Iranian Journal of Medical Education

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One of the notions entered in university fields in the last two decades is the concept of scholarship and especially educational scholarship. Due to the inclusion of this concept in the first article of faculty members' academic promotion bylaw and considering it as a mandatory component for academic promotion, great attention has been paid to this topic. Remarking the background and principles prevailing this almost new perspective, this short communication endeavors for developing a ground for familiarizing the readers with the concept of scholarship, especially educational scholarship, and its manner of evaluation. Moreover, a little note has been made about substructures needed for broadening scholarship activities in the field of education as well as the challenges before that.

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Introduction: Clinical teaching is a major part of medical education without which it is impossible to train competent physicians .With regard to the complexity of clinical teaching, current changes in medical environment and diverse roles of clinical teachers, the necessity of doing a comprehensive study on such phenomenon, was felt. This study aimed to explore effective background factors of clinical education based on clinical teachers’ experiences. Methods: This is a qualitative study with conventional content analysis. Data were collected through purposive sampling and semi-structured interviews conducted with clinical teachers, informal interviews conducted with the students, and field observations. Results: Based on the obtained results of coding steps, educational structure, professional duties and motivational elements were background factors affecting clinical teaching. Education time constraints, diverse and overloaded duties of clinical teachers, lack of financial support, lack of an appropriate position for teaching, priority of research over education and the challenges in teachers’ role are the most important factors affecting clinical teaching. Conclusions: Making a change in educational structure to have a culture that values clinical teaching and respects that as a service can solve a lot of clinical teaching and clinical teachers’ problems. The findings of the present study can help the authorities in medical universities and faculty members to take strategies to promote the quality of clinical teaching.

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Introduction: Clinical assessment in nursing education is essential because of variety of objectives and complexity of clinical performance. Programmatic approach is an opportunity for comprehensive and multidimensional assessment. Opinions of stakeholders have an effect on application and effectiveness of a program. Thus, the aim of this study was evaluation of nursing students’ and faculties’ viewpoints about using programmatic approach in assessment. Methods: In this descriptive-analytic study, a census sample of 38 internship nursing students and 8 faculties in critical care rotation have participated. Clinical assessment of students was designed based on a programmatic approach and applied for one educational semester. Then, the viewpoints of faculties and students about this assessment method and its strengths and weaknesses were collected by a questionnaire. A visual analog scale in 0-10 measure was used to evaluate satisfaction of subjects. The data were analyzed using descriptive indices and t (paired and independent) tests. Results: The mean score of faculties and students’ satisfaction with programmatic assessment was 8.70±1.82 and 7.66±1.50, respectively. Totally, 87.5% of faculties and 97.3% of students were agreed with this method for students’ clinical performance assessment. According to attitudes of both groups, the strengths of this method were objectivity, impartiality, feedback provision, accurate coverage of educational objectives and specificity. 87.5% of faculties and 89.47% of students believed programmatic approach in assessment has a positive educational impact. Conclusion: The findings showed the majority of nursing students and faculties are satisfied with clinical assessment using programmatic approach and that is acceptable because of its objectivity, feedback provision, specificity, complete coverage of educational objectives and positive educational impact. Therefore, extensive application of this method in other clinical settings can be considered.

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Introduction: Revising medical curricula & establishing reformed programs result in refined educational methods which are accompanied by development of active & student-based teaching methods such as Team Based Learning (TBL). This paper describes an experience of implementation and evaluation findings of TBL according to medical students’ viewpoints. Methods: This action research was planned for a census sample (n=187) basic science students of Tehran University of Medical Sciences with the new curriculum. After briefing the students about TBL and forming teams we did TBL in the following steps: Individual Readiness Assurance Test (IRAT), Team Readiness Assurance Test(TRAT), appeal, Team Application(TAP), and peer assessment in 15% of each program block. Data gathered by observation recording sheets, and a researcher-made questionnaire, and analyzed using descriptive statistics. Results: A major part of the students (63.8% ) have admitted TBL as a deep learning approach. Students believed that TRATs were useful (46.2%), team application was a learning facilitator in TBL classes (51.7%) and the class management was suitable (60.5%). The observational data showed that the students changed their seats in order to take part in group discussions. They were listening carefully, asking questions and giving reference to support their claims. Some were against this method because it increased their study workload. Conclusion: It seems TBL has a positive effect on deep learning and facilitates learning. The results indicate that TBL results in cooperative & active learning, and it improves class activity and may be, because of the developed interaction between students, it can promote communication skills. We recommend the use of TBL as a teaching method, beside other teaching methods, in medical sciences education.

