Iranian Medical Schools Research Articles

Are students performing the same in E-learning and In-person education? An introspective look at learning environments from an Iranian medical school standpoint

IntroductionThis study investigated medical students’ intended learning outcomes based on e-learning and in-person education.MethodsIn this cross-sectional comparative analytical study, a group of 126 undergraduate medical students’ intended learning outcomes under two different teaching methods, including e-learning and in-person, were repeatedly measured based on the census sampling method. Participants were in the preclinical curriculum phase (physiopathology) at Mashhad University of Medical Sciences (MUMS), Iran. Due to expert panel opinion, the same medical teachers and similar difficulty of lessons were considered in two investigated academic semesters. In addition, difficulty and discrimination indexes of formative and summative assessments were controlled for two study groups. The students’ learning outcome index was the knowledge test scores participants received in the relevant lessons of the General Medicine (GM) curriculum preclinical courses.ResultsThe findings indicated that students learning outcomes were significantly higher during e-learning than in in-person education for all examined variables (P < 0.05). Moreover, the difference between students’ Grade Point Average (GPA) categories among the two groups was significant (P = 0.022). Students with a GPA of less than 14 experienced higher increments in their average scores after the e-learning compared to in-person education. Compared to face-to-face courses, improvements in pharmacology, theoretical semiology, and pathology scores after e-learning courses were statistically significant (P < 0.001). The differences in mean scores related to practical pathology and semiology in the two approaches were not statistically significant, P = 0.624 and P = 0.149, respectively. Furthermore, the overall students’ average scores increased significantly during e-learning versus in-person education (P < 0.001).ConclusionWe concluded that e-learning could be appreciated as a successful method of medical education and can be used as an alternative educational method. However, considering the importance of practical or clinical courses in medical education, further research about the efficacy of the e-learning approach is highly recommended.

Development of Professional Ethics Curriculum in the Operating Room for the Current Era of Surgery: A Mixed Method Study

Introduction: The rapid advancement of intricate technologies and the emergence of novel surgical methodologies necessitate nuanced ethical decision-making under high-stress scenarios. Consequently, cultivating an understanding of professional ethics within the surgical environment is crucial for all practitioners involved in patient care. This study was initiated with the aim of designing a comprehensive curriculum for Iranian medical schools, focusing on professional ethics within the operating room. Methods: This mixed-method exploratory research was executed in distinct qualitative and quantitative phases. The first stage involved conducting 12 structured interviews with Iranian faculty members who were experts in education of professional ethics and operating room staffs for assessing the current needs and reviewing extant curricula. The subsequent quantitative phase entailed evaluating the elements of each curriculum axis via the Delphi method. Results: The qualitative phase led to the identification of 45 primary codes, 14 subcategories, and 5 primary categories. The quantitative phase confirmed 3 instructional goal domains, 12 instructional content areas, 8 teaching methodologies, and 10 evaluation methods through the Delphi process. These confirmed components were eventually incorporated into various theoretical and clinical courses as longitudinal integration themes. Conclusion: Based on our findings, we recommend the development of educational objectives targeting cognitive, affective, and psychomotor domains and the longitudinal integration of a professional ethics course.

Evaluating the Current Status of Education in Family Physicians in Iranian Medical Schools

Evaluating the Current Status of Education in Family Physicians in Iranian Medical Schools

Medicine and Psychology of Ibn Sina (Avicenna) – A Unique Scientific and Religious Approach

Ibn Sina (Avicenna) is primarily known for his philosophy and medicine, but there is almost no scientific discipline in which this great man didn't leave a significant mark. This paper gives a brief overview of his contribution to medicine and psychology through which his unique scientific and religious approach to the study of the phenomena of human being can be best seen. Medical works of Ibn Sina represent a pinnacle of most important medical achievements of his time. These works contain synthesis of all Greek, Indian and Iranian medical schools, but also new breakthroughs achieved by Muslim scholars through their own experimentation and practice. Although he wrote many medical works, his most important one is El-Kanun fit-tib, which can be translated as The Canon of Medicine. It's made out of five books which systematically show everything known in the area of medicine up until that point in time. In it, Ibn Sina discusses, among other things, the structure of psychological apparatus of human being and the connection of psychological functions with the brain. He considered psychology to be very important for medicine, so in his psychological works he discusses, in great detail, the essence of human soul, consciousness, intellect and other psychological functions. He observed a man in his entirety, taking into consideration all aspects of his existence, paying special attention to spiritual knowledge and spiritual perfection, religiosity, and methods of achieving inner peace and well-being.

