70 1608-9359 Medical Education Development Center, Isfahan University of Medical Sciences 2317 Teaching Methods Study of the method, lead to upgrading quality in training medical students in Orthopedic Units, by clinical anatomy recall1 Nouraei Mohammad hadi Aboutorabi Roshanak Avizhegan Maryam 1 6 2013 13 3 257 259 05 09 2012 08 05 2013
2663 Teaching Methods --The results of intervention studies are always reliable and generalizable to other groups? Salehiniya Hamid Dashty saeed` 1 6 2013 13 3 254 256 30 04 2013 02 06 2013 2194 Educational Technology Use of Information Resources for Clinical Decisions by Nurses and Nursing Students, and Its Barriers after Introducing Information Technology Kahouei Mehdi Babamohamadi Hassan Sadat Ghazavi Shariat Panahi Soheila 1 6 2013 13 3 244 253 27 06 2012 30 05 2013 Introduction: Holding computer skills training and information technology (IT) courses for nurses and delivering IT courses in nursing curriculum are of recent changes in nursing field. This study focuses on the identification and comparison of information sources used by nurses and nursing students after introducing information technology and identifying barriers to using them. Methods: This descriptive-analytical study was conducted on 412 nurses and nursing students in hospitals affiliated to university of medical sciences and social security organization in Semnan(Iran) during 2011. Data were collected through a researcher-made questionnaire that measured the use of information resources. Data were analyzed through descriptive and inferential statistical tests. Results: Despite that most subjects had passed IT training courses, they had little desire to use databases (2.3±0.6,out of 4, Average of monthly use) and electronic journals (2.7±0.7) in their clinical decisions. Lack of skill in the use of the library (2.2±0.6) and also difficulty in understanding scientific papers (2.1±0.9) were the most important barriers reported by nurses and students. The difference of scores for using information resources and reported barriers was significant between students and nurses (P <0.01). Conclusion: The results showed that the provision of infrastructures for using up to date information resources in nursing was not sufficient. It seems important to consider comprehensive approaches in the field of information management to increase nurses’ and students’ willingness to use these information sources. 2297 Curriculum Development Evaluation of Internal Efficiency and External Effectiveness of the General Medicine Curriculum: Perspectives of Students, Graduates and Faculty Members at Shahid Sadughi University of Medical Sciences Mohammadi Mehdi Naseri Jahromi Reza Moeini Shahraki Hajar Mehrabaniyan Nafise 1 6 2013 13 3 233 243 20 08 2012 30 05 2013 Introduction: Educating efficient doctors has always been a concern for medical schools. Therefore, it is necessary to study the educational programs and do revision and quality improvements accordingly. This study was performed to evaluate the internal efficiency and external effectiveness of the general medicine curriculum in Shahid Sadughi University of medical sciences. Methods: This study was a descriptive survey research done in 2012 in Shahid Sadughi University of Medical Sciences (Yazd, Iran). The population included all general medicine graduates from 2007 to 2012, all undergraduate medical students passing their fourth to seventh academic year, and all faculty members of the medical school. Seventy faculty members and 40 graduates were selected using convenient sampling method, and 200 students through simple random method. Internal quality of curriculum was analyzed by Kuchakpoor questionnaire based on Akker's curriculum classification. External effectiveness of curriculum was analyzed by a researcher-made questionnaire designed to cover knowledge, skill, and attitude aspects. Data were analyzed through standard t and MANOVA. Results: Internal efficiency of all elements of the general medicine curriculum was less than the desirable level (third quartile: Q3) and more than acceptable level (second quartile: Q2) from the students’, graduates’ and faculty members’ viewpoints. External effectiveness of curriculum regarding graduate knowledge and attitude was at a desirable level, while the graduate skills were not at desirable level. In all of elements of the curriculum, faculty members gave the highest internal efficiency averages and graduates had the lowest. Conclusion: Review and revision of general medicine curriculum is necessary to promote internal efficiency and external effectiveness from average level to desired level. 