Iranian Journal of Medical Education

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Introduction. Considering the fundamental role of teaching methods in promoting the quality of education, the emphasis on the necessity of a revise in teaching methods used by continuing education programs, and insufficient observantional studies about teaching process, this research was designed to study the teaching methods of continuing medical education (CME) programs in Isfahan University of Medical Sciences based on establishment, continuing, effectiveness, and concluding the communication. Methods. This study was performed as field research. The data gathering method was observation. The vali- dity and reliability of the observation form was confirmed by content validity and test/re-test. The researcher observed 89 CME programs including seminars, conferences, congresses and composed programs. The data was analyzed by SPSS software. Frequency distribution of all factors was calculated. Results. The results concerning the teaching factors revealed that, in establishment of communication more than half of the teaching methods and in continuing the communication more than two third were weak and very weak. Forty percent of teachings in continuing the communication and more than 50% in concluding the communication were good and very good. Also, in most cases, "lecture" was used as the main teaching method in CME programs, but in some programs, question/answer, case presentation and demonstration methods of teaching were also used. Conclusion. The teaching methods of CME programs need a serious revise. In order to improve the quality of continuing education, it is recommended to train faculty members regarding the process of education, teaching, adult learning theory and new models of teaching.

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Introduction. The quality of doctor-patient relationship has a significant impact on patient satisfaction and medical outcomes. Communication skills training is not formally included in medical education curriculum in Iran and as a result physicians can not communicate properly with their patients and need to receive training in this regard. In this study a communication skills training program for general practitioners was designed and its effect on their patients’ satisfaction was evaluated. Methods. In a quasi- experimental two group post-test design study, a communication skills training program was designed and implemented as a three days workshop. The study sample included 32 employed physicians (16 physicians in each experimental and control groups) and 153 patients (72 patients in experimental group and 81 in control group). The physicians in the experimental group participated in the workshop and received training using new instructional methods combined with routine communication skills teaching methods. A valid and reliable questionnaire was used to measure patients’ satisfaction. Then, patients’ satisfaction from trained physicians was compared with the satisfaction in the control group by t-test using SPSS software. Results. The mean score of patients’ satisfaction from trained physicians was 86.2 with the standard deviation of 10.3 which was significantly higher than the mean score for control group (81.5±9.58). Patients’ satisfaction from their physicians’ general communication skills, at the beginning and end of session was greater for trained physicians compared with the ones who didn’t receive any training. Conclusion. Since, communication skills training for general practitioners increased patients’ satisfaction, and considering the fact that this kind of training is not included in medical education curriculum, it is recommended to consider it as an efficient and useful component in continuing medical education programs as well as undergraduate medical education.

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Introduction. Needs assessment data provide a basis for developing learning objectives of CME activities. Identifying the viewpoints of Iranian CME experts about the characteristics of an effective needs assessment (NA) model for physicians’, dentists’ and pharmacists’ CME programs was the aim of this study. Methods. In a descriptive study all CME directors and experts (50 persons) were surveyed using a questionnaire composed of 6 multiple choice questions about some key components of CME needs assessment including the best definition for need, the source of data collection, the required level, and the procedure and criteria for prioritizing the needs. The face and content validity of the questionnaire were evaluated by some CME experts and Cronbach’s alpha was used for reliability assessment. The data was analyzed by SPSS software using frequency distribution and Chi2. Results. A total of 35 CME directors and experts (70%) responded to the survey. Based on their points of view: The best definition for need was “the distance between the present and optimum situation”(68.6%), the best source for needs assessment was “professional tasks” (34.3%), the most proper level for planning needs assessment was “national level” (34.3%) , the best method for performing needs assessment was “running needs assessment as a part of strategic planning” (45.8%) and “perceived needs of the clients” (48.6%), selection of needs assessment model according to “the level of needs assessment (37.1%)”, and the best criterion for prioritizing the needs was “the relevance with the professional tasks” ( 51.4%). Conclusion. Despite numerous literature about needs assessment, there is no unique model as the best appropriate one for all CME needs assessment programs. But, careful selection of needs assessment model for each situation, designing the content of continuing education programs based on previous needs assessments, identifying what is supposed to be assessed, and its position in planning and designing the topics of continuing education are the key points in planning needs assessment for continuing education