Discovering Rules from a National Exam Repository: A Use Case for Data Analysis from Iranian Medical Schools Entry Exam.

Many methods have been studied to analyze and interpret patterns and relationships that are embedded in the database to discover new knowledge in educational systems. Association rule mining is a type of data mining that identifies relationships among elements of the dataset. However, because these methods often generate various rules including non-significant ones, it is important to identify the most useful rules. Therefore, evaluating and ranking rules has become a topic of interest in the decision-making process in order to represent the level of usefulness of rules. We incorporated Apriori and Eclat algorithms on an educational dataset of a national medical exam in Iran. The aim of this study is to identify the usefulness of the extracted rules. This method can reliably discover new knowledge by interpreting the prioritized rules. The results show that those who have Scored in the highest category, i.e. [407,493], are accepted and who have scored in the lowest category, i.e. [150,236), are not accepted in the exam regardless of others features. Although, the rules that implication Accept=0 occurs, find out with high confidence, due to a large number of samples in this case. The ranking rules show this method is effective in the identification of insignificant rules that have no effect on decision making.

Comparison of empathy with patients between first-year and last-year medical students of Tehran University of Medical Sciences

PurposeThis study was conducted to assess the developmental factors of empathy among medical students of Tehran University of Medical Sciences (TUMS).MethodsTo assess the empathy levels, 42 first-year and an equal number of last-year medical students were randomly selected. They answered a questionnaire including the medical student version of the Jefferson Scale, demographic, and some related variables. Statistical analyses were performed using the Chi-square test, T-test, univariate, and multivariate regressions.ResultThe study population consisted of 51 (60.7 %) men and 33 (39.3 %) women with a mean (SD) age of 22.24 (4.10) years. The Jefferson score was 110.19 ± 13.61 and 103.52 ± 20.00 in first- and last-year medical students, respectively. Moreover, medical students who completely passed at least one of the considered empathy courses of the TUMS curriculum had higher empathy scores compared to their counterparts (109.83 ± 15.54 vs. 103.68 ± 19.02). There was no significant association between empathy and gender, self-experience of illness, marital status, family history of chronic disease, and parents’ education (all P-values > 0.05). After adjusting for the effects of confounders, the empathy scores were significantly associated with the academic year level (p = 0.04), level of interest in medicine (p = 0.001), and passing the empathy courses (p = 0.04).ConclusionsThe data provided from a top Iranian medical school indicated that the academic year level, level of interest in medicine, and passing the empathy courses were significantly associated with the empathy level. Further studies are recommended.

Medical educators\u2019 beliefs about learning goals, teaching, and assessment in the context of curriculum changes: a qualitative study conducted at an Iranian medical school

BackgroundAchieving changing needs, advancing knowledge, and innovations in higher education require the constant changes of medical school curricula and successfully applying the new reforms requires some modifications in the medical educators’ core beliefs. The purpose of this study was to describe the medical educators’ beliefs about the alignment of the learning goals with teaching and assessment processes in the context of the curriculum changes.MethodA qualitative method was used to study the medical educators’ beliefs through selecting the faculty participants via a purposeful sampling strategy. The study was conducted at a Medical School in Iran. For the individual interviews, we invited both the professors of the basic sciences and the clinical professors who had thought medical students for at least 5 years. Ten educators were interviewed.ResultThe results of the research showed that, in the professors’ viewpoints, the development of competencies in the students has been abandoned and this is due to the priority of treatment to education in the clinical courses and the limited learning experiences. Moreover, the gap between the content and the context and the attendance of the students in the hospitals instead of the clinics to pass their internship courses has reduced the provision of authentic learning experiences. These conditions have affected the quality of education negatively. The non-systematic assessment has also worsened the situation.ConclusionDespite the changes in the curriculum, the compartmentalization of the curriculum and the structure of the medical education have caused the professors’ beliefs to be in line with the past perspectives. Some modifications in the structure of the curriculum seem to be necessary.

