Document Type : Original Article
Authors
1 Associate Professor, Department of Emergency Medicine, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Science, Qazvin, Iran
2 Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Qazvin, Iran
3 Ph.D. in Health Education and Promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Abstract
BACKGROUND: COVID‑19 pandemic poses unique physical and emotional challenges in providing
clinical education. Failure to identify the challenges and problems that students face in the clinical
learning environment hinders their effective learning and growth. Consequently, the progress of
their skills is affected. The aim of this study was to develop a challenge in the clinical education
environment of medical students during the outbreak of COVID‑19 questionnaire and to test its
psychometric properties.
MATERIALS AND METHODS: This study is part of a larger study that was conducted using a
combined consecutive method in Qazvin. In the first stage, a phenomenological study was performed
with van Manen’s method by interviewing 12 students at Qazvin University. To extract the items of
the tool in the second stage, the concept was defined. Ultimately, the psychometric properties of
the questionnaire were evaluated with face validity, content validity (quantitative and qualitative),
construct validity (exploratory factor analysis), internal consistency (Cronbach’s alpha), and test–retest
reliability (intraclass correlation coefficient).
RESULTS: The initial tool had 70 questions. After validation, 53 items remained in the final
questionnaire. Four extracted dimensions were as follows: “Inadequate professional competency,”
“Inefficient clinical planning” and “outcomes of learning‑teaching activities,” and “the challenges
related to the stigma of medical staff.” Cronbach’s alpha for the whole questionnaire was
0.98 (range: 0.87–0.98). The test–retest (intraclass correlation coefficient) reliability was
0.98 (P < 0.001).
CONCLUSIONS: According to the obtained results, if the items of “Inadequate professional
competency,” “Inefficient clinical planning” and “outcomes of learning‑teaching activities,” and “the
challenges related to the stigma of medical staff,” the challenges of students’ clinical education can
be reduced during the COVID‑19 outbreak.
Keywords
House JB. In crisis: Medical students in the COVID-19 pandemic.
Am Educ Train 2020;4:284‑90.
2. DeFilippis EM, Stefanescu Schmidt AC, Nosheen R. Adapting the educational environment for cardiovascular fellows‑in‑training
during the COVID‑19 pandemic. J Am Coll Cardiol 2020;75:2630‑4.
3. Woolliscroft JO. Innovation in response to the COVID‑19
pandemic crisis. Acad Med 2020;95:1140‑2.
4. Alsoufi A, Alsuyihili A, Msherghi A, Elhadi A, Atiyah H,
Ashini A, et al. Impact of the COVID‑19 pandemic on medical
education: Medical students’ knowledge, attitudes, and practices
regarding electronic learning. PLoS One 2020;15:e0242905.
5. Calhoun KE, Yale LA, Whipple ME, Allen SM, Wood DE,
Tatum RP. The impact of COVID‑19 on medical student surgical
education: Implementing extreme pandemic response measures
in a widely distributed surgical clerkship experience. Am J Surg
2020;220:44‑7.
6. Abbaszade A, Borhani F, Sabzevari S. Nursing teachers´
perception of the challenges of clinical education and solutions:
A qualitative study. J Qual Res Health Sci 2013;2:134‑45.
7. Aboshaiqah AE, Roco IM, Pandaan IN, Baker OG, Tumala RB,
Silang JP. Challenges in the clinical environment: The Saudi
student nurses’ experience. Educ Res Int Hindawi 2018;2018:1‑9.
8. Jamshidi N, MolazemZ, Sharif F, Torabizadeh C, Najafi KalyaniM.
The challenges of nursing students in the clinical learning
environment: A qualitative study. Scientific World Journal
2016;2016:1846178.
9. Hoseinian M. Problems of field training of nursing students:
A strategy to enhance clinical education. Journal of Shahid
Sadoughi University of Medical sciences 2007;5(1):24‑33.
10. Van Manen M. Researching Lived Experience: Human Science
for an Action Sensitive Pedagogy. New York: Routledge; 2016.
11. Van Manen M. Researching Lived Experience. Human Science for
an Action Sensitive Pedagogy. 3rd.ed. Ontario, Canada: University
of Western, Althouse Press; 2001.
12. Creswell JW, Clark P. Designing and Conducting Mixed Methods
Research. Thousand Oaks, CA: Sage Publications, Inc.; 2011.
13. Lobindo‑WoodG, HaberJ. Nursing Research: Mehods and Critical
Appraisal for Evidence‑Based Practice. 7th ed. St. Louis: Mosby
Co.; 2006.
14. Wilson F, Robert PW, Schumsky DA. Recalculation of the critical
values for Lawshe’s content validity ratio. Meas Eval Couns Dev
2012;45:197‑210.
15. Nazari J, Mokhtari M. Factor analysis and its application in social
sciences. Book of the month of social sciences of the new period
2009;14:20‑33. (persian).
16. Munro BH. Statistical Methods for Health Care Research. 5th ed.
Philadelphia: LWW; 2005.
17. Okoronkwo I, Onyia‑Pat J, Agbo M, Okpala P, Ndu A. Students’
perception of effective clinical teaching and teacher behavior.
Open J Nurs 2013;3:63‑70.
18. Mabuda BT, Potgieter E, Alberts UU. Student nurses’ experiences
during clinical practice in the Limpopo Province. Curationis
2008;31:19‑27.
19. Fathi E, Malekshahi Beiranvand F, Hatami Varzaneh A,
Nobahari A. health care workers challenges during coronavirus
outbreak: The qualitative study. Res Behav Sci 2020;18:237‑24.
20. Duy CD, Nong VM, Van AN, Thu TD, Thu ND, Quang TN.
COVID-19 - related stigma and its association with mental health
of health-care workers after quarantine in Vietnam. Psychiatry
Clin Neurosci 2020;74:566‑8.
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