Journal of Education and Health Promotion

The double‑edged sword of emotions in medical education: A scoping review

. Nahid Toufan; . Athar Omid; . Fariba Haghani

Volume 13, Issue 2 , February 2023, , Pages 1-12

Abstract

  Emotions are universal in academic and clinical settings. A student is likely to hope for success,maybe be worried about failure, or may feel comfortable after an exam. These feelings ...  Read More Emotions are universal in academic and clinical settings. A student is likely to hope for success,maybe be worried about failure, or may feel comfortable after an exam. These feelings undoubtedlyaffect his/her motivation, effort, academic performance, and progress. This study aimed to investigatethe role of emotion in the learning and performance of medical students and its mechanism. Thisstudy was a scoping review conducted in 2022 to examine the role of emotions in medical education.The three databases PubMed, ERIC, and Science Direct and the search engine Google Scholarwere searched using the following keywords: “emotion,” “medical student,” “teaching,” “learning,”and “medical education.” English articles published from 2010 to 2022 were reviewed, and finally,34 articles that met the inclusion criteria were reviewed. Review of the selected articles showed thatthere was a significant relationship between the cognitive system and emotions in the brain. Theconceptual framework of the relationship between cognition and emotion can be explained in theform of dimensional and discrete views of emotions and based on cognitive load theory. Emotionsaffect cognition with the four mechanisms of memory, cognitive resources, cognitive strategies,and motivation and can be effective in learning self‑regulation, clinical reasoning, and academicachievement of medical students. Emotions in medical education is a double‑edged sword. In otherwords, it is highly recommended to divide emotions into activating and inactivating, instead of dividingthem into positive and negative ones. In this context, medical educators can use the positive aspectsof nearly all emotions to improve the quality of their teaching.

---

• View Article
• PDF 850.62 K

Prevalence of depression, anxiety and stress among private medical college students in South India: A cross‑sectional study

. Sangeetha Raja; . Gayathri Balasubramanian; . Jamuna Rani R

Volume 12, Issue 10 , November 2022, , Pages 1-5

Abstract

  BACKGROUND: Medical education is competitive across the globe. The long duration of the medicaland paramedical courses and exposure to clinical settings potentially causes mental health ...  Read More BACKGROUND: Medical education is competitive across the globe. The long duration of the medicaland paramedical courses and exposure to clinical settings potentially causes mental health issues.The aim of this study was to estimate the prevalence of depression, anxiety and stress amongundergraduate students in a private medical college in South India.MATERIALS AND METHODS: This cross‑sectional study was conducted among paramedical andmedical students at a private medical college hospital and research center in South India in theyear 2021. The required sample size was calculated as 783 with an expected prevalence of 53%,95% confidence interval (CI), design effect 2.0, and non‑response of 10%. The study participantswere selected based on simple random sampling. After obtaining informed consent, the data wascollected using an email questionnaire. Standard data collection tools such as the Perceived StressScale (PSS); and the Depression, Anxiety and Stress Scale ‑ 21 (DASS‑21) questionnaire wereused. The investigator computed the odds ratio (OR) and adjusted odds ratio (aOR) with a 95% CI.RESULTS: Out of 1200 students, 1015 (85%) responded to the email questionnaire. Among them, 639were females (63%), and 925 were paramedics (91%). Prevalence of depression, anxiety and stresswere 59%, 43% and 11%, respectively. Almost 95% of students experienced moderate‑to‑severestress in the last one month. Prevalence was higher among females and students of medicalcourses. Students of final year of college (aOR = 2.0; 95% CI = 1.2–3.5) and students of medicalcourse (aOR = 1.5; 95% CI = 1.1–2.4) were independently associated with stress among the studyparticipants.CONCLUSION: There is high prevalence of depression, anxiety and stress among medical collegestudents in south India. The final year of study and medical course were independently associatedwith higher stress than others. We recommend periodic assessment of mental health status andadditional mental health care for final year students and medical students.

---

• View Article
• PDF 564.21 K

Challenges faced by health professions educationists en route to educational reforms in Pakistan

. Laila S. Abbasi; . Rahila Yasmeen; . Taliya Sajjad

Volume 12, Issue 8 , September 2022, , Pages 1-6

Abstract

  BACKGROUND: Since the field of health professions education (HPE) is an emerging trend in thecountry, educationists face considerable challenges in their workplaces while proposing ...  Read More BACKGROUND: Since the field of health professions education (HPE) is an emerging trend in thecountry, educationists face considerable challenges in their workplaces while proposing any changesin the existing systems of academic institutions. The challenges affect the quality of work, hinderinnovation, and create a dysfunctional work environment, non‑conducive for both personal andprofessional progress. The study was conducted to explore the various kinds of challenges facedby educationists while bringing changes to the existing systems of academic institutions in Pakistan.MATERIALS AND METHODS: A qualitative exploratory research design was used to explore thechallenges faced by health professions educationists in Pakistan during their efforts to bring aboutchanges in the existing systems and structures. Thirteen health professions educationists workingin various academic institutions of Pakistan were interviewed through one‑to‑one semi‑structuredinterviews from March to May 2022. The data obtained were analyzed through manual thematicanalysis, and themes and subthemes were identified.RESULTS: Four themes emerged after qualitative data analysis explaining the predominantchallenges faced by educationists. These included challenges related to faculty and staff, institutionalconstraints, challenges from leadership, and stakeholders’ apprehension.CONCLUSION: Challenges are inevitable at every workplace but the field of health professionseducation in Pakistan faces significant challenges in institutions, leading to hindrance in positivedevelopments and innovations in the field. Educationists should be skilled at recognizing thepredominant challenges in the workplace and be equipped with strategies to manage conflicts toachieve productive results and to promote the long‑overdue reforms in the field.

