Medical Education In Iran Research Articles

Teaching-learning in clinical education based on epistemological orientations: A multi-method study.

Teaching-learning is the heart of medical education in the clinical setting. The objective of this research was to develop a conceptual model of effective clinical teaching in undergraduate medical education and conceptualize its operational framework based on the best fit approach. This research consisted of three sub-studies conducted using a multi-method approach. The first sub-study was conducted using a qualitative meta-synthesis approach. The second sub-study used Clarke's situational analysis approach as a postmodern version of grounded theory. Finally, the third sub-study was designed in two stages. First, it was conducted using the expert panel, in the second step, framework of synthesis based on best fit, and the framework of Ottenhoff- de Jonge et al., which formed the basis of this study. In the first sub-study, qualitative evidence on the factors of effective teaching-learning in clinical education was synthesized into five dimensions. Based on the second sub-study, the clinical teaching-learning situation in undergraduate medical education in Iran was represented in three maps, including situational, social worlds/arenas, and positional. Finally, in the third sub-study, based on model modification and development in the expert panel, the effective teaching-learning dimensions were developed into behavioral, social, pedagogical, technology, contextual, educational leadership, and financial dimensions. In the second step, based on the framework of Ottenhoff- de Jonge et al., a three-dimensional matrix was developed concerning epistemological orientations about teaching and learning. Moving from a single teaching-centered and learning-centered orientation to a teaching-learning-centered orientation is required for effective teaching-learning in clinical medical education.

Educational scholarship and Ph.D. curriculum of medical education in Iran: A serious critique and a proposal

Medical education as a discipline currently accepts students with two M.Sc. and Ph.D. degrees in Iran. This Ph.D. course was approved by the Curriculum Council Committee in Medical Sciences in 1386 AH (2016 AD). The curriculum of medical education has a total of 50 credits (including core: 20, non-core: 8, and dissertation: 22), which subsume various courses and topics such as student assessment, curriculum planning, educational leadership, program and teacher evaluation, qualitative research, educational research, clinical teaching, and so on (1). One of the necessary competencies expected from graduates of Ph.D. in medical education in Iran is to be able to have activity and innovation in various units of the Education Development Center (EDC), and it is necessary to acquire knowledge and skills about these units. One of these units is the “educational scholarship” unit, which performs various activities such as consulting, writing, and activities in the field of innovative and educational projects. The serious critique of the curriculum is that no course credit related to educational scholarship has been considered in the Ph.D. curriculum of medical education, so there is no time and program to teach this important topic to Ph.D. students of medical education, while it is one of their necessary and expected competencies. The absence of an educational program will lead to a lack of learning, and as a result, the student will not be empowered in this field. The proposal that is presented is that a 2-credit course (1 theoretical and 1 practical credit) with the title "Educational Scholarship" be placed in the curriculum of Ph.D. medical education (as a core course).

Epidemiologic Aspects of Animal Bite, Rabies, and Predictors of Delay in Post-exposure Prophylaxis: A National Registry-based Study in Iran.

The increasing trend in animal bites and rabies in recent years makes the disease a public health concern in Iran. The objectives of the current study were to investigate the epidemiologic aspects of the animal bite and determine the associated risk factors of the delay in initiation of post-exposure prophylaxis (PEP) against rabies in Iran. National registry-based cross-sectional study. This study included all registered cases of animal bites between March 2021 and March 2022 at the Ministry of Health and Medical Education in Iran. We retrieved epidemiologic data on person, time, place, and PEP outcome. A total of 260470 animal bite cases (approximately 334 per 100000 populations, and 11 deaths) were registered during the study period. About 77.2% of them were reported in males, 4.3% in children aged less than 5 years, 56.4% occurred in urban areas, 98% in domestic animals, and mostly in north and northeast areas of Iran. Additionally, 2.8% of cases had a delay of more than 48 hours in the initiation of PEP. Significant determinants of the increase in delay were female gender (OR=1.43, 95% CI: 1.36, 1.51, P<0.001), foreign nationality (OR=1.19, 95% CI: 1.01, 1.12, P=0.001), rural residence (OR=1.07, 95% CI: 1.01, 1.12, P=0.010), and the wild animals (OR=1.22, 95% CI: 1.12, 1.34, P<0.001). The observed frequency of animal bites in a year indicates a serious public health concern and the need for targeted interventions, especially in at-risk areas and vulnerable populations.