English

BACKGROUND According to World Health Organization (WHO) emphasis, medical universities should adapt education, research, and service activities to prioritise health needs and challenges of society. To meet education, research, and service responsibilities to society, medical universities should subject themselves to measurement and assessment. Design, development and validation of a measurement instrument for Iranian Medical Schools' social accountability education function is the aim of study. This instrument is designed and developed to measure quality of education related activities within the accreditation of Iranian medical universities. METHODS This is a psychometric study, to develop the first draft of systematized instrument. Comprehensive literature review of resources, university sites, pre-existing scales, and valid universal metrics were used to extract initial items (questions) and to provide the theoretical support for the initial item pool. The theoretical analysis of the first draft would be done by assessing the face and content validity of the new instrument during the two rounds of Delphi technique for instrument validation. RESULTS Eighty-two items included nine dimensions and were developed and validated after two rounds using the Delphi method. Nine dimensions include: Anticipation of Society's Health Needs on the mission and goals of the program (6 items), planning and managing university activities (12 items), educational research (6 items), curriculum planning and educational programs (27 items), faculty members / staff (5 items), participation in health services (9 items), graduates (7 items), accreditation (7 items), admission of entries (3 items). The overall content validity index of the instrument based on the content experts that makes consensus, S-CVI of relevancy was equal to 0.93. CONCLUSIONS Present paper demonstrates new instrument for education function quality judgment of medical universities. To foster the accreditation standards and norms that reflect social accountability is an urgent need. Therefore, educational institutions and universities should be measured and rewarded based on their real status to meet the important health care needs of society.

Effect of Persian Medicine Remedy on Chemotherapy Induced Nausea and Vomiting in Breast Cancer: A Double Blind, Randomized, Crossover Clinical Trial.

BackgroundChemotherapy induced nausea and vomiting (CINV) is a side effect, and has negative effect on quality of life and continuation of chemotherapy. Despite new regimen and drugs, the problems still remain and standard guidelines, effective treatment and supportive care for refractory CINV are still not yet established. Persian medicine, the old Iranian medical school, offer Persumac (prepared from Rhus Coriaria and Bunium Persicum Boiss).ObjectiveThe specific objectives were to assess the effect of Persumac on the number and severity of nausea and vomiting in refractory CINV in acute and delayed phase.MethodsThis randomized, double blind, crossover clinical trial study was carried out on 93 patients with breast cancer and refractory CINV, who received outpatient high emetogenic chemotherapy in Imam Reza hospital, Mashhad, Iran from October 2015 to May 2016. The study has three stages: in stage I patients received a questionaire and completed it after chemotherapy. In stage II they were randomly divided into intervention group with Persumac and control group with placebo (lactose were used). In stage III, wash out and crossover was conducted. Both groups in all stages received standard antiemetic therapy for CINV. The following were set as the inclusion criteria of the study: female, Age ≥18 years, clinical diagnosis of breast cancer, history of refractory CINV, normal blood tests and at least three courses of chemotherapy remaining. Exclusion criteria of this study were: Total or upper abdominal radiation therapy along with chemotherapy, drugs/therapy for nausea and vomiting not prescribed in this study, hypersensitivity to Sumac or Bunium Persicum, use of sumac and Bunium Persicum in seven days prior to the intervention, clinical diagnosis of digestion disorders, non-chemotherapy induced nausea and vomiting, milk allergy, loss of two consecutive or three intermittent doses of Persumac or placebo. Outcomes were gathered by Persian questionnaire. Number and severity of nausea and vomiting was measured with a self-reporting tool; visual analog scale.ResultsDemographic data and other characters in both groups have no significant diffrence. Eighty of 93 eligible patients in stage I completed the study and in stage II, eleven declined participation for stage III (crossover). P value of carry over, period and treatment effects demonstrated that they had not affected the results before and after crossover. The mean severity of nausea in acute phase was in stage I: 4.83 ± 1.40, stage II: 4.54 ± 2.0 and stage III: 4.15 ± 0.92 in sequence AB (first Persumac and then placebo in crossover), and in sequence BA (first placebo and then Persumac in crossover) was respectively 4.83 ± 1.40, 4.54 ± 2.0, 4.15 ± 0.92 with p value of carry over effect: 0.03 and period effect: 0.22. Except for severity of nausea in acute phase, the mean number and severity of nausea and vomiting scores significantly decreased in acute and delayed phase of CINV.ConclusionPersumac may control the refractory CINV. The implicable and clinical importance of this research is that another option exists for refractory CINV. Higher doses, different cancers, patients with more various features, and more complete methodology and tools can provide appropriate designs for new research on this topic.Trial registrationThis trial was registered at the Clinical Trials.gov ID: NCT02787707.FundingThis study is part of a Ph.D. thesis and under grant; No: 930735 of Research Chancellery of MUMS.