---

• View Article
• PDF 431.16 K

Identification of change leadership dimensions and components in medical science education to move toward the third‑generation universities: A qualitative study

. Ghobad Ramezani; . Shoaleh Bigdeli; . Yadolah Zarezadeh; . Zohreh Sohrabi

Volume 12, Issue 5 , June 2022, , Pages 1-11

Abstract

  BACKGROUND: Change is a multidimensional and pervasive issue in the modern world, andorganizations are constantly changing in social, cultural, political, economic, and technological ...  Read More BACKGROUND: Change is a multidimensional and pervasive issue in the modern world, andorganizations are constantly changing in social, cultural, political, economic, and technological fields.Change leadership is a model that employs a combination of leadership styles to keep the employeesand the organization prepared for learning and continuous growth. This study aims to identify thedimensions and components of change leadership in medical sciences education to move towardthird‑generation universities through a qualitative approach.MATERIALS AND METHODS: The present study was an applied explorative qualitative study.Participants included the experts in the field of management and key informants in the field of changeleadership and third‑generation universities who were selected through purposive sampling. Theresearch tool was semi‑structured interviews aimed at the identification of dimensions and componentsof the change leadership. Interview‑guided questions were about change leadership to move towardthe third‑generation universities followed by probing questions. Colaizzi content analysis techniquewas used to analyze the data.RESULTS: Data from interview transcript analysis resulted in the identification of 335 initial codes,13 subcategories, and 3 categories or dimensions. The main categories included “change leadershiproles and specifications,” “providing a context and preparing for change,” and “change leadershipprocess and path.” Each of the main dimensions included several components.CONCLUSION: The importance of leadership in the process of change is since change entails theestablishment and institutionalization of new systems and structures which is impossible withoutan effective leadership style. Leaders have high expectations of their followers and inspire themto strive toward organizational goals and facilitate the realization of the shared vision throughencouraging them. As a leadership paradigm for organization performance improvement capableof encouraging employees and building an organizational culture in which ethical procedures areconsidered behavioral norms, change leadership seeks to predict the environment changes so thatit can move in accordance with them.

---

• View Article
• PDF 537.45 K

Exploration challenges of the implementers of Iran’s transformational innovation plan in medical education

. Mohammad Hasan Keshavarzi; . Javad Kojuri; . Habibolah Rezaei; . Ali Reza Safarpour

Volume 12, Issue 5 , June 2022, , Pages 1-7

Abstract

  BACKGROUND: The Health System Reform Plan, especially in medical education, has undoubtedlycaused changes in the university. The continuation of this project requires recognizing the ...  Read More BACKGROUND: The Health System Reform Plan, especially in medical education, has undoubtedlycaused changes in the university. The continuation of this project requires recognizing the challengesconfronted by those in charge of its implementation. This study aimed to explore the challenges ofthe implementers of the Transformation and Innovation Plan in Medical Education in the universitiesof Macroregion 5.MATERIALS AND METHODS: The qualitative research was conducted using the content analysismethod. Semi‑structured interviews with health and medical education managers were used tocollect information. Participants were 11 educational leaders of universities who were selected bypurposeful sampling. Data collection continued until data saturation was reached. Data analysiswas performed continuously and simultaneously with data collection. The Graneheim and Lundmanmethods were used to analyze the data.RESULTS: From 11 interviews, one theme, five categories, and 12 subclasses were obtained. Fivecategories include lack of proper groundwork, weak leadership, structural problems, inability to fund,and inadequate monitoring.CONCLUSION: Innovation and transformation in medical education are one of the critical missionsand admirable actions of the Ministry of Health in the field of education, but a review of this plancan, in addition to identifying shortcomings and problems, pave the way for success, and progressin future programs.

---

• View Article
• PDF 461.58 K

Metamotivation in medical students: Explaining motivation regulation strategies in medical students

. Ali Norouzi; . Maryam Alizadeh; . Dean Parmelee; . Saharnaz Nedjat; . Saiideh Norouzi; . Mohammad Shariati

Volume 12, Issue 5 , June 2022, , Pages 1-8

Abstract

  BACKGROUND: Metamotivation is a process that students use to monitor their motivational statesto reach their academic goals. To date, few studies have addressed the ways that medical ...  Read More BACKGROUND: Metamotivation is a process that students use to monitor their motivational statesto reach their academic goals. To date, few studies have addressed the ways that medical studentsmanage their motivational states. This study aim to identify the motivational strategies of medicalstudents as they use the metamotivational process to monitor and control their motivational states.MATERIALS AND METHODS: This qualitative study uses directed content analysis of the narrativeresponses of 18 medical students to draft an in‑depth and semistructured interview protocol which wereconducted through WhatsApp due to social distance restrictions of COVID‑19. Data were collected,encoded, and analyzed using deductive content analysis approach descripted by Elo and Kyngäs.RESULTS: Seven main themes were extracted as the motivational strategies of medical studentsincluding “regulation of value,” “regulation of situational interest,” “self‑consequating,” “environmentalstructuring,” “efficacy management,” “regulation of relatedness,” and “regulation of situationalawareness.” In this study by identifying new strategies, we provide a broader framework ofmetamotivational strategies in the field of the progression of learners in medical education.CONCLUSION: Medical students use a variety of strategies to regulate their academic motivation. Tosustain and improve the motivation of medical students, identifying and strengthening metamotivationalstrategies is the first step.

---

• View Article
• PDF 686.96 K

Explaining medical students’ perceptions of asynchronous virtual education in the COVID‑19 pandemic: A qualitative study

. Roghieh Sodeify; . Zeinab Habibpour; . Masoumeh Akbarbegloo

Volume 12, Issue 4 , April 2022, , Pages 1-7

Abstract

  INTRODUCTION: With the unintended closure of classrooms following the outbreak of COVID‑19, the virtual education method is used as an alternative to face‑to‑face education. ...  Read More INTRODUCTION: With the unintended closure of classrooms following the outbreak of COVID‑19, the virtual education method is used as an alternative to face‑to‑face education. Virtual education is one of the important factors in promoting the learning of medical students and has many benefits such as increasing the ability of critical thinking, problem‑solving skills, and self‑directed learning. However, critically examining students’ perceptions of e‑learning can help improve quality and better planning.MATERIALS AND METHODS: This research was a qualitative study. Twelve students were enrolled in the study based on purposive sampling. Data were collected using in‑depth semi‑structured interviews in 2020. All interviews were recorded and then transcribed and analyzed using a continuous comparison and conventional content analysis approach.RESULTS: Data analysis revealed four main themes and ten subthemes. The main themes included “student concern,” “teacher barriers,” “technology weakness,” and “asynchronous virtual learning flexibility.”CONCLUSION: Asynchronous e‑learning in the COVID‑19 outbreak had its advantages and disadvantages. By analyzing students’ perceptions in this field, some better designs and planning can be done to increase the quality of education.