A comparative study of the curriculum in master degree of medical education in Iran and some selected countries

BackgroundWhen training efficient human resources for the health system, it is necessary to train appropriate student teaching and assessment methods and necessary skills for educational planning and evaluation. Therefore, studies and efforts to train human resources in the field of Iranian medical education have begun since 1994. The aim of the present study is a comparative study of the curriculum in master’s degree of medical education in Iran and some selected countries.MethodsThis is applied, descriptive and comparative research. Data were collected by electronic search on the website of the selected universities. Each of these selected educational curricula, the newest curriculum of the studied universities at the time of the present research, was translated into fluent Persian and studied in detail. The model used in the present study is the famous Polish Bereday model. A quota sampling method was used and universities were selected at a 1:10 ratio from each classified area. Institutions that offered master’s degrees in medical education were chosen in each region using the World Health Organization (WHO) classification based on QS World University Rankings (2020). The data collection instrument was a researcher-made checklist, which was used to extract the relevant data available on the website of selected universities. This checklist consisted of eight items, which included course title, course length, mission, vision, goals, admission process, teaching methods (online, In-person, and both), educational strategies, teaching methods, and student assessment. These eight items were compared at selected universities.ResultsThe samples included seven selected universities including Kebangsaan University in Asia, the University of Toronto in Canada, the University of Michigan in America, the University of Bern and Imperial College in Europe, Monash University in Australia, and Iranian universities. Student admission in Iran is carried out through a centralized exam; therefore, most faculties do not have the option to select students and criteria for student selection. The course length in all universities is between 1–3 years (depending on part-time/full-time) and most of the studied universities offer this field as modular degree courses.ConclusionsThe characteristics of the curriculum for the master’s degree of medical education in Iran and selected countries showed the differences and similarities of this course among the top universities of different continents. Unlike other countries, the curriculum for a master’s degree in medical education in Iran is offered in a centralized manner in eight universities of Tehran, Shahid Beheshti, Iran, Isfahan, Shiraz, Tabriz, Kerman, and Mashhad.

Community-engaged medical education is a way to develop health promoters: A comparative study.

Although the importance of health promotion and empowerment of the community has been recognized for many years, there are still many barriers to adopting health promotion in the world. One of the solutions is socially accountable medical education and community engagement. This study aimed to compare the medical programs of five medical schools that practiced community-engaged medical education to medical education in Iran. This comparative study has been performed in 2022 by the four-stage Bereday method, including description (the educational programs of the selected medical schools were examined), interpretation (a validated checklist was prepared according to community-based strategies), proximity (similar and different information was identified), and comparison (solutions were recommended to improve health promotion and community engagement in Iran's medical education program. The purposive sampling method was used to select five universities. Although successful initiatives have been attempted to integrate public health promotion and community orientation into the Iranian curriculum, they do not appear to be sufficient in comparison to leading countries. The main distinction is that the community is actively engaged in all stages of curriculum design, implementation, and evaluation. Although Iran's medical education program has a long way to go in terms of social accountability, by including more community-oriented initiatives into the curriculum, health needs of the community can be met and physician shortages in poor areas can be alleviated. It is recommended to implement modern teaching methods, to recruit diverse faculty and community members, and to increase the community placement in medical education.

Evaluation of the Prevalence of Malaria and Cutaneous Leishmaniasis in the Pre- and Post-Disaster Years in Iran.

Natural disasters (NDs) are calamitous phenomena that can increase the risk of infections in disaster-affected regions. This study aimed to evaluate the frequency of malaria and cutaneous leishmaniasis (CL) before and after earthquakes, floods, and droughts during the past four decades in Iran. Malaria and CL data were obtained from the reports of the Ministry of Health and Medical Education in Iran for the years 1983 through 2017. The data of NDs were extracted from the Centre for Research on the Epidemiology of Disasters (CRED). Interrupted time series analysis with linear regression modeling was used to estimate time trends of mentioned diseases in pre- and post-disaster conditions. For the periods preceding the disasters drought and flood, a decreasing time trend for malaria and CL was found over time. The time trend of malaria rate preceding the 1990 earthquake was stable, a downward trend was found after 1990 disaster until 1997 (β coefficient: -10.7; P = .001), and this declining trend was continued after 1997 disaster (β coefficient: -2.7; P = .001). The time trend of CL rate preceding the 1990 earthquake had a declining trend, an upward trend was found after 1990 earthquake until 1999 (β coefficient: +8.7; P = .293), and a slight upward trend had also appeared after 1999 earthquake (β coefficient: +0.75; P = .839). The results of the current study indicated the occurrence of earthquakes, floods, and droughts has no significant effect on the frequency of malaria and CL in Iran.

