Medical Students’ Satisfaction with a Web-based Training Module of Clinical Reasoning

Background: There is a paucity of literature regarding the medical students’ perspectives on web-based training of clinical reasoning. Objectives: This study aimed to describe the implementation of a web-based training course of clinical reasoning for medical students and to evaluate their satisfaction with the program. Methods: This cross-sectional study was conducted at the Tehran University of Medical Sciences in 2018. Fifty internal medicine interns were consecutively enrolled. The study consisted of two phases. The first phase focused on the development of a web-based training module of clinical reasoning. The second focused on evaluating the trainee’s satisfaction with the virtual course. The educational content of the program was prepared by an expert panel and incorporated in a web-based educational tool designed for virtual training purposes. The students’ satisfaction with the virtual course was assessed using a questionnaire. Each item of the questionnaire was scored from 0 (0) to 1.5 (100). The content validity of the questionnaire determined by an expert panel, and its reliability was measured. Results: The mean score of each item of the questionnaire ranged from 77.3 to 85.3 which showed that the participants agreed with the items of the questionnaire. Also, Cronbach’s alpha coefficient was excellent in nine items of the questionnaire, good in four items, and acceptable in three items. The intraclass correlation coefficient was also estimated as 0.98. Conclusions: The participants were satisfied with the web-based training tool for clinical reasoning, used in the present study. The developed questionnaire also showed good validity and reliability for the assessment of trainees’ satisfaction with the web-based training module of clinical reasoning. Keywords: Logic, Distance Education, Assessment, Medical Studen

Study Guides : Effective Tools to Improve Self-Directed Learning Skills of Medical Students

We would like to thank the participants for contribution in this study.Peer reviewedPublisher PD

Effects of a curriculum integrating critical thinking on medical students’ critical thinking ability in Iran: a quasi-experimental study

Purpose Improving physicians’ critical thinking abilities could have meaningful impacts on various aspects of routine medical practice, such as choosing treatment plans, making an accurate diagnosis, and reducing medical errors. The present study aimed to measure the effects of a curriculum integrating critical thinking on medical students’ skills at Tehran University of Medical Sciences, Iran. Methods A 1-group pre-test, post-test quasi-experimental design was used to assess medical students’ critical thinking abilities as they progressed from the first week of medical school to middle of the third year of the undergraduate medical curriculum. Fifty-six participants completed the California Critical Thinking Skills Test twice from 2016 to 2019. Results Medical students were asked to complete the California Critical Thinking Skills Test the week before their first educational session. The post-test was conducted 6 weeks after the 2 and half-year program. Out of 91 medical students with a mean age of 20±2.8 years who initially participated in the study, 56 completed both the pre- and post-tests. The response rate of this study was 61.5%. The analysis subscale showed the largest change. Significant changes were found in the analysis (P=0.03), evaluation (P=0.04), and inductive reasoning (P<0.0001) subscales, but not in the inference (P=0.28), and deductive reasoning (P=0.42) subscales. There was no significant difference according to gender (P=0.77). Conclusion The findings of this study show that a critical thinking program had a substantial effect on medical students’ analysis, inductive reasoning, and evaluation skills, but negligible effects on their inference and deductive reasoning scores

Guide for reporting a qualitative study

Letter To Edito

Mapping the core competencies and entrustable professional activities of medical ethics for faculty members

Abstract Introduction The present study aimed to develop core competencies and Entrustable Professional Activities (EPAs) for faculty members through participating in faculty development programs in medical ethics. Methods This study included five stages. First, categories and subcategories were extracted based on the literature review and interviews with 14 experts and through inductive content analysis. Second, the content validity of the core competency list was checked by 16 experts using qualitative and quantitative approaches. Third, based on the previous phase, a framework for EPAs was developed by the taskforce in two sessions through consensus. Fourth, the content validity of the list of EPAs was compiled based on a three-point Likert 11 medical ethics experts from necessity and relevance perspectives. Fifth, EPAs were mapped by ten experts to the developed core competencies. Results After conducting the literature review and interviews, 295 codes were extracted, which were further classified into six categories and 18 subcategories. Finally, five core competencies and 23 EPAs were developed. The core competencies include “Teaching medical ethics”, “Research and scholarship in the field of medical ethics”, “Communication skills”, “Moral reasoning”, and “Policy-making, decision-making, and ethical leadership”. Conclusion Medical teachers can be effective in the moralizing healthcare system. Findings showed that faculty members should acquire core competencies and EPAs for proficiently integrating medical ethics into curricula. Faculty development programs can be designed in medical ethics for faculty members to help them to acquire core competencies and EPAs