---

• View Article
• PDF 486.15 K

The viewpoints of medical sciences wealth creators regarding the wealth creation strategies and path in medical sciences universities

. Atefeh Zabihi Zazoly; . Shoaleh Bigdeli; . Zohreh Sohrabi

Volume 12, Issue 4 , April 2022, , Pages 1-8

Abstract

  BACKGROUND: In the recent years, the wealth creation of educational institutions has attracted an enormous attention in different countries. Exploring experiences of these institutes ...  Read More BACKGROUND: In the recent years, the wealth creation of educational institutions has attracted an enormous attention in different countries. Exploring experiences of these institutes help to improve the wealth creation of universities. In this regard, this study was an attempt to explain the viewpoints of the wealth creators of medical sciences regarding wealth creation strategies and define the general path of wealth creation in medical sciences universities.MATERIALS AND METHODS: This qualitative study was conducted at Iran University of Medical Sciences, Tehran, Iran, in 2021. Participants were the experienced knowledgeable wealth creation experts. Fourteen semi‑structured interviews were conducted to reach data saturation. Interview guided questions were about strategies and paths of wealth creation followed by probing questions. Data were analyzed using conventional qualitative content analysis.RESULTS: Data analysis showed that the most important strategies were related to nine extracted categories of “the productions”, “contracts and relations”, revising, predicting and foresight” ‑, “education”, “research”, “healthcare services”, “ interdisciplinary fields between Information Technology (IT) and health‑care”, “ saving and maintenance”, and “altering the procedure of the wealth accelerator centers.” In general, wealth creation path in medical sciences includes six main categories.CONCLUSIONS: The result of this study provide an opportunity for educational policy‑makers and authorities to improve wealth creation in medical universities. Especially, accentuated by the COVID‑19 pandemic, to consider the interdisciplinary fields between IT and health‑care and integrating technology to the various categories of medical sciences are absolute needs.

---

• View Article
• PDF 500.65 K

Occurrence of urinary tract infection and preventive strategies practiced by female students at a tertiary care teaching institution

. Prasuna Jelly; . Rajni Verma; . Reena Kumawat; . Suman Choudhary; . Lisa Chadha; . Rakesh Sharma

Volume 12, Issue 4 , April 2022, , Pages 1-8

Abstract

  BACKGROUND: Urinary tract infections (UTIs) are more common in females than males and predominantly based on their unhealthy practices in their day to day lives. This study is ...  Read More BACKGROUND: Urinary tract infections (UTIs) are more common in females than males and predominantly based on their unhealthy practices in their day to day lives. This study is trying to assess the occurrence of UTI and strategies used by female student to prevent UTI.MATERIALS AND METHODS: A cross‑sectional descriptive study carried out in a tertiary care teaching institute. A total of 338 conveniently selected B. Sc. Nursing and MBBS Medical students were surveyed. The data were collected by using a pretested, a self‑structured questionnaire related to occurrence and practices to prevent UTI along with necessary demographic details. Descriptive (frequency, percentage, mean and standard deviation) and inferential (Chi‑square test) statistics was used to compute the data.RESULTS: The result of this study shows that 10.05% female students reported of having UTI. The proportion was higher in nursing students (67.6%) than medical (32.4%) but did not show a significance difference (P = 0.61). Age, duration of hostel life, and marital status were significantly associated with the status of UTI (P = 0.001). To prevent UTI, students were using commercial product with Tea Tree Oil, soap, drinking 3–4 l water/day, increased frequency of peri‑wash during menstruation period, and use of Citrus Fruits. The use of western toilet was also significantly associated with status of UTI (P = 0.04).CONCLUSION: The occurrence of UTI was more among nursing students. Most of the perineal hygienic practices by the female students were associated with occurrence of UTI; hence, it is necessary to emphasize on preventive practices to minimize re‑occurrence.

---

• View Article
• PDF 606.32 K

Medical students and doctors’ perceptions toward COVID‑19 health communication on social media

. Resiana Citra; . Rizma Adlia Syakurah

Volume 12, Issue 2 , February 2022, , Pages 1-12

Abstract

  BACKGROUND: Ineffective health communication could cause the increase of COVID‑19 cases in Indonesia. Medical students can involve in efforts in health communication on social ...  Read More BACKGROUND: Ineffective health communication could cause the increase of COVID‑19 cases in Indonesia. Medical students can involve in efforts in health communication on social media to positively impact prevention behaviors during a pandemic. This study aims to identify and analyze medical students’ and internship doctors’ perceptions toward health communication related to COVID‑19 through social media.MATERIALS AND METHODS: A mixed method with exploratory sequential used. A qualitative study was done using phenomenology approach through deep and semi‑structured interviewing. After data analysis, the draft of the instrument prepared. Items in the draft selected based on the respondents’ answer. Then, a quantitative cross‑sectional study was used. The data obtained from 399 medical students and doctors at a University in Indonesia using Google Form on October 14 to October 20, 2020 through media social. Data were analyzed using Pearson Correlation and Chi‑square (alternative: Fisher’s exact test) and logistic regression analysis with P < 0.05 and 95% confidence interval, respectively.RESULTS: Based on interview, respondents communicate health on social media because the condition of COVID‑19 in Indonesia is dangerous, feel vulnerable to COVID‑19, understand the benefits, obligations, or responsibilities as a candidate and/or medical personnel and believe theycan create content/find valid sources. Meanwhile, the perception of limited knowledge is their biggestobstacle in conducting health communication. There were a relationship between gender (P = 0.028, PR = 0.657), perceived severity (P = 0.044, PR (Prevalence Ratio) =4.844 [0.725–32,354]), perceived susceptibility (P = 0.005, PR = 1.803 [1.182–2.750]), perceived barrier (P < 0.001, PR = 2.543 [1.908–3.388]), and self‑efficacy (P = 0.012, PR = 1.810 [1.120–2.926]) with health communication behavior. The perceived barrier (P < 0.001, RR = 4.278 [2.709–6.754]) and perceived susceptibility (P = 0.004, PR = 2.304 [1.302–4.077]) were the most influenced behavior.CONCLUSIONS: This study showed that perceived severity, perceived susceptibility, perceived barrier, and self‑efficacy are predictor factors of health communication behavior related to COVID‑19on social media with perceptions of susceptibility and perceived barriers as the most influentialvariables. It is necessary to provide communication learning on social media as effectively and applied directly to reduce perceived barriers and increase self‑efficacy.