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Introduction: Curriculum reform of MD program in Tehran University of Medical Sciences involves fundamental changes in many aspects of the program. Three years after implementation of the new curriculum, evaluation of program outcomes is necessary. The aim of this study was to compare academic achievement and educational environment of basic sciences phase of the previous curriculum with those of the revised curriculum. Methods: In this retrospective cohort study, the average score of basic sciences courses for all medical students accepted to Tehran University of Medical Sciences in 2011 and previous three years (2008-10) was extracted. The results of the 44th, 46th, 48th and 50th basic sciences comprehensive exams, including university rank and the standard score were analyzed. DREEM questionnaire was used to assess the educational environment which was completed by students admitted in 2010 and 2011 at the end of basic sciences phase. The data were analyzed by means of ANOVA, Chi-Square and t-test. Results: The total number of medical students from 2008 to 2011 was 1032, of whom 589 students (57%) were female. The difference between the basic sciences average score, number of probationary and failed semesters over the years was not statistically significant. Based on the results of comprehensive exams, the university ranked third in 2008 and first in three subsequent years. University’s standard scores in all comprehensive exams were 0.61, 0.96, 0.85 and 0.94 respectively. The DREEM questionnaire scores were 91.5±0.46 and 93.5±0.41 (out of 200) respectively before and after the reform. This difference and differences between scores of questionnaire’s five areas were significant for the two groups. Conclusion: Although slight improvements could be seen in most of the assessed outcomes after the reform, they are not statistically significant. This could be attributed to near-perfect performance of the university in previous years or to the short interval between the intervention and outcome evaluation and therefore, concerns about academic failure following the curriculum reform do not seem to be valid. Regular monitoring of the outcomes is necessary for assessing long-term effectiveness of the curriculum reform.

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Introduction: One of the most important challenges in outcome based education is to understand the necessity of acquiring competences by students. The purpose of this study was to investigate students’ views and attitudes towards the introduction of expected competences in the undergraduate medical education program.
Methods: This quasi-experimental study used a one-group pretest-posttest design. A total of 442 medical freshmen were selected by census method and participated in the competence introduction program. After showing a footage, students would discuss and brainstorm about the scenes on the expected competences. Pretest and posttest were administered to compare the students’ attitudes toward the importance of obtaining the competences. A researcher-made evaluation questionnaire was completed by the participants at the end of the program. Descriptive statistics and dependent t-test were used to analyze the data.
Results: Most of the students (83.5%) stated by participating in the program they could develop a clear understanding of the expected competences. In addition, 69.7% of the students said that the program increased their motivation for learning and reinforced their competences during their studies. There was also a significant difference between the students’ understanding of the importance of acquiring the competences before and after the program in some areas including effective communication with patients and their families (p=0.03, t=2.15), interaction with medical team members, nurses and colleagues ( p>0.01, t=2.90), work-life balance (p=0.01, t=2.40), stress and emotions management ability (p>0.01, t=2.72), ability to collect and critique valid information (p=0.02, t=2.37), and familiarity with the healthcare system (8p=0.03, t=2.25).
Conclusion: Most of the students believed that the competences introduction program at the beginning of the undergraduate medical education program is necessary and that their attendance at this program has increased their motivation to acquire and reinforce the competences during their studies.
 