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Introduction: Identifying educational needs of general dentists and prioritizing them in continuing education programs are matters of necessity. This study was conducted to identify the viewpoints of general dentists concerning their educational needs, proper methods of teaching, and implementing continuing education program of restorative dentistry in Rafsanjan and Kerman. Methods: This descriptive cross-sectional study, in which 145 general dentists in Kerman and Rafsanjan participated, was performed in the year 2007. Data was gathered by a questionnaire consisting of demogra-phic questions, 17 questions about the subjects and headings of continuing education program of restorative dentistry, 8 and 6 questions about proper teaching methods and implementing continuing education programs, respectively. The questionnaire was based on 5 point Lickert scale. Data was analyzed by SPSS software using descriptive statistics and t-test. Results: Ninety three general dentists from Kerman and 52 ones from Rafsanjan participated in this study. The most important educational priorities in continuing education program of restorative dentistry were new generations of composites, infection control, sterilization principles, causes of anterior and posterior composite resin restorations failure and porcelain laminate veneer. Participants preferred teaching methods of practical training in educational workshops, observing practical works, and lecture along with film presentation they also realized the study of textbooks and scientific journals, watching educational film, attending seminars and congresses more suitable for continuing education program of restorative dentistry. Conclusion: The headings of continuing education program of restorative dentistry should be revised regularly based on the learners' needs. Performing or observing practical work are recommended as teaching methods for this kind of programs. Also new methods should be employed in implementing the program.

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Introduction: Retraining is an important way for professional development of health staff and keeping them up to date, and evaluation is one of the essential principles for enhancing the efficiency of these trainings. The aim of this study was to determine the viewpoints of paramedics employed in Golestan province towards continuing education programs. Methods: In this descriptive study, 274 samples were selected out of 1016 paramedics employed in clinics of the province, through systematic random sampling. The data gathering tool was a questionnaire. Data was analyzed by SPSS software using descriptive statistics, Chi², and independent T-test. Results: Among the participants, 26.2%, 41.8%, 25.5% and 6.5% had very weak, weak, average, and desirable viewpoint towards the courses, respectively. As the motivation for participating in the courses, 55.5% mentioned achieving points for job promotion opportunities, 21.2% resorting and reviewing former information, 13.8% exchanging information and experiences with other colleagues, and 9.5% mentioned seeking solutions for their professional problems. Thirty one percent reported lack of equity and fairness in participating in the programs on behalf of their direct administrator and 33.9% stated that the planning for participation in these courses was not favorable. Conclusion: Participants had a weak or very weak viewpoint toward programs and regarded their motiva-tion for participation in these programs as achieving points for job promotion. It is necessary for admini-strators to plan for changing the staff's viewpoint toward participation in continuing education programs.

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Introduction:. Knowing about web-based education outcomes compared to traditional method can help instructors to use more effective methods for future continuing education Programs. The aim of this study was to compare the effect of web-based and traditional teaching methods on nurses' knowledge about Bird Flu. Methods: In this quasi-experimental study with two groups, pretest post-test design, 140 nurses were randomly selected and by blocking random allocation method divided equally into two groups of web-based and face-to-face. In face-to-face group, the intervention consisted of one day program about Bird Flu delivered by lecture. The other group received web-based education. In both groups, samples’ knowledge about bird flue was measured by a questionnaire before and after intervention.Pre –post test scores were compared within and between groups by Independent and paired T-test. Results: Based on the findings, both web-based and face-to-face teaching methods were effective on promotion of nurses’ knowledge(P<0.001), and had the same effect (p=0.221). Conclusion:Web-based teaching seems to be as effective as traditional teaching in continuing education of nurses. With regard to numerous advantages of web-based method, it is recommended to be used in future programs.