---

• View Article
• PDF 1.2 M

Knowledge and attitude toward professional ethics: A study among Iranian medical and nursing students’

. Poria Hoseinialiabadi; . Ali Omidi; . Mansour Arab; . Zohreh Makarem; . Mojtaba Jafari

Volume 12, Issue 1 , January 2022, , Pages 1-5

Abstract

  BACKGROUND: Professional ethics is a set of principles and standards of human behavior thataffect individual behavior and leads to improve care that provided by medical staff. The presentstudy ...  Read More BACKGROUND: Professional ethics is a set of principles and standards of human behavior thataffect individual behavior and leads to improve care that provided by medical staff. The presentstudy examined the knowledge and attitude of medical and nursing students toward professionalethics in Iran.MATERIALS AND METHODS: This descriptive‑analytic study was carried out on 176 medical andnursing students in Bam University of Medical Science, Iran in 2019. In this study, students wereselected by census sampling. Data collected using two researcher‑made questionnaires related toknowledge and attitude toward professional ethics. Data were analyzed in SPSS software.RESULTS: The mean scores of knowledge among nursing and medical students were 86.56 (8.76)and 85.10 (12.19), respectively. The mean score of attitude among nursing and medical studentswas 127.06 (12.45) and 129.9 (11.88), respectively. Results of the Pearson correlation test showed apositive and significant associated between the score of knowledge and attitude nursing and medicalstudents’ (P < 0.001), (r = 0.76) (r = 0.66). Among the demographics characteristics, student agewas associated to their attitude and knowledge significantly (P = 0.03).CONCLUSION: Iranian nursing and medical students have a positive attitude and a high level ofknowledge about professional ethics. A high level of knowledge was related to the most positiveattitude.

---

• View Article
• PDF 464.03 K

Medical students’ perspective on online teaching during pandemic: Experience from a Government Medical College in Uttarakhand, India

. Pooja Sharma Kala; . Naveen Thapliyal; . Hari Shankar Pandey; . A. R. Piyush; . Sonam Maheshwari; . Vikram Singh Chaudhary

Volume 11, Issue 11 , December 2021, , Pages 1-6

Abstract

  BACKGROUND: COVID‑19 pandemic has forced medical education to undergo suddenmetamorphosis from the traditional face‑to‑face education to distance online learning. This transitionwas ...  Read More BACKGROUND: COVID‑19 pandemic has forced medical education to undergo suddenmetamorphosis from the traditional face‑to‑face education to distance online learning. This transitionwas dealt with a lot of infrastructure and technical difficulties from both teacher and learner ends,especially in a developing country like India. This study was conducted with the aim of analyzingstudents’ perspective and problems faced in the live online teaching.MATERIALS AND METHODS: This was a prospective longitudinal study conducted on medicalstudents enrolled in the 1st, 2nd, and 3rd years of Bachelor of Medicine and Bachelor of Surgerycourses at a government medical college located in hilly state Uttarakhand, India. Clearance fromthe institutional ethical committee was obtained. The students were invited to voluntarily participate inonline survey by filling Google Forms which was E‑mailed as well as shared in social media platform.A total of 237 medical students participated. The first survey was conducted at the time of initiationof online mode of teaching, during May 1–7, 2020, and second, after completion of 6 months ofregular online teaching, during November 1–7, 2020. The questionnaire comprised initial sectionon demographic details and consent followed by 27 and 30 sets of statements pertaining to onlinemedical education experience in the first and second questionnaires, respectively. A 5‑point Likertscale was used. Data were analyzed using IBM SPSS version 24.0. Chi‑square test was applied forassociation, and P ≤ 0.05 was considered statistically significant.RESULTS: A total of 237 students participated in the study. The response rate was 52.7%. Majority ofrespondents had suitable devices (89.1%) and Internet facilities (62%) for online classes. The studentsaccepted the new method of teaching very well, but for practical sessions and clinics, traditionalclasses were necessary. Long screen time, lack of student–teacher interaction, and interaction withpeers were major concerns of students. However, over the study period, the availability of resources,friendliness toward technology, and inclination toward virtual classes increased.CONCLUSIONS: The pandemic has introduced to a new normal where online teaching cannot beignored. Despite challenges faced during online learning, 65.5% of students preferred hybrid teachingin future for delivering medical education. Acceptance for online education by students increasedover time in the study.

---

• View Article
• PDF 625.84 K

The effect of integration of basic and clinical aspects of a specific topic in a parasitology course on medical students learning: A randomized controlled trial

. Mitra Amini; . Fattaneh Mikaeili; . Farhad Handjani; . Gholamreza Hatam; . Qasem Asgari

Volume 11, Issue 9 , October 2021, , Pages 1-6

Abstract

  BACKGROUND AND AIM: Parasitology course is one of the basic science courses in the educationalcurriculum for medical students. Since the integration of basic and clinical sciences has ...  Read More BACKGROUND AND AIM: Parasitology course is one of the basic science courses in the educationalcurriculum for medical students. Since the integration of basic and clinical sciences has helpedstudents better understand the basic science course content, the aim of the present study was todetermine the effect of integration of basic and clinical aspects of a specific topic in a parasitologycourse on medical students learning.MATERIALS AND METHODS: A randomized controlled trial was conducted on 110 undergraduatefifth‑semester medical students from April to July 2018. The students were randomly divided into twogroups, based on student identification number: Intervention and control groups. The topic selectedfor this study from the parasitology course was “cutaneous leishmaniasis.” At the beginning of theprogram, a dermatologist presented the clinical aspects of the topic to the intervention group. Then,a parasitologist delivered a traditional lecture about the basic aspects of the topic to both groups.The students’ scores on questions related to cutaneous leishmaniasis in the final exam were usedas a measure of learning and teaching outcomes. A questionnaire that consisted of seven items andthree open‑ended questions was used based on the objectives of the randomized controlled trial.Statistical analysis was performed by SPSS software.RESULTS: Based on the result of the final examination, there was no significant difference inthe learning rate of students between the intervention and control groups (P ≥ 0.05). Accordingto students’ comments, the teaching of clinical science alongside basic science increased theimportance of the topic and the students’ interest in basic science. Most students agreed that thismethod prepares them for their clinical years.CONCLUSION: Many medical students believe that the content of many basic science courses areforgotten in the future. Therefore, basic science education alongside clinical science presentationsare suggested.

