Eyelid Avulsion Following Animal Bite: a Case Report

AbstractAnimal bite is a relatively frequent health problem with the main cause being domesticated dogs responsible for around 90 % of cases. Other common aggressors include cats, cows, camels, donkeys and horses. Here we report a case of total lid avulsion by a pet dog in a middle-aged man. This report represents the medical and surgical approaches used and the result of the lid injury treatment.Keywords: Bites and stings; Eyelid; Evulsion

Systematic Review of Studies in the Field of Competencies of New or Soon To-Be-Graduate General Physicians in Iran

Background & Objective: One method to evaluate and monitor the effectiveness of the general medicine curriculum is the collection of results of research in this field. In this study, research results on the extent of predefined general competency in the formal document of the minimum competencies of Iranian general physicians have been systematically integrated. Methods: The search strategy in this study included the searching of words doctor, student, interns, or graduate, and ability, competency, knowledge, skill, attitude, or performance, in the title, abstract, or keywords of articles. All papers published from 2002 to 2014 in Persian language journals were retrieved from the Irandoc, Iranmedex, Magiran, Medlib, and SID databases. Results: After the removal of irrelevant or duplicate papers, from 270 recorded papers, 24 articles were selected and analyzed. All studies were descriptive studies and most used self-reporting methods to assess the competency of physicians. Reviewed articles focused on only 48% of subdomains of the formal document of the minimum competencies of physicians. In 70% of assessed skills, physicians’ competencies were estimated as low to moderate. Conclusion: Although these studies did not assess all skills mentioned in the formal document of the minimum competencies of physicians, estimates show that the competencies of general physicians in assessed skills were not desirable. It is recommended that future studies in this field to be managed. Key Words: General practitioners, Clinical competence, Program evaluation, Educational achievemen

Comparing the effects of “lecture” and “simulated patient” teaching methods on promoting the knowledge and performance of healthcare providers

Introduction: Postpartum depression is a common disorder among women. Therefore, proper and efficient training of healthcare providers for this disorder is of great importance. The purpose of this study was to compare the effects of “lecture” and “simulated patient” teaching methods on teaching postpartum depression to healthcare providers. Methods: This quasi -experimental study employed a pretest-posttest design with intervention and control groups and it was carried out in Shahin Shahr healthcare system in 2016. 80 subjects who met inclusion criteria were selected by census method from among 86 healthcare providers and divided randomly into two groups of 40. Postpartum depression was taught to the intervention group and the control group using the “simulated patient” and “lecture” methods respectively. Both groups were given a valid and reliable test before and after the intervention to measure their knowledge and performance. Data were analyzed using descriptive statistics, independent t-tests and paired t-test. Results: In both groups, the posttest mean score was significantly higher than the pretest mean score (p<0.00001). Based on the survey questionnaire, 87% of the intervention group believed that the simulated patient was an appropriate teaching method and 85% preferred it to the lecture method. Conclusion: The results showed that the simulated patient method in teaching postpartum depression had a greater effect on increase healthcare providers’ knowledge and performance than the lecture method and participants preferred this method to the lecture method

Development and Psychometric Evaluation of a Tool for Assessing Emotional Intelligence in Teaching

Introduction: Emotional Intelligence (EI) has become a matter of great interest in teaching due to its positive effects on teaching-learning process, achievement in life, and improvement potential. Several instruments have been developed to measure individuals’ EI but none of them have been able to show to what extent a teacher uses EI in his teaching. This study was performed to develop an emotional intelligence measurement tool in teaching and evaluate its psychometric features. Methods: The preliminary questionnaire of 109 questions was developed based on literature review and determining emotional teaching factors. Content and face validity were confirmed by experts. The construct validity was confirmed by determining the correlation between the instrument and the Bar-On questionnaire among 30 randomly selected faculties. For factor analysis and data reduction also, 350 questionnaires were distributed among faculties in Isfahan University of Medical Sciences. Exploratory factor analysis was performed through principal components analysis. Data was analyzed using descriptive statistics, correlation, and factor analysis. Results: 350 faculties received the questionnaire and 204 filled it out (response rate =58%). The designed questionnaire was correlated with Bar-On (p<0.001;r=0.714). Based on the results of factor analysis and negotiation with experts, the final questionnaire was prepared comprising 31 questions in 8 categories of “responding to learners’ feelings, motivation in teaching, communication with learners, responsibility towards learners, leading learners, sensitivity to learners’ social development, teaching abilities, and prompt reaction. Reliability coefficient of the questionnaire was 0.9 calculated through Cronbach’s alpha. Conclusion: This 31 item questionnaire seems to be a valid, reliable, and useful instrument to measure teachers’ emotional intelligence in teaching. Evaluation of the designed questionnaire in larger populations is recommended

Critical Thinking Skills and Their Relationship with Emotional Intelligence in Medical Students of Introductory Clinical Medicine (ICM) Course in Isfahan University of Medical Sciences