Development and application of a social accountability assessment tool at the Shahid Beheshti University of Medical Sciences

Background: One of the critical needs of governmental agencies and educational institutions is meeting community needs. Organizations and governmental systems that rely on social capital are considered inefficient and vulnerable if they are unable to meet the needs of society. Thus, accountability is a critical pillar of government management that leads to effective actions and better service delivery. Methods: Critical review methodology was used in the first phase to review texts and documents available in the field of social accountability and to collect items used to develop the social accountability assessment tool. The Delphi method was then used to finalize and approve the model and assessment tool. University processes were investigated and evaluated based on the social accountability tool in the second phase. Result: In all, 422 university processes were investigated and evaluated to determine their accountability in different fields. The mean score of the evaluated processes was 11.9 out of 100. Conclusion: The results show that social accountability is a relatively new topic that has received considerable attention in medical education in Iran. Given the relative newness of this topic, these results could be expected; social accountability should try and be expected to improve in the coming years.

The effects of Pre-hospital Trauma Life Support (PHTLS) training program on the on-scene time interval

BackgroundRecent studies have shown that reducing pre-hospital time could improve the outcomes of trauma victims. Due to the importance of pre-hospital time management, this study aims to determine the effects of the Pre-hospital Trauma Life Support (PHTLS) training program on the on-scene time interval reduction.MethodsThe PHTLS training program was implemented based on global standards for pre-hospital emergency technicians. The research tool was a questionnaire designed by the Ministry of Health and Medical Education in Iran. The mean on-scene time interval was calculated before, after and one month after the intervention in the control (n = 32) and experimental group (n = 32). The data were analyzed using SPSS.ResultsThe mean on-scene time interval in the target group (one month after intervention) has been significantly lower than that of the control group. Moreover, the mean and standard deviation from the on-scene time interval in the target group has been reduced from 17.6 ± 5.5 (before intervention) to 12 ± 3.8 min (one month after intervention) which was statistically significant.ConclusionThe implementation of the PHTLS training program can lead to the reduction of on-scene time interval. Therefore, considering the role of reducing on-scene time intervals on victims’ survival, the integration of the PHTLS training programs with pre-hospital emergency medical service systems seems inevitable.

Academic Librarians' Attitudes towards Augmented Reality

Academic Librarians' Attitudes towards Augmented Reality

Design and Psychometrics of the Managerial Practical Wisdom Scale in the Hospitals Affiliated to Inistry of Health and Medical Education in Iran

Design and Psychometrics of the Managerial Practical Wisdom Scale in the Hospitals Affiliated to Inistry of Health and Medical Education in Iran

Challenges and Barriers to the Interaction of High Councils of Health with the Ministry of Health and Medical Education in Iran: A Qualitative Study

Challenges and Barriers to the Interaction of High Councils of Health with the Ministry of Health and Medical Education in Iran: A Qualitative Study

Effect of COVID-19 on the Number of CT-scans and MRI Services of Public Hospitals in Iran: An Interrupted Time Series Analysis.

In February 2020, the Ministry of Health and Medical Education in Iran announced the first case of COVID-19. The aim of this study was to investigate the impact of COVID-19 on the number of CT-Scans and MRI services in public hospitals in western Iran. We collected CT-scans and MRI services data from 18 public hospitals via Vice-Chancellor Office, Lorestan University of Medical Sciences from January 2017 to February 2021. Interrupted time series analysis (ITSA) was conducted to assess the impact of COVID-19 on CT-Scans and MRI services. More specifically, ITSA was conducted using ordinary least squares regression with the number of CT-Scans and MRI services per 1,000 registered persons per month as dependent variable. At the beginning of the observation period, the monthly rate of CT-Scans was constant (p for trend = 0.267) at 291.9 (from 95%CI 240.5 to 343.4) per 1,000 registered patients. The first case of COVID-19 coincided with an abrupt increase by 211.8 (from 95%CI 102.9 to 320.7) per 1,000 patients. Thereafter, the trend of CT-Scans did not change (p=0.576) compared to the pre-pandemic period. The rate of MRI services was 363.5 per 1,000 per registered patients per month (P = <0.0001) with a slightly decreasing trend (coefficient=-5; 95%CI, -6.9 to -3.1). The findings of this study showed that crises such as COVID-19 can affect the service delivery process. Health policymakers and decision makers should work to prevent potential reductions in health care during events such as COVID-19.

