The Use of Cumulative Disciplinary Score in an Integrated Curriculum to Prevent Deliberate Omission of Course Content

Background & Objective: Student assessment is one of the most challenging issues of an integrated curriculum. While calculating an overall score is in line with the goals of integrated curriculum, it poses the risk that some students will deliberately leave out the content of some disciplines, based on the fact that they have lower credits in each block exam. In the present study, we describe the experience of Tehran University of Medical Sciences, Iran, where an integrated medical curriculum has been launched since September 2011 as part of curriculum reform initiative. Methods: In the first academic year, students passed 4 blocks: Molecule and Cell; Tissue; Development and Function; Cardiovascular Function; Blood circulation; and Blood-Respiratory Function. Each block included anatomy, histology, physiology, and embryology. The overall block score was reported at the end of each block. In addition, a cumulative disciplinary score was calculated at the end of the academic year through the summation of the weighted subscores of each discipline in each block. Results: At the end of the year, the number of students who had failed in histology, anatomy, embryology, and physiology were 15, 17, 44, and 3, respectively. They were required to take a disciplinary examination before the beginning of the next academic year. Conclusion: A comparison of the number of students who failed disciplines with low credits (e.g. histology) with those who failed disciplines with high credits (e.g. physiology) suggests that the former had systematically been ignored by some students. The calculation of a cumulative disciplinary score may reduce the deliberate omission of course content in integrated blocks. Key Words: Integration, Student assessment, Cumulative disciplinary scor

Developing Comprehensive Course Evaluation Guidelines: A Step towards Organizing Program Evaluation Activities in Tehran University of Medical Sciences, Iran

Background & Objective: One of the potential strategies for ensuring the quality of educational programs is adopting a systematic approach to its evaluation. Current evidence indicates the lack of high quality program evaluation activities in the field of medical education. The aim of this study was to review the current status of program evaluation activities in Tehran University of Medical Sciences, Tehran, Iran, and formulate guidelines to promote program evaluation activities at the University level. Methods: A survey was conducted to investigate the current conditions of program evaluation using a questionnaire in 2012. Then, the comprehensive course evaluation guidelines, consisting of 22 items, were developed based on literature review, survey results, and experts’ opinions. Finally, each affiliated school developed its own evaluation plan. The evaluation taskforce reviewed evaluation plans using a checklist. Results: Using one tool or resource, 9 schools (90%) conducted course evaluation at least once. The views of students, faculty, staff or alumni were used occasionally. Moreover, 4 schools (40%) reported the evaluation results. After reviewing 14 submitted course plans based on the checklist, 51 feedbacks were provided. Most and least feedbacks were related to evaluation design and implementation and evaluation infrastructure, respectively. Conclusion: The process of developing guidelines and plans resulted in stakeholders reaching a common understanding of course evaluation, and in turn, creating evaluation capacity and more accountability. Keywords: Program evaluation; Ongoing evaluation; Evaluation system; Comprehensive evaluatio

Developing a Microanalytic Self-regulated Learning Assessment Protocol for Biomedical Science Learning

Background & Objective: Self-regulated learning (SRL) is highly task and context dependent. Microanalytic assessment method measures students’ SRL processes while performing a particular learning task. The present study aimed to design a microanalytic SRL assessment protocol for biomedical science learning. Methods: This mixed method study was conducted in Tehran University of Medical Sciences, Iran, in 2013. The data collection tool was a microanalytic SRL assessment protocol that was designed based on the literature review, expert opinion, and cognitive interview with medical students, and then, piloted. The participants consisted of 13 second year medical students. The subjects were interviewed while conducting a biomedical science learning task. Interviews were recorded, transcribed and coded based on a predetermined coding framework. Descriptive statistics were used to analyze the data. Results: The microanalytic SRL assessment protocol was developed in three parts; interview guide, coding framework, and biomedical science learning task. An interview guide was designed consisting of 6 open-ended questions aimed at assessing 5 SRL sub-processes of goal setting, strategic planning, meta-cognitive monitoring, causal attribution, and adaptive inferences and a close-ended question regarding self-efficacy. Based on the pilot study, most participants reported task-specific and task-general processes for the sub-processes of strategic planning (92%), metacognitive monitoring (77%), causal attribution (85%), and adaptive inferences (92%). Conclusion: The developed protocol could capture the fine-grained nature of the self-regulatory sub-processes of medical students for biomedical science learning. Therefore, it has the potential application of modifying SRL processes in early years of medical school. Key Words: Self-regulated learning, Microanalytic assessment method, Biomedical science learnin

The Concept of Scholarship: Educational Scholarship and Its Application in Iran

One of the notions entered in university fields in the last two decades is the concept of scholarship and especially educational scholarship. Due to the inclusion of this concept in the first article of faculty members' academic promotion bylaw and considering it as a mandatory component for academic promotion, great attention has been paid to this topic. Remarking the background and principles prevailing this almost new perspective, this short communication endeavors for developing a ground for familiarizing the readers with the concept of scholarship, especially educational scholarship, and its manner of evaluation. Moreover, a little note has been made about substructures needed for broadening scholarship activities in the field of education as well as the challenges before that