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Introduction: Transfer of training has been defined as the application of new knowledge, skills, and attitudes learned from continuing education programs to the job. Learning transfer can be influenced by many factors that can facilitate or hinder it. A supportive work climate is crucial for successful transfer of learning to job. The aim of this study was to evaluate the nurses' attitude toward supportive work climate affecting transfer of learning to job in two social security hospitals (Alborz of Karaj and Shahriar ) in 2009. Methods: This is a descriptive study conducted on 132 nurses from two social security hospitals ( Alborz of Karaj and Shahriar), selected through census sampling. The tools used included the sample selection form, demographic data form and Transfer Climate Scale. This scale indicates how nurses perceive their working environment to apply their knowledge and skills learned during the continuing education programs. It consists of 4 sub- scales of peers’ support, supervisors’ support, encouragements and situational constraints. Data were analyzed by SPSS software using descriptive statistics, T-test and ANOVA. Results: This study showed that mean scores of nurses’ attitude toward supportive work climate was 92.15±16.61. Most of the nurses (60.6%) had average attitude toward supportive work climate .The highest mean score was for peer support (40.54±8.42) and the lowest was for situational constraints(11.54±3.35). Conclusion: The findings of this study showed that supportive work climate affects nurses’ ability to apply their knowledge and new skills to their job. Planning to improve supportive work climate seems essential for development of nurses’ quality of care and productivity.

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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.

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Introduction: It is necessary to choose and implement proper teaching and evaluation method for implementing an effective education. This study aimed to evaluate the implementation quality and to determine suitable teaching methods in department of anesthesiology at Isfahan University of Medical Sciences. Methods: In this descriptive cross-sectional study, all anesthesiology residents (40) who participated in class in 2011 were selected. Data collection was done through a researcher-made questionnaire. Data analysis was done through descriptive and inferential statistics. Results: The questionnaire response rate was 100 percent. Mean age and duration of medical practice were 34.75±3.9 and 7.6±4.8 years, respectively. 85.5 percent of participants had the high satisfaction with quality of program implementation, 12.5 percent had moderate and 2 percent had poor satisfaction. The most preferred teaching method was lecture along with showing films and PowerPoint presentations and the least one was lecture without film and slide. There was no significant difference between female and male residents regarding to the satisfaction of teaching method and program implementation (P>0.3). Conclusion: Using educational material and active teaching methods involving students in teaching process is effective in learners’ satisfaction and teaching quality.

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Introduction: Learning about the viewpoints of participants on different aspects of continuing medical education programs is of great importance. The aim of this study was to determine general practitioners’ views toward quality of these programs. Methods: In this cross-sectional descriptive study, the survey population included 267general practitioners selected from among participants of CME programs in Tabriz University of Medical Sciences from October 2010 to March 2011 using convenience sampling method. The data collection tool was a researcher-made questionnaire. After confirming the validity and reliability of the questionnaire, data was collected and then analyzed. Results: Findings showed that 64.8 % of participants were male and 92.1 % had experienced continuing education programs before. 62.9% of physicians rated the program success rate high and very high in providing up-to-date knowledge for physicians. 74.5% indicated that instructors had shown respect and rated their conduct high and very high. According to 41.2%, the possibility of sharing participants’ experiences in discussions was low and very low. A sum of 79.8% pointed out that a need for planning CME programs based on common public health and treatment problems is high and very high. Conclusion: Applying new teaching methods and encouraging participation of physicians in planning and implementation of programs and continuous needs assessment is felt essential to improve the educational programs.

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Introduction: The rapid development of science and technology has endowed a fresh significance to continuing education as its necessity has become undeniable. Considering the significance of keeping physicians’ knowledge up-to-date and their limited free time to participate in their classes on the other hand, e-learning could be a useful option to train these people. The main objective of this study is to identify main factors which deter these physicians to participate in e-learning courses of continuing medical education in Mashhad University of Medical Sciences. Methods: This descriptive cross-sectional study was performed during summer 2011 in Mashhad University of Medical Sciences. Study population included 378 physicians subject to continuing medical education which were selected through stratified sampling method. Data gathering tool was a reliable and valid questionnaire made by researcher. Descriptive and inferential statistics were used for data analysis. Results: Considering the weighted mean achieved, contextual issues (2.71±.63) showed the highest and personal issues (2.15±.70) and attitudinal issues (1.98±.64)( out of 4) showed the lowest deterrence rate respectively. Personal concerns of individuals formerly participated in e-learning courses were lower than that of individuals who didn’t participate beforehand (p<0.01, F=6.51). The scores attributed to each of these three fields of personal, contextual, and attitudinal problems to attend e-learning courses were higher for men compared to woman (f=86.1, p<0.01). Conclusion: Contextual problems were the most important deterring factor among community of continuing medical education to participate in e-learning courses.