Students' perceptions of the educational environment in an Iranian Medical School, as measured by The Dundee Ready Education Environment Measure

Learning environment is found to be important in determining students' academic success and learning. The goal of this study was to investigate the viewpoints of medical students toward learning environment based on The Dundee Ready Education Environment Measure (DREEM) at Rafsanjan University of Medical Sciences (RUMS). This descriptive study was conducted using the Persian DREEM questionnaire. All medical students in basic and clinical courses except internship students (fifth and sixth year) were approached to participate during the study period, of which 223 provided consent and completed the survey. Data were analyzed by SPSS-17, t-test and ANOVA statistical tests were used. The mean total score was 113.8 ± 17.31 (out of a maximum of 200, 56.9%) indicating relative satisfaction with the perceived environment. There were no individual areas of excellence. Some items scored consistently badly indicating cause for concern. The highest score were related to Academic Self-Perception (64.11%) and learning (57.2%) domains. The lowest score were related to Teachers (55.9%), Social Self-Perceptions (56.6%) and atmosphere (55.8%) domains. Basic science students perceived the environment to be significantly more positive than preclinical students (p < 0.05). Native and married students perceived the environment to be significantly more positive (p < 0.05). Second and fourth year students were significantly higher than the others (P < 0.01). There was significant difference between mean scores of total mean DREEM and sub-domains by year of enrolment (p = 0.001). This tool identified areas of concern within RUMS medical school. Further use of the DREEM as a monitoring tool would be useful to re-evaluate the environment following appropriate intervention. To create an appropriate educational environment and reduce the deficits in order to provide a better learning environment with facilitate and supportive system for students.

Informed choice of entering medical school and academic success in Iranian medical students

Background: One of the challenges medical education policy-makers confront is matriculants’ informed choice of entering medicine. However, students’ reasons for choosing medicine do not seem rational.Aim: We compared students who made an informed choice about entering medicine with those who did not, in terms of academic success.Methods: The study was carried out with a self-administered questionnaire on 220 final-year medical students randomly selected from six Iranian medical schools. Depending on their informed choice of entering medicine or not at the time of application, they were divided into two groups. We compared these two groups’ academic achievement as well as their satisfaction with medicine.Results: The students who had not made an informed choice had a higher tendency not to choose medicine if they were to start over (p value ≤0.001). The pre-admission scores of students who had made an informed choice of medicine were worse than the other group (p = 0.03). However, their final year scores as well as their satisfaction with medicine were higher than the other group.Conclusions: Idealistic views of medicine should be replaced by rational and logical ones to help students select the careers best suited to their abilities and talents.

White Coat Ceremony: a Medical Student’s Journey from Basic Sciences to Clinical Medicine

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How to teach medical students to critically appraise a published article in the public health domain

The core part of evidence-based medicine (EBM) is the ability to critically appraise published articles on a given subject. Medical students, especially within the developing world, usually do not learn how to critically appraise a published article since this is not part of their designed curriculum. This paper is reporting an innovative approach on how to teach critical appraisal skills to medical students, from an Iranian Medical School.

Student evaluation of the academic advising process in an Iranian medical school

ObjectiveThe purpose of this study was to examine student evaluation of the academic advising process in an Iranian medical school.MethodWe conducted a cross sectional survey of all fourth and fifth year students who studied medicine, nursing and laboratory technology. A short version of a validated questionnaire was administrated to 85 students (23 males and 62 females) at Fasa Medical School, Iran.ResultsOf the students, 48(56%) were satisfied with the academic advising process. The descriptive analysis of the study showed that many students (n=72) valued the importance of feedback on student ability in the academic advising process. A further descriptive analysis showed that 34 students (40%) were satisfied that advisers were aware of their records. There was a significant difference between student’s main course (χ2 (2) = 8.9; p= 0.012) and satisfaction with academic advising. However, the observed differences between female and male students in this study were not statistically significant (χ2 (1) = 2.2; p= 0.107).ConclusionsThe results of this study reveal a lack of systematic planning, skills and resources for the academic advising process at the Fars Medical School. The results indicate the need for academic staff development initiatives to improve the academic advising process. An ongoing evaluation program of the academic needs of students may help to advisors to provide academic advising and academic support for students in various courses.