---

• View Article
• PDF 848.28 K

Providing a model for validation of the assessment system of internal medicine residents based on Kane’s framework

. Mostafa Dehghani Poudeh; . Aeen Mohammadi; . Rita Mojtahedzadeh; . Nikoo Yamani; . Ali Delavar

Volume 11, Issue 9 , October 2021, , Pages 1-13

Abstract

  BACKGROUND: Kane’s validity framework examines the validity of the interpretation of a test at thefour levels of scoring, generalization, extrapolation, and implications. No model ...  Read More BACKGROUND: Kane’s validity framework examines the validity of the interpretation of a test at thefour levels of scoring, generalization, extrapolation, and implications. No model has been yet proposedto use this framework particularly for a system of assessment. This study provided a model for thevalidation of the internal medicine residents’ assessment system, based on the Kane’s framework.MATERIALS AND METHODS: Through a five stages study, first, by reviewing the literature, themethods used, and the study challenges, in using Kane’s framework, were extracted. Then, possibleassumptions about the design and implementation of residents’ tests and the proposed methods fortheir validation at each of their four inferences of Kane’s validity were made in the form of two tables.Subsequently, in a focus group session, the assumptions and proposed validation methods werereviewed. In the fourth stage, the opinions of seven internal medicine professors were asked aboutthe results of the focus group. Finally, the assumptions and the final validation model were prepared.RESULTS: The proposed tables were modified in the focus group. The validation table was developedconsisting of tests, used at each Miller’s pyramid level. The results were approved by five professorsof the internal medicine. The final table has five rows, respectively, as the levels of Knows and KnowsHow, Shows How, Shows, Does, and the fifth one for the final scores of residents. The columnsof the table demonstrate the necessary measures for validation at the four levels of inferences ofKane’s framework.CONCLUSION: The proposed model ensures the validity of the internal medicine specialty residencyassessment system based on Kane’s framework, especially at the implication level.

---

• View Article
• PDF 978.46 K

Virtual learning during the COVID‑19 pandemic: What are the barriers and how to overcome them?

. Sujata Yadneshwar Khobragade; . Htoo Htoo Kyaw Soe; . Yadneshwar Sudam Khobragade; . Adinegara Lutfi bin Abas

Volume 11, Issue 8 , September 2021, , Pages 1-10

Abstract

  CONTEXT: Virtual learning is not without challenges. It can cause stress, lack of motivation, and socialisolation. Due to COVID‑19 pandemic, our college shifted from face‑to‑face ...  Read More CONTEXT: Virtual learning is not without challenges. It can cause stress, lack of motivation, and socialisolation. Due to COVID‑19 pandemic, our college shifted from face‑to‑face to virtual teaching–learningstyle. the aim was to find out the barriers in virtual learning among medical students and providesolutions to overcome them.MATERIALS AND METHODS: This cross‑sectional study was conducted among 3rd‑ and 4th‑yearBachelor of Medicine and Bachelor of Surgery students in 2020. Prevalidated electronic survey formson institutional barrier, technical barrier, and individual barrier were sent to students, 160 studentsresponded. SPSS version 12 was used to calculate descriptive statistics and independent t‑test.RESULTS: The students had the highest mean score in individual barrier(mean: 2.82 [standard deviation (SD): 0.72]) followed by institutional barrier (mean: 2.79 [SD: 0.74])and technological barrier (mean: 2.72 [SD: 0.75]). Regarding technological barriers, 38.6% of thestudents agreed difficulty in procurement of the laptop and 66.4% faced slow Internet connection.Regarding institutional barriers, 75.9% were stressed to join one lecture to another lecture as thelectures were continuous, 69.6% had limited opportunity to interact with lecturers, and 62.7% hadpoor communication between lecturers and students. Regarding individual barriers, 74.1% of thestudents were not motivated for online learning, 71.5% of the students could not learn as well asthey were in the classroom, and 58.2% disagreed taking online courses in future.CONCLUSION: Low motivation, communication, Internet connectivity, and technical problems werethe main barriers. Smaller size class, highly motivated and well‑trained lecturers, and interactivelectures may help in breaking the barriers of virtual learning.

---

• View Article
• PDF 660.53 K

Assessing the compliance of educational curricula of selected disciplines with the content standards of cancer‑related palliative care

. Zahra Ebadinejad; . Maryam Rassouli; . Ali Fakhr‑Movahedi

Volume 11, Issue 6 , July 2021, , Pages 1-13

Abstract

  BACKGROUND: Management of cancer complications requires the provision of palliative care as acomprehensive care by the main and trained members of this method of care. The aim of the ...  Read More BACKGROUND: Management of cancer complications requires the provision of palliative care as acomprehensive care by the main and trained members of this method of care. The aim of the presentstudy was to assess the compliance of educational curricula of selected disciplines with the contentstandards of cancer‑related palliative care.MATERIALS AND METHODS: In this descriptive–comparative study, the content standards ofpalliative care for nurses, physicians, and social workers were identified based on the World HealthOrganization guideline and Oxford Textbook of Palliative Nursing. For this purpose, a separatechecklist was prepared for the disciplines with different dimensions. Then the face and contentvalidity of the checklists were checked. Finally, we examined the coordination between selectedcurricula available on the website of Education Deputy of the Ministry of Health, Treatment andMedical Education with the dimensions of the checklists.RESULTS: All three curricula in most domains were relevant with the content standards, but therewas the biggest education need in the areas related to the dimensions of “planning and educational,”“educating physician in palliative care,” and “considering patient preferences” in these disciplines.CONCLUSIONS: To meet the educational needs, it is suggested to change some course topics,hold training courses, or joint workshops.