Assessing mental health status among Iranian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study.

ObjectivesThe present study was conducted to assess 3(HCWs) during the COVID‐19 pandemic.MethodsA total number of 7626 HCWs were included in this web‐based cross‐sectional study, via the convenience sampling technique. To collect the required data, the sociodemographic characteristics information form, the Depression Anxiety Stress Scale‐21 (DASS‐21), and the Corona Disease Anxiety Scale (CDAS) were also employed. In addition, data analysis was performed using the SPSS Statistics software (ver. 24), as well as descriptive statistics, Chi‐square test (χ2 ), and univariate/multivariate logistic regression models.ResultsThe CDAS results revealed that 47.9% and 70.5% of the HCWs had experienced moderate levels of physical and psychological anxiety, respectively. Based on the DASS results, 44.8%, 43%, and 34.8% of the HCWs had been subjected to depression, anxiety, and stress symptoms during the COVID‐19 pandemic, respectively. The logistic regression models correspondingly showed that depression among the HCWs was significantly correlated with risk factors, such as the age groups of 20–30 years (p = .001), 31–40 years (p = .006), female HCWs (p> .001), history of physical illnesses (p = .004), and history of psychiatric disorders (p> .001). Moreover, factors including the age groups of 20–30 years (p < .001), 31–40 years (p < .001), 41–50 years (p < .001), female HCWs (p> .001), history of physical illnesses (p < .001), and history of psychiatric disorders (p>.001) were assumed as significant predictors of anxiety in these individuals. Besides, factors such as the age groups of 20–30 years (p = .002), 31–40 years (p = .004), female HCWs (p>.001), occupation (p = .016), history of physical illnesses (p < .001), and history of psychiatric disorders (p> .001) could significantly predict the prevalence rate of stress in the HCWs in times of this crisis.ConclusionGiven the importance of mental health status among HCWs during the COVID‐19 pandemic, health administrators and policymakers of the Ministry of Health and Medical Education in Iran are suggested to provide psychological screening and supportive care programs for HCWs with the aim of enhancing their mental health and successful coping with critical circumstances.

PROVIDING A MODEL FOR IMPLEMENTATION OF GOOD GOVERNANCE IN THE HEALTH IN MINISTRY OF HEALTH (CASE STUDY AT TEHRAN UNIVERSITY OF MEDICAL SCIENCES)

Purpose of the study: The current paper seeks to evaluate the feasibility of good governance in the Ministry of Health (Case study at Tehran University of Medical Sciences). In this regard, good governance and providing its requirements including participation, rule of law, transparency, accountability, consensus, fairness, efficiency, and effectiveness.&#x0D; Methodology: The population of this study were managers at Tehran University of Medical Sciences. According to the characteristics of the population in which the number of employees and experts is unlimited and uncertain, 300 questionnaires were distributed and 267 questionnaires were collected.&#x0D; Main Findings: The result of the Friedman test for ranking the components of good governance showed that the highest average among good governance factors was related to the resource factor. Structure factors were placed in the second rank and process factors had the last rank among good governance factors.&#x0D; Applications of this study: The results of this study can be applied in the government's decision and as a result, effective management of policy-making, assistance in the implementation of general policies of the administrative system of the country, achieving the positive consequences of the effective implementation of the country's policy-making management system, helping the growth and development of the organization, managers, and employees of the organization.&#x0D; Novelty/Originality of this study: According to the studies and archival studies in the field of good governance, the model of good governance in the Ministry of Health and Medical Education in Iran has not been worked on before. This can lead to the expansion of knowledge and the production of science.

