Journal of Education and Health Promotion

Abstract BACKGROUND: Critical thinking is one of the goals of education. It is a criterion for academic
accreditation in medical education by concentration on students’ soft skills. Due to lack of basic
information on critical thinking tendency in undergraduate medical program, this study aimed to
determine the trend of tendency toward critical thinking of medical students in two phases: basic
science (year 1) and preinternship (year 5) at Tehran University of Medical Sciences.
MATERIALS AND METHODS: This longitudinal descriptive–analytic study has been conducted
in two phases (2010 and 2015); all 105 medical students were selected by accessible sampling
method. Years of entrance to college was the inclusion criterion. The psychometric properties of The
California Critical Thinking Dispositions Inventory (CCTDI) were confirmed, and then, the instrument
was completed twice by participants. Data were analyzed by SPSS: 16 using student t-test, and
paired t-tests.
RESULTS: There was a significant difference between genders of students (P < 0.05). Males were
more disposed toward critical thinking than females. The significant increase was found between mean
of truth‑seeking in the second test compared to the first test; instead, the mean of inquisitiveness,
analyticity and self‑confidence and inquisitiveness was significantly decreased (P < 0.05).
However, in other subscales, there were no significant differences between the 1st and the 5th year
students (P > 0.05). The total score of the test in the second phase was lower than the first phase,
which was not significant.
CONCLUSION: According to the findings, there is necessary to consider the critical thinking
dispositions in medical students training programs and break down the barriers. Tendency toward
critical thinking seems to be as prerequisite of critical thinking skills in undergraduate medical program.

Abstract INTRODUCTION: Assessment interprofessional collaboration (IPC), in community health‑care
setting usually has been neglected due to the lack of standard tools and assessors. In the present
study, the IPC checklist extracted from CANMEDS collaborator toolkit for teaching and assessing
the collaborator role is contextualized in Iranian community healthcare.
MATERIALS AND METHODS: According to CANMEDS Toolkit, an instrument extracted for IPC
assessment. Using Chavez’ toolkit, face and content validity were studied through two rounds of
Delphi by 12 experts of TUMS. Qualitative content validity including content validity index (CVI),
and content validity ratio (CVR) were assessed following watching a standard video about IPC by
them. Construct validity was studied by confirmatory factor analysis through LISREL software. To
check reliability, Cronbach’s alpha was calculated, and the other 12 experts completed checklists in
test–retest process with a 2‑week interval.
RESULTS: Face and qualitative content validity were confirmed using the Delphi method. CVI and
CVR were calculated as 0.61 and 0.86. In factor analysis, x2/df and RMSEA were calculated as
1.363 and 0.036; CFI, IFI, GFI, and AGFI were >0.7, and hence, the construct validity was confirmed.
Cronbach’s alpha was 0.953 for internal consistency. Test–retest was also calculated as 0.918
indicated to confirm reliability.
CONCLUSION: CANMEDS framework as an assessment tool for evaluating IPC in community health
setting is not only valid and reliable in the Iranian context but also it is easy to use for respondents
resulted from the rational number of items in community.

Abstract BACKGROUND AND OBJECTIVE: Applying the Best Evidence Medical Education (BEME)
in real educational arena is a necessity in medical education. As to the literature, there are
enough evidence; however, their application by educators and policymakers has been still failed.
Therefore, this study conducted to explore the experience of educators about applying BEME in
Iranian context.
MATERIALS AND METHODS: Qualitative approach using content analysis method was utilized for
exploring 25 participants involved with medical education in different levels, introduced the study using
purposeful sampling. Data were collected through a semi‑structured interview by which they answered
to researcher’s questions in around 45 min about how they apply evidence in their educational setting.
To make more clarification, probing questions were used. Interviews were recorded and transcribed
and then analyzed by coding paradigm immediately.
RESULTS: Three categories were emerged as: applying different levels of evidence, substitution
of evidence‑based medicine for BEME, and variation of understanding BEME. The first category
includes subcategories of using personal experience, textbooks, and filtered papers. The second
contains lack of knowledge about BEME elements, time and motivation as well as no priority for
applying available medical education evidence; and third, using different terminology and having
some problems in applying process, based on individual understanding and using papers with or
without modification.
DISCUSSION: For effective evidence application, it is necessary to operationalize BEME terminology
and overcome any ambiguity surrounded it. It is also important to suggest educators to apply the
appraised evidence as well as teach them how they search and appraise evidence independently.
Certainly, in the first steps, supervision and providing a proper context for BEME applications are
crucial.