---

• View Article
• PDF 550.11 K

Mental health state in medical students during COVID-19 pandemic

. Dian Natalia; . Rizma Adlia Syakurah

Volume 11, Issue 5 , June 2021, , Pages 1-6

Abstract

  BACKGROUND: Before the COVID-19 pandemic, medical students had reported experiencing highrates of distress, burnout, anxiety, and depression. The psychological impact of the COVID-19 ...  Read More BACKGROUND: Before the COVID-19 pandemic, medical students had reported experiencing highrates of distress, burnout, anxiety, and depression. The psychological impact of the COVID-19 in thegeneral population suggested that the mental health impact was increased anxiety, depression, andstress. There were no exceptions if medical students also experience the same psychological impact.The aimed to this study is analyze the mental and emotional effects of the COVID-19 pandemicamong medical students.MATERIALS AND METHODS: An observational analytic study was used with a cross-sectionalapproach. Data were obtained with questionnaires distributed through social media platforms fromJuly 14, 2020, to July 21, 2020. This study using the Fear of COVID-19 (FCV-19) Scale and theDepression, Anxiety, and Stress Scale-21 to assess FCV-19, anxiety, stress, and depression.statistical analysis used IBM SPSS Statistics 24 was used to analyze the two-tailed Chi-square test,the Mann–Whitney test, and the Kruskal–Wallis test, which were used with statistical significanceas P < 0.05 for all tests.RESULTS: Out of 1027 samples, 44.6% had stressed, 47.8% had anxiety, and 18.6% had depression.The gender (P = 0.000), educational stage (P = 0.000), and the comorbidity factor (P = 0.001 forstress and anxiety, P = 0.036 for depression, and P = 0.000 for FCV-19) had a significant associationwith stress, anxiety, depression, and FCV-19 in medical students. The hometown that showed zonerisk of infection only showed significant differences in FCV-19 (P = 0.026).CONCLUSIONS: Protection and psychological support for a medical student is extremely highimportance given that COVID-19 is now a well-established pandemic and there will be otherpandemics in the future.

---

• View Article
• PDF 526.23 K

Medical faculty perception toward digital teaching methods during COVID‑19 pandemic: Experience from India

. Karthik Vishwanathan; . Geetika Madan Patel; . Devanshu Jayeshbhai Patel

Volume 11, Issue 3 , March 2021, , Pages 1-7

Abstract

  BACKGROUND: Videoconferencing has been used as a modality of online medical teachingby various institutes. There is a paucity of studies reporting the perception of medical teacherstoward ...  Read More BACKGROUND: Videoconferencing has been used as a modality of online medical teachingby various institutes. There is a paucity of studies reporting the perception of medical teacherstoward teaching using teleconferencing platforms. The objective of this survey was to evaluate theperception of medical teachers toward teaching using videoconferencing platforms such as Zoommeet, Google meet, and Google classroom during the COVID‑19 pandemic. Our hypothesis wasteaching faculty would have a positive perception and experience toward web‑based teachingmodalities.MATERIALS AND METHODS: Medical teachers of a medical college were invited to participatein a prospective observational cross‑sectional online survey. The faculty demographic information,perception, experience, and satisfaction were noted. Perception data were presented as proportionand percentage.RESULTS: 104 out of 160 faculty members participated in the study (response rate = 65%).61 male (58.7%) and 43 female (41.3%) faculty members participated in the study. The mean ageof the faculty members was 39.3 years ± 13 (range: 27–69 years). Laptop (n = 73 [70.2%]) was themost commonly used electronic device by the faculty members for conducting e‑teaching sessionsfollowed by smartphone (n = 25 [24%]). Google meet was the most preferred videoconference toolfor online teaching. Ninety‑six faculties (92.2%) were satisfied with the e‑teaching method adoptedby the institute. Eighty‑three faculty (79.8%) perceived the e‑teaching method to be very useful andquite useful as a modality for teaching during the lockdown period.CONCLUSIONS: The teaching faculties had a positive perception toward digital education methodsadopted for teaching of undergraduate medical students at our institute.

---

• View Article
• PDF 494.28 K

Students’ perspectives on the virtual teaching challenges in the COVID‑19 pandemic: A qualitative study

. Forough Mortazavi; . Raha Salehabadi; . Masoume Sharifzadeh; . Fatemeh Ghardashi

Volume 11, Issue 2 , February 2021, , Pages 1-6

Abstract

  BACKGROUND: The COVID‑19 pandemic led to the closure of crowded places such as universitiesand replaced face‑to‑face learning with virtual education. The purpose of this qualitative ...  Read More BACKGROUND: The COVID‑19 pandemic led to the closure of crowded places such as universitiesand replaced face‑to‑face learning with virtual education. The purpose of this qualitative study wasto investigate the challenges of virtual learning from the students’ perspectives.MATERIALS AND METHODS: This qualitative descriptive study was conducted on students ofSabzevar University of Medical Sciences. Purposeful sampling was performed by semi‑structuredgroup interviews on the Internet in the WhatsApp social network. Fifty‑two nursing, midwifery,hygiene, and paramedical students were interviewed. Every interview was started by asking thequestion “what is your experience about virtual teaching?” The data were analyzed using MAXQDAsoftware version 2020. According to the steps of qualitative content analysis, content analysis wasperformed and the themes were extracted.RESULTS: Fifty‑two students were interviewed in eight group sessions. Qualitative data analysisleads to the extraction of 23 codes, 7 categories, and the 2 main themes; dissatisfaction with virtualeducation with 4 categories (lack of feedback, communication channel problems, the unpreparednessof the message receiver, and weakness in educational content) and solutions to the modification ofvirtual teaching with three categories (possibility of receiving feedback, channel improvement, andstrengthening educational content) were extracted. The highest frequency of code was related tothe dissatisfaction with the uploaded contents.CONCLUSIONS: Virtual education has created a negative experience among students for variousreasons, including the lack of distance learning infrastructure and the lack of a standard for preparingquality content. Therefore, it is necessary for the officials of the Education Development Center tosupervise the prepared contents and improve distance learning infrastructure.