Introduction: Critical Thinking is one of the most important skills for people of 21th century, especially for medical students. Emotional intelligence is another outstanding factor for success in all aspects of life, profession and education. It seems that both critical thinking and emotional intelligence altogether can play an important role in training professional doctors. The aim of this study was to evaluate the critical thinking skills of medical students and their relationship with emotional intelligence score of them in the first semester of 2010-2011 school year. Methods: The target group was all the students of the term 6 of medicine (n=69) in the Isfahan Medical University.California Critical Thinking Skills Test-(CCTST) with 5 subscales and Bar-On Emotional Quotient Inventory- EQ-i with 5 scales and 15 subscales were used for data collection. Data were analyzed by SPSS11.5, using descriptive statistics, Pearson's correlation coeffitient, paired-samples T-test and independent-samples T-test. Results: Based on the findings, mean age of the target group was 22 years, and 72% of them were women. Mean score and standard deviation of Critical thinking test respectively were 11.96 out of 34 and 3.69. The mean score of deductive reasoning (6.12 out of 16) was significantly higher than inductive reasoning (4.92 out of 14). The total scores and standard deviation of Bar-On test were 330.7 (out of 450) and 34.29 respectively.There was no significant relationship between total score of Critical Thinking and Emotional Intelligence, except for the field of social responsibility of emotional intelligence that was directly related to Critical Thinking score (r=0.45, p=0.001). Conclusion: Although, mean score of critical thinking in medical students was not appropriate enough compared to the similar international studies, it was consistent with national ones. This can reflect the lack of critical thinking training in iranian educational curriculum. Lack of relationship between critical thinking and emotional intelligence scores might have been due to the difference in the type of questionnaires and students’ overestimation about their emotional abilities

Physical Environment Status of Educational Clinics in Isfahan University of Medical Sciences: An Inseparable Part of Teaching-Learning Process in Clinic

Introduction: The trend of medical education is going toward ambulatory medicine and clinics and the effect of physical environment on teaching-learning process is undeniable. This study was performed to determine the frequency distribution of physical environment indices in educational clinics of hospitals affiliated to Isfahan University of Medical Sciences. Methods: In a descriptive study, all educational clinics affiliated to Isfahan University of Medical Sciences (33 clinics) were investigated through census sampling method. The data gathering tool was a researcher-made checklist including features of a clinic and its qualitative and quantitative characteristics. Clinics were directly observed by the researcher. The data was analyzed by SPSS software and reported through descriptive indices. Results: The highest frequencies in the clinics under investigation belonged to the domains of light (100%), facilities (78.8%), and arrangement of seats (84.8%). The lowest frequency percentages belonged to the existence of anti-acoustic walls (0%), access to educational resources such as internet and computers (3%), and access to reference books (6.1%). Conclusion: The physical environment of the investigated clinics was evaluated as weak regarding access to educational resources, as average regarding the existence of internal room, conditioning and access to facilities, and as very good in regard to the amount of light. Due to the lack of study in the field of physical environment, especially in clinical education, it is recommended to conduct further studies

Problems and challenges in providing feedback to clinical teachers on their educational performance: A mixed-methods study

INTRODUCTION: Given the importance of feedback to improve teachers' educational performance, the current study aimed to identify the challenges and problems involved in providing feedback to clinical teachers on their educational performance. MATERIALS AND METHODS: In the first phase of this mixed-methods study, the clinical teachers, students, and university officials were interviewed on feedback problems and challenges. After an inductive content analysis, and based on the problems enlisted, a ten-item questionnaire was developed. Subsequently, 25 clinical teachers completed the questionnaire by scoring the importance and urgency of each problem. RESULTS: Overall, 18 individual and group interviews were conducted with 24 people. A total of ten themes and five categories emerged, including “lack of transparency of feedback system,” “absence of criticizability culture,” “lack of motivation to improve performance,” “failure to consider factors affecting teacher's performance,” “lack of formative evaluation,” “inappropriate data obtained on teacher's performance,” “inappropriate feedback providers,” “inappropriate feedback recipients,” “inappropriate feedback provision,” and “no feedback follow-up.” Three items of priority involved “inappropriate feedback providers,” “inappropriate data,” and “failure to consider factors affecting the teacher's performance.” CONCLUSIONS: All the raised problems obtained high scores; nevertheless, the interviewees had more problems with the feedback provider, the data collected on the performance, and inattention of university officials to the factors influencing performance than feedback presentation methods. Hence, gaining the trust of teachers on the collected data, providing feedback by their trustworthy individuals, and paying attention to the factors influencing teachers' performance are associated with an increased possibility of feedback acceptance

Training and validation of standardized patients for evaluation of general practitioners′ performance in management of obesity and overweight

Background: Standardized patient (SP) can serve as a valuable tool to measure the physician performance in actual clinical settings, but it has not been validated for obesity/overweight disorders. This study has been conducted to describe the process of creating reliable and valid SPs for evaluation of general-practitioners′ management of obesity/overweight in Iran. Materials and Methods: A total of 6 obese/overweight volunteers (potential SPs) took part in training. Three scenarios, along with corresponding checklists including 102 items representing different aspects of diagnosis and treatment of obesity/overweight, were developed by an expert group. The SPs were trained using role playing method. During this part, one of the SPs failed. The SPs′ portrayal of their respective scenario was online watched in another room and the checklist filled independently by the physician, research assistant and other SPs. The reliability of the checklist to be used by the SPs was assessed by Cronbach′s alpha. The overall inter-rater agreement was calculated by the intraclass correlation coefficient statistic for total scores. Results: The 5 eligible SPs were all women between 20 years and 39 years of age. Inter-rater agreement between the SPs′ total scores was 0.899, value (95% confidence intervals) were 11.8 (0.68-0.98) and P value was <0.001. The Cronbach′s alpha for reliability of completed checklists was 0.91. Conclusion: SP could be a powerful instrument for evaluating medical performance of general practitioners in the field of obesity/overweight management. Further research is needed to find the more aspects of training and validation of unannounced SPs in this field