2255 Educational Management Barriers to Effective Diabetes Self-Management Education Abazari Parvaneh Vanaki Zohreh Mohammadi Eesa Amini Masoud Massoud 1 6 2013 13 3 221 232 31 07 2012 03 06 2013 Introduction: Self-management education is the key component of diabetes care. Furthermore, high levels of patient non-compliance or non-adherence to the treatment regimen suggest that patient education for self-management is faced with some shortcomings. This study aimed to identify barriers to effective diabetes self-management education. Methods: This is a traditional review of published studies during 1990-2010 on barriers to diabetes self-management and control. Electronic search through Iranian and international databases was done. Results: Barriers to effective diabetes self-management education were put in two main categories including patient-related barriers and caregiver-related barriers. The most common patient-related barriers are demographic barriers (such as age, sex, education, and health literacy), financial problems, lack of attention to the disease, psychological problems, and insufficient knowledge. Patient-caregiver relationship, inadequate knowledge, and high workload were caregiver-related barriers. Conclusion: The results of this review introduced a variety of factors that can affect the effectiveness of diabetes self-management education. Patients and caregivers are facing serious challenges due to these barriers. Understanding and attemping to overcome these barriers may help us to empower patients to achieve self-management. 2338 Clinical Skills Evaluation Direct Observation of Procedural Skills (DOPS) in Restorative Dentistry: Advantages and Disadvantages in Student's Point of View Akbari Majid Mahavelati Shamsabadi Reza 1 6 2013 13 3 212 220 24 09 2012 07 04 2013 Introduction: Direct Observation of Procedural Skills (DOPS) is a valuable method in evaluation of clinical procedures. The aim of this study was to evaluate the advantages and disadvantages of this evaluation method from the restorative dentistry students' point of view in Mashhad University of Medical Sciences Methods: This cross-sectional study was conducted on the students of restorative dentistry in Mashhad University of Medical Sciences, where 110 students were enrolled. "Direct Observation of Procedural Skills" was designed in accordance with the objectives of restorative department and executed. An unstructured interview with 12 students was done to develop a valid questionnaire for the evaluation method used. All of the 4th and 5th grade students were asked to fill the questionnaire. The data were reported with descriptive statistics. Results: Seventy one percent (71%) of the students recommended this method be continued because of its positive effect on their independency and learning. Seventy six percent (76%) mentioned that this method failed to improve inter-rater reliability between the teachers. Eighty five percent (85%) believed that students should not fail the course upon failure to meet requirements for a standard treatment. It was also mentioned that it is preferred for formative rather than summative assessments. Conclusion: Within the limitations of this study it can be concluded that DOPS is a suitable formative assessment method for restorative dentistry in Mashhad University of Medical Sciences. 2308 Curriculum Development A Comparison between Integrated Courses and Discipline-Based physiopathology Program in Zanjan University of Medical Science Valizadeh Majid Mousavinasab Nourodin Ahmadi Akram Rostami Ali 1 6 2013 13 3 201 211 29 08 2012 29 03 2013 Introduction: Medical education in general, and physiopathology teaching program in particular, have undergone a number of changes in recent years. Outcomes of recent reforms performed in undergraduate medical curriculum should be determined. The present study investigated the possible effects of a simple horizontal integration in curriculum of physiopathology phase on the attitude scores of the stakeholders including students and curriculum directors, and academic achievement of students. Methods: In this descriptive cross – sectional study each physiopathology course marks and the mean of grand point averages of 287 students of physiopathology from 2001 till 2008 was gathered from the school office for education. These observed indices were compared between students who had passed discipline-based program and who had passed the integrated program. Also a researcher–made questionnaire was used for the survey of the physiopathology educators’ and students’ attitude. The data were analyzed using independent t-test and correlation to compare student marks and attitude scores. Results: Total mean of students’ grand point averages in physiopathology phase was 14.3±.71 in traditional group and 14.49±.93 in the integrated group. The difference was statistically significant (p=0.047, t=-1.994). The score of educators' attitude was 3.22(±0.63) out of 5. Most of educators had positive attitude to course system and the score of students’ attitude was 3.21 (±0.35) out of 5. Conclusion: Changing the curriculum in physiopathology phase to the integrated system improved students' academic performance. Also most educators and an average of students were satisfied with these changes. Thus, this change could affect teaching and learning process positively. 