Misconceptions and Integration

Introduction: Pervasive beliefs regarding curricular reform and integration have flourished among medical students, faculty members and medical school administrators. These concepts have extensively impacted the reform process, sometimes by resisting the reforms and sometimes by diverting the curriculum from its planned objectives. In the current paper, we have tried to address the challenges of integration in MD program by looking at the existing literature and the experience of the international universities. Methods: We collected the questions frequently asked during the curricular reform process. We, then, evaluated them, and selected 5 main ideas. In order to find their answers, we searched the literature using these keywords: integration, reform, and undergraduate medical curriculum. Results: The findings are discussed in five sections: 1) Reform is not equivalent to integration, 2) Integration can be implemented in both high school and graduate programs, 3) Organ-system based integration is not the only method available for integration, 4) Integration of two phases (basic sciences and physiopathology) can be considered but it is not mandatory, 5) Integration does not fade basic sciences in favor of clinical courses. Conclusions: It seems that medical education literature and prior experience of the leading universities do not support most of the usual concepts about integration. Therefore, it is important to consider informed decision making based on best evidence rather than personal opinions during the curricular reform process

Viewpoints of Nursing Students and Faculties about Clinical Performance Assessment Using Programmatic Approach

Introduction: Clinical assessment in nursing education is essential because of variety of objectives and complexity of clinical performance. Programmatic approach is an opportunity for comprehensive and multidimensional assessment. Opinions of stakeholders have an effect on application and effectiveness of a program. Thus, the aim of this study was evaluation of nursing students’ and faculties’ viewpoints about using programmatic approach in assessment. Methods: In this descriptive-analytic study, a census sample of 38 internship nursing students and 8 faculties in critical care rotation have participated. Clinical assessment of students was designed based on a programmatic approach and applied for one educational semester. Then, the viewpoints of faculties and students about this assessment method and its strengths and weaknesses were collected by a questionnaire. A visual analog scale in 0-10 measure was used to evaluate satisfaction of subjects. The data were analyzed using descriptive indices and t (paired and independent) tests. Results: The mean score of faculties and students’ satisfaction with programmatic assessment was 8.70±1.82 and 7.66±1.50, respectively. Totally, 87.5% of faculties and 97.3% of students were agreed with this method for students’ clinical performance assessment. According to attitudes of both groups, the strengths of this method were objectivity, impartiality, feedback provision, accurate coverage of educational objectives and specificity. 87.5% of faculties and 89.47% of students believed programmatic approach in assessment has a positive educational impact. Conclusion: The findings showed the majority of nursing students and faculties are satisfied with clinical assessment using programmatic approach and that is acceptable because of its objectivity, feedback provision, specificity, complete coverage of educational objectives and positive educational impact. Therefore, extensive application of this method in other clinical settings can be considered

Comparison of Academic Achievement and Educational Environment of Basic Sciences Phase of MD Program in Tehran University of Medical Sciences, before and after Curricular Reform

Introduction: Curriculum reform of MD program in Tehran University of Medical Sciences involves fundamental changes in many aspects of the program. Three years after implementation of the new curriculum, evaluation of program outcomes is necessary. The aim of this study was to compare academic achievement and educational environment of basic sciences phase of the previous curriculum with those of the revised curriculum. Methods: In this retrospective cohort study, the average score of basic sciences courses for all medical students accepted to Tehran University of Medical Sciences in 2011 and previous three years (2008-10) was extracted. The results of the 44th, 46th, 48th and 50th basic sciences comprehensive exams, including university rank and the standard score were analyzed. DREEM questionnaire was used to assess the educational environment which was completed by students admitted in 2010 and 2011 at the end of basic sciences phase. The data were analyzed by means of ANOVA, Chi-Square and t-test. Results: The total number of medical students from 2008 to 2011 was 1032, of whom 589 students (57%) were female. The difference between the basic sciences average score, number of probationary and failed semesters over the years was not statistically significant. Based on the results of comprehensive exams, the university ranked third in 2008 and first in three subsequent years. University’s standard scores in all comprehensive exams were 0.61, 0.96, 0.85 and 0.94 respectively. The DREEM questionnaire scores were 91.5±0.46 and 93.5±0.41 (out of 200) respectively before and after the reform. This difference and differences between scores of questionnaire’s five areas were significant for the two groups. Conclusion: Although slight improvements could be seen in most of the assessed outcomes after the reform, they are not statistically significant. This could be attributed to near-perfect performance of the university in previous years or to the short interval between the intervention and outcome evaluation and therefore, concerns about academic failure following the curriculum reform do not seem to be valid. Regular monitoring of the outcomes is necessary for assessing long-term effectiveness of the curriculum reform