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Introduction: The issue of continuing professional development is a necessity in the medical sciences. Also nursing staff need Continuing Education (CE) for their scientific and professional development. The aim of this study is to determine the factors influencing nurses’ participation in continuing educational programs. Methods: This study is a cross-sectional descriptive study that was conducted in year 2010 in Tabriz. A quota sample of 256 staff nurses were selected from nurses in hospitals of Tabriz University of Medical Sciences. Data was collected using a valid and reliable questionnaire, which focused on gathering participants’ viewpoints on the influence of four categories of factors (i.e., personal, organizational, professional, and program) on their participation in CE activities. Data were interpreted using frequency indices. Results: 33.9 percent of nurses mentioned that professional factors are very important in their participation in programs. The most important professional factors were patients’ expectations from nurses and nurses’ tendencies to learn and increase their professional knowledge. Among organizational factors influencing on participation, 48.4 percent of nurses stressed that setting rotating shift work in the ward is the most important. Conclusion: According to the important role of meeting patients expectations and professional development in participation of nurses in CE programs, nurse managers should support and facilitate the nurses’ participation in the programs and should play an effective role in nurses’ empowerment.

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Introduction: Continuing education is an essential component of the professionalization of nursing and could be viewed as a catalyst for the development of nursing practice. This study aimed to determine the concordance of the continuing education programs with the principles of adult learning and the effectiveness of these programs from the perspective of nurses. Methods: In this cross-sectional descriptive study, 150 nurses working in teaching hospitals affiliated to Mashhad University of Medical Sciences in 2011 were selected using quota sampling. Data were collected using a researcher-made questionnaire which proved to be valid and reliable. The questionnaire had 3 sections, focusing on “Concordance rate of in-service training programs with the adult learning principles”, “Effectiveness rate of these programs”, and “the preferred educational methods”. Data were analyzed using descriptive statistics, and Pearson correlation coefficient. Results: 68% of participants were women and 89% had a BS degree in nursing. The mean score of compliance of continuing education program with principals of adult learning was 35.2±4.6 out of 65.The mean score for the effectiveness was 28.6±6.2 out of 55. As for adult learning principles, 46.9% of the participants rated the program weak. Conclusion: It is suggested that the continuing education program be revised in term of planning and implementing, based on the principles of adult learning in order to increase the effectiveness of this program.

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Introduction: Developing continuing medical education (CME) programs should be based on assessments of learners’ needs. On the other hand, one of the prevalent problems in Iran is the excessive use of blood products, and the highest demand for blood transfusion is related to surgical wards. Hence, the purpose of this study was to assess the educational needs of anesthesiologists and surgeons in transfusion medicine.

Methods: This survey was carried out on a convenience sample of 134 anesthesiologists and surgeons in Isfahan. The educational need assessment was administered using two valid and reliable researcher-made questionnaires: self-assessment and knowledge assessment. Cronbach’s alphas were calculated at 0.958 for information self-assessment questions, 0.981 for educational needs questions, and 0.72 for knowledge assessment questions. Data were imported to Excel Software. Distribution frequency indices and Pearson correlation coefficient test were used respectively to analyze the data and compare the findings.

Results: The majority of participants were male (70.9%) with a mean work experience of 15.9±8.8 years. 65.8 percent of the participants evaluated their knowledge at an “average level”. The most important educational need was about cryoprecipitate and the least important was related to packed red blood cells. The mean score of knowledge assessment questions was 6.60±0.24 (out of 20). There was a significant correlation between self-assessment mean scores and the knowledge assessment mean scores and the frequency of encountering blood products (P≤0.0001). No significant correlation was found between the educational need assessment mean scores and the self-assessment mean scores and the frequency of encountering blood products (P=0.23).

Conclusion: Given the findings of the present need assessment and little knowledge of the physicians, it is suggested that an appropriate educational program should be developed for surgeons and anesthesiologists. Such program could be offered in the form of continuing education programs for graduates. Further research is needed to make decision about how transfusion medicine should be introduced into the anesthesiology and surgery residency programs.

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