---

• View Article
• PDF 682.85 K

Challenges and strategies of clinical rounds from the perspective of medical students: A qualitative research

. Amin Beigzadeh; . Nikoo Yamani; . Kambiz Bahaadinbeigy; . Peyman Adibi

Volume 11, Issue 1 , January 2021, , Pages 1-12

Abstract

  INTRODUCTION: Clinical rounds provide opportunities for medical students to acquire essentialskills to practice medicine in the real world. Although this kind of training is one of ...  Read More INTRODUCTION: Clinical rounds provide opportunities for medical students to acquire essentialskills to practice medicine in the real world. Although this kind of training is one of the most importantcomponents of medical education, it is replete with barriers in its effective implementation. This studyaimed to investigate medical students’ experiences concerning the barriers and strategies of clinicalrounds in Kerman University of Medical Sciences (KMU).MATERIALS AND METHODS: This qualitative research was conducted on 12 medical studentsin KMU in 2017. Purposive sampling was used and participants in three grades (stagers, interns,and residents) were selected, and individual semi‑structured interviews were conducted until datasaturation. The average of the interview time differed among the three batches (stagers, 51 min;interns, 38 min; and residents, 31 min). Content analysis using deductive approach was used fordata analysis. MAXQDA version 10 was used for data analysis.RESULTS: Data analysis yielded the identification of six themes related to the system of clinicaleducation, fields of clinical education, clinical environment, educational program, medical teachers,and medical students concerning the barriers and five themes related to the strategies for clinicalrounds.CONCLUSIONS: Findings revealed a deeper understanding of medical students’ experiences. Ourinvestigation identified multiple challenges embedded in our context and strategies to overcomethem. As teaching in clinical rounds is invaluable, there is a need to take into account the identifiedchallenges and overcome them. Thus, more effective rounds with higher efficacy toward students’professional development can be implemented.

---

• View Article
• PDF 649.22 K

Knowledge, attitude, practices, and barriers regarding pharmacovigilance and adverse drug reaction reporting among medical and dental faculties of the teaching hospitals in Bhubaneswar City

. Avinash Jnaneswar; . Suranjana Jonak Hazarika; . Kunal Jha; . Vinay s; . Gunjan Kumar

Volume 10, Issue 10 , October 2020, , Pages 1-5

Abstract

  AIM: To assess the knowledge, attitude, practices (KAP), and barriers regarding pharmacovigilanceand adverse drug reaction (ADR) reporting among medical and dental faculties of the ...  Read More AIM: To assess the knowledge, attitude, practices (KAP), and barriers regarding pharmacovigilanceand adverse drug reaction (ADR) reporting among medical and dental faculties of the teachinghospitals.METHODOLOGY: This study was conducted for a period of 3 months among medical and dentalfaculties. A self‑structured, 42‑item closed‑ended questionnaire based on pharmacovigilance andADR reporting was used in this study. Data were analyzed using Statistical Package for the SocialSciences Version 21. All the items of the domains along with demographic variables were summarizedas absolute and relative frequencies. Intergroup comparison was done using Kruskal–Wallis test andMann–Whitney U‑test. The correlation between the domains was assessed by Spearman correlationcoefficient.RESULTS: Among the study subjects, 272 (60.4%) were females and 178 (39.6%) were males.The number of medical and dental faculties was 360 (80%) and 90 (20%), respectively. The meanKAP scores for medical and dental faculties were 7.58 and 5.37, 8.78 and 6.01, and 6.91 and 6.32,respectively. The Spearman correlation coefficient (ρ) was found to be significant for knowledge–attitude and knowledge–practice domains. The values obtained between attitude with practice andbarrier also were significantly correlated.CONCLUSION: Our study findings advocate that although medical faculties have better knowledgeabout pharmacovigilance and ADR reporting, dentists have a positive attitude, thereby suggesting ahuge scope of progress if more emphasis is given on the need for continuous educational initiativesand including the topic in their academic curriculum.

---

• View Article
• PDF 517.1 K

A systematized review of cognitive load theory in health sciences education and a perspective from cognitive neuroscience

. Sahar Ghanbari; . Fariba Haghani; . Majid Barekatain; . Alireza Jamali

Volume 10, Issue 7 , July 2020, , Pages 1-13

Abstract

  INTRODUCTION: To design instructions in health sciences education, it is highly relevant to heedthe working memory and the approaches for managing cognitive load. In this article, we ...  Read More INTRODUCTION: To design instructions in health sciences education, it is highly relevant to heedthe working memory and the approaches for managing cognitive load. In this article, we tried tomention the implications of cognitive load theory (CLT) for optimizing teaching-learning in healthsciences education and discussing cognitive load from the perspective of cognitive neurosciencesas brain-aware medical education.MATERIALS AND METHODS: We searched databases of Pubmed, Proquest, SCOPUS, and ISIWeb of Science for relevant literature in September 1, 2018.RESULTS: The 27 articles out of a total of 46 records, along with 23 papers from snowballing andhand searching were included in this study. Main items encompassed; “Various types of cognitiveloads,” “Aim of cognitive load theory,” “Strategies to managing Cognitive Load,” “Cognitive Load Theoryin novice and experienced learners and “expertise reversal effect,” Medical and Health SciencesCurriculums and Cognitive Load Theory,” “Challenges of Cognitive Load Theory.”CONCLUSIONS: We discussed six important themes for CLT in health sciences education accordingto the literature. Mental imagery (visualization) as one of the useful techniques to optimize germaneload was suggested, as it processes further gain access to neural circuits that are engaged in sensory,motor, executive, and decision-making pathways in the brain.