Medical Education in Iran: How amazingly AMEE live Conference 2018 engaged more Iranian Medical Educationists

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Challenges and Problems of Clinical Medical Education in Iran: A Systematic Review of the Literature

Context In order to improve the quality of clinical education, it is necessary to investigate the current situation in clinical settings and identify its problems. This step is the most important part of modifying a clinical education program and meeting learning goals. The purpose of this study was to identify the challenges and problems of clinical medical education in Iran. Evidence Acquisition This systematic review was performed to determine the challenges and problems of clinical medical education in Iran in 2017. In order to retrieve articles, the following keywords: Clinical education, bedside teaching, clinical teaching, teaching round, ward round, ward round teaching, bedside round, teaching round, medical education, clinical round, ambulatory education, clinic education, grand round, and education in emergency were searched in reliable Persian and English databases. Then, the articles related to the research objective were carefully reviewed and key information was extracted. Data were analyzed using MAXQDA software version 10. Conclusions The problems of clinical education are in different areas. Identifying these areas and planning for them can improve clinical education status, achieve educational goals, and provide medical students with a more effective education.

Challenges of Developing Religious Competencies in Medical Education in Iran: A Qualitative Study

Challenges of Developing Religious Competencies in Medical Education in Iran: A Qualitative Study

Electronic Medical Education Effect on Learner Application of Health Care Knowledge in Iran

Background: Like most of countries, medical education in Iran consists of undergraduate, postgraduate, and continuing medical education (CME). The use of Internet technologies, have been integrated into all three level of medical education. The effect of Electronic medical education on application of health care knowledge in compare with traditional medical education could show the effectiveness of program.&#x0D; Aims: The aim of this study is to examine the effect of E-Learning on application level of knowledge &amp;clinical reasoning issues as compared to lecture-based learning in a medical education program.&#x0D; Study Design and Methodology: This randomized controlled trial was conducted in scientific meetings for 68 Physicians. Knowledge assessment tests were performed before and immediately after E-Learning and lecture-based educational session.&#x0D; Results: A significant improvement at the application level of knowledge &amp; clinical reasoning was found in both groups (P &lt; 0.01). There was no significant difference between the E-Learning &amp; traditional educational approaches. Course completers had significant improvements in application level of health care knowledge.&#x0D; Conclusion: The effect of E-Learning in medical education and on learner basic knowledge, application of health care knowledge in response to clinical vignettes is comparable to a lecture-based approach. Therefore, E-Learning can be effective in all levels of Medical Education, and it will enable Physicians to have a self-directed learning with choosing the place and time of their lifelong learning process.

Performance Evaluation Criteria for Hospitals' Managers: A Qualitative Study

Background: Hospitals are the most important element of the health system. Hospitals play a key role in providing health services and have a major impact on the health system's performance. The success of organizations depends on their managers’ performance. Organizations with qualified and experienced managers will be more successful in achieving their goals and can reach optimal efficiency. Methods: This is a phenomenological qualitative study in which content analysis was used to achieve study objectives. The study population included the hospitals managers and senior experts of the vice chancellor for treatment of a provincial department of the Ministry of Health and Medical Education in Iran. Participants were selected by purposive and heterogeneous methods and data collection continued until data saturation was achieved. Data were collected by semi-structured face-to-face interviews. Results: From our data, seven main themes were drawn, consisting of monitoring and control, planning, organizing, leadership and motivational factors, management of resources and information, communication and interdepartmental coordination and patient orientation Conclusion: Hospital managers play a key role in improving hospital function. Assessing hospital managers' performance, determining their strengths and weaknesses and taking corrective actions are beneficial to the improvement of hospitals’ performance.

Internationalization of medical education in Iran: A way towards implementation of the plans of development and innovation in medical education.

Academic institutions are the most important organizations for implementation of internationalization policies and practices for integrating an international, intercultural and global dimension in higher education system. Also, a globally increasing demand for higher education has been seen in the past two decades so that the number of students enrolled in higher education institutions in the worldwide nation-states has increased dramatically. The National Plan of International Development of Medical Education was designed with the aim of identifying available potentials in all the universities of medical sciences, encouraging the development of international standards of medical education, and planning for the utilization of the existing capacity in Islamic republic of Iran. Authors have tried to review the several aspects of international activities in higher education in the world and describe national experiences and main policies in globalization of medical education in Iran within implementation of the National Plan for Development and Innovation in Medical Education. The findings of some global experiences provide the policy makers with clear directions in order to develop internationalization of higher education. The Program for International Development of Medical Education was designed by the Deputy of Education in the Ministry of Health and the effective implementation of this Program was so important for promotion of Iranian medical education. But there were some challenges in this regard; addressing them through inter-sectoral collaboration is one of the most important strategies for the development of internationalization of education in the field of medical sciences.