Dosimetric characteristic of a new 125I brachytherapy source

A new brachytherapy (125)I source has been investigated at Iranian Agricultural, Medical and Industrial Research School. Dosimetric characteristics [dose-rate constant Λ, radial dose function g(l)(r) and anisotropy function F(r,)] of IRA-(125)I were theoretically determined in terms of the updated AAPM task group 43 (TG-43U1) recommendations. Versions 5 and 4C of the Monte Carlo radiation transport code were used to calculate the dosimetry parameters around the source. The Monte Carlo calculated dose-rate constant of the (125)I source in water was found to be 92×10(-4) Gy h(-1) U(-1) with an approximate uncertainty of ±3 %. Brachytherapy seed model, 6711-(125)I, carrying (125)I radionuclides, was modelled and benchmarked against previously published values. Finally, the calculated results were compared with the published results of those of other source manufacturers.

Identifying challenges for academic leadership in medical universities in Iran

CONTEXT The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. OBJECTIVES This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. METHODS A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. RESULTS The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). CONCLUSIONS This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance.

Evaluation of student opinion regarding curriculum in an Iranian medical school.

Evaluation of student opinion regarding curriculum in an Iranian medical school.

Modelling Information-Seeking Behaviour Patterns of Iranian Medical School Academic Staff

The aim of this study was to investigate the information-seeking behaviour of academic staff in the schools of medical sciences of Iran and to draw up a model of their information-seeking behaviour. A qualitative research method – Grounded Theory – was employed to carry out this research, analyze the data, and data were collected through interviews. Data analysis showed that the information-seeking behaviour of these Iranian Medical Schools' academic staff has seven stages: selecting subjects, searching information, retrieving information, browsing, gathering information sources, using information, and transferring information to others.

Organizational culture, values, and routines in Iranian medical schools

In Iran, restructuring of medical education and the health care delivery system in 1985 resulted in a rapid shift from elite to mass education, ultimately leading to an increase in the number of medical schools, faculties, and programs and as well as some complications. This study aimed to investigate views on academic culture, values, and routines held by faculty members. A nation-wide survey conducted in six public medical schools in Iran. The research findings show weak organizational culture and values, together with routine behaviors sensed as a negative and low satisfaction with academic leadership. The research evidence suggests bureaucracy, politicization, conservativeness, and centralization as common features of medical schools in Iran and also suggests suitable supervisory skills to tackle the tension between governmental management and academic leadership with cultural changes, the creation of new values, and adoption more efficient routines.

Organizational role stress among medical school faculty members in Iran: dealing with role conflict

BackgroundLittle research has been conducted to investigate role stress experienced by faculty members in medical schools in developing countries. This becomes even more important when the process of reform in medical education has already taken place, such as the case of Iran. The objectives of this study were to investigate and assess the level and source of role-related stress as well as dimensions of conflict among the faculty members of Iranian medical schools. Variables like the length of academic work, academic rank, employment position, and the departments of affiliation were also taken into consideration in order to determine potentially related factors.MethodsA survey was conducted at three different ranks of public medical schools. The validated Organizational Role Stress Scale was used to investigate the level of role stress and dimensions of role conflict among medical faculty members. The response rate was 66.5%.ResultsThe findings show that role stress was experienced in high level among almost all faculty members. All three studied medical schools with different ranks are threatened with relatively the same levels of role stress. Specific differences were found among faculty members from different disciplines, and academic ranks. Also having permanent position and the length of services had significant correlation with the level of role stress. The major role- related stress and forms of conflict among faculty members were role overload, role expectation conflict, inter-role distance, resource inadequacy, role stagnation, and role isolation.ConclusionThe most role-related stressors and forms of conflict among faculty members include too many tasks and everyday work load; conflicting demands from colleagues and superiors; incompatible demands from their different personal and organizational roles; inadequate resources for appropriate performance; insufficient competency to meet the demands of their role; inadequate autonomy to make decision on different tasks; and a feeling of underutilization. The findings of this study can assist administrators and policy makers to provide an attractive working climate in order to decrease side effects and consequences of role stress and to increase productivity of faculty members. Furthermore, understanding this situation can help to develop coping strategies in order to reduce role-related stress.