---

• View Article
• PDF 487.1 K

Exploration of mental health problems in association with health‑promoting lifestyle profile in Iranian medical students: A cross‑sectional study

. Nilufar Safaie; . Sara Ketabi; . Naimossadat Kia; . Majid Mirmohammadkhani; . Mohammad Reza Moonesan; . Fatemeh Paknazar

Volume 10, Issue 4 , April 2020, , Pages 1-8

Abstract

  OBJECTIVE: The aim was to explore the relationship between mental health problems (MHPs) andhealth‑promoting lifestyle (HPL) in the medical students.METHODS: This cross‑sectional ...  Read More OBJECTIVE: The aim was to explore the relationship between mental health problems (MHPs) andhealth‑promoting lifestyle (HPL) in the medical students.METHODS: This cross‑sectional study was carried out on medical students in 2017 at SemnanUniversity of Medical Sciences applying a stratified random sampling. The Symptom Checklist‑25and the HPL profile scales were used. Logistic regression models were used to analysis.RESULTS: Of the participants, 84 were male and 148 were female. The mean age was22.69 years (±2.42). Most students (95.3%) were single and 40.1% were in the preclinical stage.The mean MHP score was 44.14 (±13.99), and 3% were in the severe category. The mean HPLscore was 104.88  (±16.84); 95.7% and 4.3% of them had average and satisfactory lifestyles,respectively. The MHP score of the female (P < 0.001), younger (P < 0.001), single (P = 0.045),preclinical (P < 0.001), and who were away from home (P  =  0.009) were significantly higher.The HPL score of female (P < 0.001), older (P = 0.041), and married students (P = 0.028) weresignificantly higher. The female gender (odds ratio [OR] = 4.45, P < 0.001) and studying in the clinicallevel (OR = 0.30, P < 0.001) were the most important associated factors with MHP. Adjusting forthem, there was a significant relationship between an increase in the HPL score and a decrease inthe likelihood of MHP (OR = 0.96, P < 0.001).CONCLUSIONS: The mental health of medical students was shown to be in association with lifestyleindependent of other important determinants, including gender and academic level. It seems thatmodifying the lifestyle to a healthier way can improve students’ mental health.

---

• View Article
• PDF 553.96 K

Practical points for brain‑friendly medical and health sciences teaching

. Sahar Ghanbari; . Fariba Haghani; . Malahat Akbarfahimi

Volume 9, Issue 10 , October 2019, , Pages 1-11

Abstract

  BACKGROUND: Special learning outcomes are considered for medical and health sciences educationwhich can be acquired by some interactive learning systems in the human brain. Given the ...  Read More BACKGROUND: Special learning outcomes are considered for medical and health sciences educationwhich can be acquired by some interactive learning systems in the human brain. Given the importanceof this issue, based on literature, we attempted at mentioning certain practical points for medical andhealth sciences educators to employ in preclinical and clinical teaching.MATERIALS AND METHODS: We searched databases of PubMed, Proquest, Scopus, ERIC, andISI Web of Science for relevant literature from January 2010 to January 2019.RESULTS: From a total of 1029 records, 30 articles along with 35 papers from snowballing and handsearching were included in this study. The following 12 main items were encompassed: teachingstudents the basic neuroscience of learning and set individual learning goals, “just right challenge”heeding the balance between supervision and autonomy, brain‑friendly coaching, repetition withspaced learning, visualization as a powerful learning tool, multimodal teaching, cognitive learningand mental model, cognitive‑emotional learning, active and social learning, creativity and art, sleep,medical faculty’s participation regarding the courses of “neuro‑education studies,” and “neuro‑myths”were suggested for brain‑friendly medical and health sciences teaching.CONCLUSIONS: We considered 12 practical points for brain‑aware medical and health sciencesteaching according to the recent literature on the basis of the association between education, cognitivescience, neuroscience, and psychology. Interdisciplinary research and practice regarding this issuecan improve teaching–learning quality, students’ well‑being, and ultimately patient outcomes.

---

• View Article
• PDF 513.63 K

Developing knowledge and clinical competency in a respiratory system‑based practice of final‑year medical students through a novel structured bedside teaching module

. Lalita Fernandes; . Anthony Menezes Mesquita

Volume 8, Issue 6 , June 2018, , Pages 1-6

Abstract

  BACKGROUND: Respiratory diseases are a major cause of mortality and morbidity worldwide.A sound knowledge of management of respiratory diseases is thus very vital. The clinical exposureof ...  Read More BACKGROUND: Respiratory diseases are a major cause of mortality and morbidity worldwide.A sound knowledge of management of respiratory diseases is thus very vital. The clinical exposureof undergraduate medical students is limited to 2 weeks in pulmonary medicine. We hypothesizedthat the short duration of posting can be best utilized by developing need‑based modules for bedsideteaching.AIMS: This study aimed to determine gain in knowledge and skills of final‑year medical studentsin diagnosis and management of common pulmonary diseases and assess students’ perception ofthe module.METHODS: A one‑group pretest‑posttest quasi‑experimental study design enrolled a conveniencesample of 48 final‑year medical students. Twenty‑four students were posted at a given time for thebedside clinical posting in pulmonary medicine between August 2013 and November 2013. Thesestudents were divided randomly into two groups of 12 students each. All students consented to bepart of the study. Two trained faculty taught in rotation. The bedside teaching module was preparedby Delphi technique and curriculum was based on Kern’s six‑step approach. History taking, physicalexamination, tuberculosis, chronic obstructive pulmonary disease, asthma, lung cancer, chest X‑rays,and spirometry were taught. Students were administered pre‑ and post‑test questionnaires to assessknowledge, while Objective Structured Clinical Examination assessed skills. Students’ feedbackquestionnaire evaluated the teaching module. A two‑tailed paired sample t‑test assessed mean gainin knowledge and skills. Effect size was calculated by Cohen’s d, while Cronbach’s alpha estimatedthe reliability testing of perception questionnaire. Statistical analysis was performed using statisticalsoftware package IBM SPSS version 23.RESULTS: Mean pre‑ and posttest knowledge scores were 12.46 (8.09) and 43.17 (10.7),respectively, P = 0.001. Mean pre‑ and posttest skills scores were 7.00 (4.76) and 24.79 (3.31),respectively, P = 0.001, and Cohen’s d showed large effect size. Most students stated that themodule enhanced their clinical skills, helped to understand difficult material, and promoted inquiryand thinking. Cronbach’s alpha for perception questionnaire was 0.854.CONCLUSIONS: Structured bedside teaching module in pulmonary medicine improved the knowledgeand skills of undergraduate medical students. The contents and various teaching methodologieswere evaluated positively.

---

• View Article
• PDF 817.71 K