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Introduction: One of the challenges of medical education is students’ absence from the classrooms. This study was conducted to determine the factors affecting class absenteeism from the viewpoint of faculty members and students, and to compare their views on the effect of class attendance on students’ achievement, faculty members’ motivation and class attendance as a criterion of professionalism.
Methods: This mixed method study was conducted in 2015-2017 at the faculty of medicine of Tehran University of Medical Sciences. Participants were students and faculty members of basic sciences of the faculty of medicine at the time of the study. Purposive sampling and convenience sampling were used for developing the instrument and for analyzing the views respectively. Two valid and reliable researcher-made instruments were used. Data were analyzed using descriptive statistics and independent t-test.
Results: From the viewpoint of faculty members and students, the most important factor affecting student attendance was faculty members’ scientific expertise, their mastery of the content and power of expression. There was a statistically significant difference between the views of students and faculty members (T = -2.34, P = 0.02) in the effect of class attendance on academic achievement. The faculty members believed that class attendance was a criterion of student professionalism, while students were less likely to agree with this criterion (T = -6.21, P = 0.001).
Conclusion: The most important factor affecting student attendance was faculty members’ expertise, their mastery of the content and power of expression. It seems that in order to increase student attendance, further attention should be paid to how faculty members are recruited and to their empowerment in the field of education.
 

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Introduction: Considering the increasing importance of examining the effectiveness of faculty development programs in medical universities, the current study aimed to review various aspects of evaluation of the faculty development programs in medical education.
Methods: This review study was conducted by searching the databases of Google Scholar, Medline, Eric, Scopus, Ovid, Science Direct, Medical Education, Medical teacher, PubMed, BMC, SAGE, and Magiran using the keywords staff training/development, in-service training, medical faculty, faculty training/ development, and program evaluation and their combinations. The aspects of faculty development programs evaluation were then reviewed.
Results: A total of 62 articles were found of which 29 were selected for review. The aspects of development program evaluations were classified into four categories: theoretical evaluation model, evaluation data collection method, source of evaluation data, and evaluation findings. Most of the studies conducted to evaluate development programs followed Kirk Patrick’s model. Questionnaire was the most common data collection tool. The sources of the data were mostly program attendants (faculty members), and evaluation results indicated the faculty’s high satisfaction with the development programs.
Conclusion: The results suggest that development program evaluations should utilize mixed evaluation methods and that the changes resulted from faculty development programs and the extent of using learned materials should be evaluated at the organizational level and workplace respectively.
 

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Letter To Editor

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Introduction: The appropriate design of educational content in PowerPoint format is one of the important dimensions for promoting the quality of the teaching-learning process. This study endeavored to determine the technical and educational principles of slide design in PowerPoint as the common tool for presenting content in medical education.

Methods: This qualitative study includes two stages: Systematic search and Delphi technique. In the first stage, a search was made in internal and external databases with relevant keywords to obtain the educational and technical principles available in the sources, and the findings were collected, categorized, and analyzed in a questionnaire to conduct Delphi. In the second stage, with the Delphi method throughout the two rounds, the educational and technical principles of slide design in PowerPoint were determined by experts and students in the fields of medical education, health education and health promotion, educational technology, e-learning, intelligence education, educational management and computer science.

Results: In the first stage, the result of search in internal and external sources with related keywords was 974 studies, after the initial review and removing redundancies or unrelated items based on the inclusion criteria, 60 studies were examined and finally 29 studies were included in the research. The questionnaire of the first round of Delphi had 49 items, which were modified based on the opinions of 18 experts, including 13 professors and five students. The result of the second round of Delphi was a list of 47 items regarding technical features (22 items) and educational principles of slides, including the nature and types of slides (9 items), content design strategies(9 items), and presentation strategies (7 items).

Conclusion: Achieving technical and educational standards could be used as a tool to evaluate the quality and quantity of educational content, and considering these principles in designing PowerPoint slides by educators could be a step towards improving the quality of teaching-learning processes.