Document Type : Original Article
Authors
Abstract
INTRODUCTION: As an integral and the most important part of medical education, clinical education
provides the opportunity to prepare medical students as professionals. This study explores the
standpoints of informants concerning the optimal conditions for clinical education and its components,
including learning opportunities, clinical settings, and clinical tutors, with the aim to improve clinical
teaching and standards.
METHODS: The study design is built on qualitative content analysis with the directed approach. The
participants were selected using purposive sampling with maximum variation, and the data were
collected through online focus group discussion (FGD) and semi‑structured individual interviews
conducted either face‑to‑face or on the telephone.
RESULTS: Twenty vice‑chancelleries of education and medical education planners from across the
country participated in this study. Concepts resulted in four main categories: educational settings,
tutors, creating learning opportunities, and learning situations. The concepts were sorted into 15
subcategories, also 21 subclass 1 and 14 subclass 2. The most extensive subcategories comprised
variety of educational settings, teaching team conditions, and learning strategies.
CONCLUSION: Optimal conditions for clinical education are associated with the use of educational
settings close to the real workplace of general practitioners such as general inpatient settings,
outpatient settings, and emergency department. Moreover, optimal conditions require the provision
of learning opportunities by organized team of tutors and team member empowerment along with
policy‑making and planning on the national scale by the Ministry of Health in consideration of local
conditions.
Keywords
training in the perspective of medical trainees and interns. Health
Syst Res 2014; Health education supplement:1829‑38.
2. Rowe M, Frantz J, Bozalek V. The role of blended learning in the
clinical education of healthcare students: A systematic review.
Med Teach 2012;34:e216‑21.
3. Amin Z, Eng KH. Basics in Medical Education. 2nd ed. Singapor:
World Scientific; 2009.
4. Malekanrad A, Einolahi B, Hoseini J, Momtazmanesh N. Clinical
Teaching and Assessment what Every Clinical Teacher Must
Know. 1st ed. TehranMobtakeran; 2006.
5. Perkins D, Daly M. What is the evidence for clinical placements
in underserved areas? Med Educ 2013;47:958‑60.
6. Amiresmaili M, Nekoei Moghadam M, Moosazadeh M,
Pahlavan E. Challenges of general practice education in Iran:
A qualitative study. Strides Dev Med Educ 2013;9:118‑31.
7. Anbari Z, Ramezani M. The obstacles of clinical education
and strategies for the improvement of quality of education at
Arak University of medical sciences in 2008. Arak Med Univ J
2010;13:110‑8.
8. Siabani S, Moradi MR, Siabani H, Rezaei M, Siabani S, Amolaei K,
et al. Students’ view points on the educational problems in medical
school of Kermanshah university of medcial sciences (2007).
J Kermanshah Univ Med Sci 2009;13:162‑71.
9. Köhl‑Hackert N, Krautter M, Andreesen S, Hoffmann K,
Herzog W, Jünger J, et al. Workplace learning: An analysis of
students’ expectations of learning on the ward in the department
of internal medicine. GMS Z Med Ausbild 2014;31:Doc43.
10. Ministry of Health and Medical Education. General Medical
Education Regulations. Available from: http://www.scume.
behdasht.gov.ir. [Last accessed on 2017 Apr 06].
11. Greenstock L, Brooks P, Malloy E, Fiddes P, Fraser C. Medical
students’ perceptions of role models on clinical placements. Clin
Teach 2014;11:104‑8.
12. GhaffariR, AminiA, Yazdani S, AlizadehM, Salek RanjbarzadehF,
Hassanzadeh Salmasi S. Comparative study: Curriculum of
undergraduate medical education in Iran and in a selected
number of the world’s renowned medical schools. Iran J Med
Educ 2012;11:819‑31.
13. Ministry of Health and Medical Education. Medical Education
Basic Standards 1386. Available from: http://www.scume.
behdasht.gov.ir/uploads/172_277_New‑standard.pdf. [Last
accessed on 2015 Mar 27].
14. Hsieh HF, Shannon SE. Three approaches to qualitative content
analysis. Qual Health Res 2005;15:1277‑88.
15. Braun V, Clark V. Successful Qualitative Research a Practical
Guide for Beginners. 1st ed. London: Sage; 2013.
16. Wildemuth BM, Zhang Y. Qualitative Analysis of Content.
Available from: http://www.old‑classes.design4complexity.
com/7702‑F12/qualitative‑research/content‑analysis.pdf. [Last
accessed on 2016 Feb 01].
17. Ramani S, Leinster S. AMEE guide no 34: Teaching in the clinical
environment. Med Teach 2008;30:347‑64.
18. Dent J, Skene S, Nathwani D, Pippard M, Ponnamperuma G,
Davis M, et al. Design, implementation and evaluation of a
medical education programme using the ambulatory diagnostic
and treatment centre. Med Teach 2007;29:341‑5.
19. van der Zwet J, Hanssen VG, Zwietering PJ, Muijtjens AM,
Van der Vleuten CP, Metsemakers JF, et al. Workplace learning
in general practice: Supervision, patient mix and independence
emerge from the black box once again. Med Teach 2010;32:e294‑9.
20. Duvivier RJ, van Dalen J, van der Vleuten CP, Scherpbier AJ.
Teacher perceptions of desired qualities, competencies and
strategies for clinical skills teachers. Med Teach 2009;31:634‑41.
21. Croft A, Carruthers D, Justice E. Undergraduate teaching in the
outpatient clinic: Can we do better? Med Teach 2012;34:674.
22. Alweshahi Y, Harley D, Cook DA. Students’ perception of
the characteristics of effective bedside teachers. Med Teach
2007;29:204‑9.
23. Garakyaraghi M, Sabouri M, Avizhgan M, Ebrahimi A,
Zolfaghari M. Interns’ viewpoints toward the student of training
by residents in Isfahan univeristy of medical sciences. Iran J Med
Educ 2008;7:361‑9.
24. Weinholtz D, Edwards JC. Teaching During Rounds: A Handbook
for Attending Physicians and Residents. 1st ed. Tehran: Hayan;
2003.
25. Sheehan D, Wilkinson TJ, Bowie E. Becoming a practitioner:
Workplace learning during the junior doctor’s first year. Med
Teach 2012;34:936‑45.
26. Van Der Hem‑Stokroos HH, Scherpbier AJ, Van Der Vleuten CP,
De Vries H, Haarman HJ. How effective is a clerkship as a learning
environment? Med Teach 2001;23:599‑604.
27. Pearson DJ, Lucas BJ. Engagement and opportunity in clinical
learning: Findings from a case study in primary care. Med Teach
2011;33:e670‑7.
28. Yazdani S, Arab M, Noghabaei G, Hosseini F. Quality dimensions
of educational morning report sessions. J Med Educ 2015;14: 82‑6.
29. Moharari RS, Soleymani HA, Nejati A, Rezaeefar A, Khashayar P,
Meysamie AP, et al. Evaluation of morning report in an emergency
medicine department. Emerg Med J 2010;27:32‑6.
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