Preparing Medical Students to Become Effective Tutors: A Reaction, Learning and Behavior Evaluation Study

Background We investigated three specific research purposes: (1) To assess the performance of tutors in guiding problem-based learning groups after participating in the tutor training program (TTP); (2) to examine the differences between tutors’ performance in related factors, including the tutors’ gender and education level; (3) to determine the tutors’ reaction to and learning from TTP. Methods This mixed method, concurrent triangulation study was carried out at Tehran University of Medical Sciences, School of Medicine in 2015. The participants included 22 students of medicine as tutor and 240 newly admitted students as tutee. After training, each tutor was assigned to a group of 10 members (a total of 22 groups) (n = 240) at a PBL session. Based on the Kirkpatrick's model, the tutors’ reaction to and learning from the TTP were evaluated using a peer evaluation form. Furthermore, utilizing the field note record form, their performance was recorded by an expert external observer. Results There was no evidence of difference in tutors’ performance between men and women. The median was 13.37 (13.16 - 13.90) for men and 13.40 (12.37 - 13.48) for women, P = 0.89. We found no difference in tutors’ performance based on the level of education using the Kruskal- Wallis test (χ2 = 1.84, DF = 2, P = 0.39). Analysis of the field notes showed 4 main themes. Conclusions The performance of men is as good as women in tutoring. Furthermore, junior students perform the same as senior students. Four main themes of tutors’ performance in PBL session were “helping to learn how to apply basic science”, “deep learning enhancement”, “group dynamics creation” and “interest in the field of education”

Training and validation of standardized patients for assessing communication and counseling skills of pharmacy students: A pilot study

Objective: The objective of this study is to describe the process of training valid simulated patients (SPs) for assessing communication and counseling skills of pharmacy students' performance. Methods: This is a cross-sectional and correlational study. Psychometric properties of checklist and SPs' portrayals and their filling of the checklist regarding assessing pharmacy students were assessed. Five SPs who were working in the simulated patient's pool were volunteered to take part in the project, which one of the SPs failed. Three scenarios, along with corresponding checklists, were developed based on the usual medications of different diseases consisting of asthma, respiratory infections, and osteoporosis. The SPs' role-play performance was video-recorded and rated independently by two experts according to an observational rating scale to assess validity. The role-play was repeated after 1 week with the same scenario and the same doctor, to assess test-retest reliability. The inter-rater agreement between SPs and experts was determined by calculating the intraclass correlation coefficient and kappa coefficient. Findings: The four eligible SPs were all women, with an average age of 37 years. The correlation between mean scores of raters and mean scores of SPs was 0.91 and 0.85, respectively. The Pearson's correlation between mean scores of raters with SPs was 0.75. The checklists' reliability, Cronbach's alpha, was calculated to be 0.72. The measured weighted Cohen's kappa for the ratings of by each SP, and the gold standard was between 0.53 and 0.57, indicating a moderate agreement. The inter-rater reliability kappa coefficient between raters was 0.75 (P = 0.01). Conclusion: The authors have demonstrated the technique of using standardized patients to evaluate communication and counseling skills of pharmacy students. The findings indicated that trained SPs can be used as an effective tool to assess pharmacy students' communication and counseling skills

Determining the expected competencies for oncology nursing: A needs assessment study

Background: A critical component of cancer care, rarely addressed in the published literature, is an expected competency in oncology nursing education. The present text describes an effort to develop cancer-nursing competencies in Iran and the process of the needs assessment. Materials and Methods: A 3-phase, mixed-method approach for needs assessment was used, incorporating modified Delphi technique, literature review, interviews, and an expert panel. Different stakeholders, consisting of nurses, faculty members in fields related to oncology nursing education, and patients and their families, participated in different phases of the study. Data were analyzed using manual content analysis. Results: In the present study, totally 123 sub-competencies were identified under holistic physical healthcare for patients, psychological and social care, spiritual care, palliative care, ability to prevent at three levels, teamwork and inter-professional competencies, management and leadership competencies, ability to conduct research and evidence-based nursing, supportive care, communication skills, professionalism, provision of education and counselling to patients and their families, and reasoning, problem solving, and critical thinking skills, respectively. Conclusions: An updated and applicable list of competencies was extracted, which can be used to design and develop educational programs, which seek to train qualified oncology nurses for an effective nursing care