2324 Community Based Medicine Factors Affecting Learning in Instructional Design Model: Medical Students’ Viewpoint in Fasa University of Medical Sciences Makoolati Zohreh Naghdi Majid Naghizadeh jahromi Mohammad mehdi Bahar Mahboobeh 1 6 2013 13 3 190 200 08 09 2012 03 06 2013 Introduction: Instructional technology is used to decrease educational problems nowadays. The first step for using this technology is designing. To apply a design, a model is used. This model consists of four components: objectives, conditions, sources, and evaluation (outcomes). The aim of this study was to survey the opinion of medical students of Fasa University of Medical Sciences about the role of effective factors of instructional design model on learning. Methods: This descriptive-analytical study used a census sample of 95 medical students (entering years from 2009-2011). To collect data, a researcher-made questionnaire consisting of demographic information and factors related to instructional design model pertaining to 4 general areas and 20 questions. Data were analyzed with one sample T test. Results: The highest mean score was for simultaneous theoretical and practical teaching of courses in laboratories (4.18±0.95, out of 5) and the lowest concerned electronic learning system (2.45±1.13). Furthermore, significant differences were observed in all fields: goals (4±0.92), conditions (3.46±1.15), sources (3.67±1.1), and evaluation (3.93±0.83) with the mean score (=3) of responses (P≤ 0.05). Conclusion: The results helped to recognize and solve problems for successful systematic educational planning. Also, with regard to the positive viewpoint of students in this study about importance of students’ preview of lessons before the class, simultaneous theoretical and practical teaching of courses in laboratories, and useful coordination between educational content and teaching approach, it seems that by considering these items in universities , effective education could be more accessible. 2483 Teaching Methods Clinical Supervision in Nursing Education: Definitions and Models Nasiriani khadijeh Salimi Tahera Dehghani Hamide 1 6 2013 13 3 179 187 22 12 2012 13 03 2013 Introduction: Clinical supervision, as a mechanism for promoting knowledge and professional skills of nurses, is a core activity in nursing practice. To use clinical supervision in nursing education, it is necessary to have a comprehensive understanding of definitions and models. This paper explains the role and models of clinical supervision in nursing education. Methods: This study is a narrative review of the literature. It was conducted through Internet search in Pubmed and Science direct & Scopus. Using supervision nursing education, nursing administration, and supervisory as the key words, only English papers were searched for. Finally 47 articles, books and Persian article in the field of clinical supervision were reviewed. Results: Based on the literature review, clinical supervision is a continuous & systematic process through it nurses get advice from their supervisors. They practically review, maintain, and develop skills, knowledge, and standards of care. It helps to identify educational needs of nurses, which in turn, helps to understand the strengths and weaknesses of teaching and learning in order to promote purposeful learning in nurses. Conclusion: Findings show clinical supervision is a formal process. it has supportive and educational potential for nursing education. This can help last year nursing students and especially during the start-up work. 2521 other The Comparison of Two Models for Evaluation of Pre-internship Comprehensive Test: Classical and Latent Trait Abbasi Hadi Falsafinejad Mohammad Reza Delavar Ali Farrokhi Noor Ali Mohagheghi Mohammad Ali 1 6 2013 13 3 167 178 17 01 2013 22 04 2013 Introduction: Despite the widespread use of pre-internship comprehensive test and its importance in medical students’ assessment, there is a paucity of the studies that can provide a systematic psychometric analysis of the items of this test. Thus, the present study sought to assess March 2011 pre-internship test using classical and latent trait models and compare their results. Methods: In this cross-sectional descriptive research, item analysis based on classical model was conducted by calculation of difficulty and discrimination coefficients, estimation of reliability by Cronbach’s alpha coefficient method and distracters analysis by comparing distracter proportions using EXCEL software. NOHARM4 software was also used to assess test dimensionality. To assess items parameters (difficulty, discrimination, guessing, information functions, and standard error of measurement) latent trait models and BILOG-MG3 software were used. Results: According to the classical test theory, 30 items (15%) were in the acceptable range of difficulty and discrimination coefficients. Test reliability coefficient was 0.913. Seventy three items (36.5%) had problems with the distracters. The analysis of test dimensionality indicated that the test was unidimensional. Using Three-Parameter Logistic Model, we obtained the mean and standard deviation of items parameters, i.e. item difficulty (0.321, 1.874), item discrimination (1.021, 0.666), and item guessing (0.209, 0.082). Maximum test information function was between 1.0 to 2.8 ability levels, and the test had lower information compared to the higher levels of ability at cutting scores. Conclusion: The findings indicate that analyses of latent trait models can be used to overcome the limitations of the classical test theory.