research method.

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Introduction:Educational methods can be classified into two groups: active methods and passive ones. Applying games is an active approach in teaching. The present study aimed at investigating the effect of games on teaching oncology. Methods: Twenty three medical students participated in the study. They took two class sessions of oncology. In the first session the basic principles and concepts on oncology were taought and in the second session , they were randomly divided in two groups. A selected modified text of esophagus cancer treatment from up-to-date version 17.3 was presented to both groups. Some especial cards containing a cancer treatment modality were given to the case group. The students were asked to sequence the possible treatments for the case. At the end of the session, esophagus cancer treatment was presented to the students. The students’ responses were gathered, scored and compared applying T test. Results:They were 12 in the experiment and 11 in the control group. There was a statistically significant difference between the mean score of the control (28.46 ± 22.6) and experiment(55.8±26.1)groups, (t=2.67, df =17.63, p=0.016). The number of sequences proposed by the control group was (4.85 ± 1.72), while the number of sequences in the experiment group was 3.85 ± 0.07, resulting in t=2.54, df =16.751, p=0.021. Discussion: The mean score in the experiment group is significantly higher than that of the control group. Although the time spent was equal in both groups ,the game lead to more concentration and deeper learning in the experiment group. Significantly, the number of treatment sequences in the experiment group is lower than that of the control group. It seems that treatment selection was done more delicately and responsibly by the experiment group. So, teaching oncology through games can increase learning in medical students, which in turn,leads to better treatment selection and problem solving.

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Introduction: National Board exam is one of the important ways of assessment throughout a physician’s life span. This exam could be considered as the major director for acquiring knowledge during the residency educational program. This way, it should be in the way of social accountability and the medical problems which they would be faced with. This study evaluates the budgeting and quality of the National board exam in the adult cancer.
Methods: In a descriptive study, the questions within the national board exams in adult cancer specialty in the academic years 1395 and 1396 as well as the same exams in hematology and oncology sub-specialty between the academic years 1392 and 1396 were analyzed. The sampling method was convenience sampling. Budgeting regarding the distribution and Bloom’s taxonomy was evaluated. We considered the questions in three Bloom’s level, namely, recall (first), application and analysis (second), and composition and evaluation (third). Frequencies and respective frequencies were calculated and reported.
Results: Most of the questions in hematology and adult cancer board exams were in the first and second Bloom’s level. However, in endocrinology sub-category of questions, the third level was dominant. Palliative care and cancer complications had no place in the board examinations.
Conclusion: Despite our expectation in terms of being at the higher levels, most of the questions were in the first and occasionally in the second level of Blume’s taxonomy. Therefore, it is highly recommended that questions are aimed at the higher levels, particularly in the area of diagnosis and treatment. It is also recommended that faculty members should be trained to develop questions at higher levels of cognition.