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Volume 20, Issue 108 (6-2013)
Background: Today, one of the main concepts in the health care systems is maintaining safety and security of patient and disclosing medical errors to patient and educational system is an important aspect of moral and necessary of care that reduces the error. This study aimed to design a valid and reliable instrument to determine the attitudes of residents towards self-disclosure of medical errors and factors affecting it.
Methods : This study is a descriptive survey that 150 residents were conducted in Tehran University of Medical Sciences who were selected through stratified random sampling method. The researcher-made questionnaire was used for data collection. Collected data were entered into SPSS 16 statistical software using descriptive statistics, the objectives and research questions were analyzed.
Results: 125 residents completed the questionnaires (response rate 83.3%). In overall, more residents (62.4%) agreed that medical errors are one of the most serious problems in health care systems. Almost all residents (66.4%) agreed that serious errors should be disclosed to patients, but only 36.8% of residents agreed that minor errors should be disclosed to patients and almost more than half of residents (60%) were agree that near miss errors should be disclosed to patients. Almost all residents (91.2%) was interested in to be in receiving general education or training on disclosing medical errors to patient.
Conclusions: In according to residents̕ interest to learn about medical errors, designing a curriculum for training medical students is needed. Students also need to be trained on patient̕s bed and supervisors monitor their trainings, until the medical students at the end of training, be capable of disclose medical errors independently.
Volume 20, Issue 116 (2-2014)
Background: One
of the most important activities in educational processes is evaluation of
students. For evaluating the students’ professional
performance, selecting an appropriate evaluation system is important. The aim
of this study was to assess the clinical performance of medical interns and its
affecting factors by mini-CEX test.
Methods: This study was
semi-experimental and
mini-CEX test was given to the emergency department interns’ twice at the
beginning and end of the period and the assessor gave score the interns’ performance according to the
checklist. Test scores were compared.
Results: In total 76 participants were able to
fulfill the first and second tests. Mean of test scores increased from 11.3 with a standard deviation
1.67 to 12.3 with a standard deviation 1.53 and increased 1.07 score (p value=
0.000).
Conclusions: The result of
the study emphasizes the affect of the variables on improvement of the clinical
skills of interns’ and evaluating them at the beginning and end of the courses
to investigate learning outcomes.
Volume 21, Issue 124 (10-2014)
Background: Emergency personnel in hospitals are at high risk of exposure to violence. The aim of this study was to evaluate effect of communication skills education to emergency personnel in terms of verbal and physical violence.
Methods: This study was quasi-experimental and for implementing this project, all of Hazrat-e-Rasoul Akram Hospital emergency department personnel (Nurses, secretaries and helping healthcare workers and guards) participated in one of the two consecutive educational classes at a distance of one month. The incidence of violence during before and after education was measured using a researcher made questionnaire which was completed by the personnel. The results were compared using Wilcoxon test.
Results: Following education, average of verbal violence was reduced from 5.8 to 5.1 and from standard deviation 2.67 to 2.11 (p= 0.135). Also Average of physical violence was reduced from 1.8 to 1.4 and from standard deviation 2.11 to 2.33. (p= 0.165). Both physical and verbal violence’s following the educational course decreased, although was not statistically significant.
Conclusion: The incidence of physical and verbal violence’s decreased after the educational course, but was not significantVolume 21, Issue 127 (1-2015)
Background: Survey of patients’ demand and need
to receive dental services, has a special role in providing these services and
meeting the community therapeutic needs. This study compares patients’ demand and need to
receive restorative dental services in a dental clinic in Isfahan.
Methods: This was a descriptive-cross sectional study and
data gathering was by checklist. The data of identified demands and needs of
restorative dental services of
refered patients to Farhangian dental clinic chosen by non-random consecutive sampling during three
months were entered into statistical software SPSS (version 17. Chi-square test was used for data analyzing. P
<0.05 was considered as significant level.
Results:
Totally
1040 patients were studied that included 603 peoples (58.2 %) were in 15-49 years age group. The most referring reason of
patients were respectively related to endodontic (24.8%), restorative and
prosthetic included 193 peoples (each 18.5 %)
and periodontics included 133 peoples (12.8%)
and the least of referring reason was oral diseases included 7 peoples (0.7 %). 1027 patients (98.75%) needed to restorative dental services
but just 195 patients (18.8%) had demand for these services (p<0.05).
Volume 22, Issue 139 (1-2016)
Background: Infective diseases are one of the most important causes of life quality decrease and death in HIV/AIDS patients. The aim of this study was comparison of viral hepatitis B and C and tuberculosis simultaneous infections Prevalence of positive-HIV patients in incubation and AIDS phases and causes of death in Isfahan Behavioral Consultation Center during ten years (1999 to 2009).
Methods: In this cross-sectional study, Tuberculosis and viral hepatitis B and C simultaneous infections of positive-HIV patients in incubation and AIDS phases and causes of death in Isfahan Behavioral Consultation Center were investigated; they were selected by census method. Patient information was entered to SPSS version 19 software and data were analyzed via descriptive analytic statistical methods.
Results: Totally 116 (48.1%) of 241 patients had one or two disease hepatitis C and B and Tuberculosis (TB) that 18 patients (15.5%) were in AIDS phase. In incubation phase hepatitis C and in AIDS phase TB had the most frequency. 72 patients died that 18 patients (25%) were in AIDS phase. The most causes of death in patients, including 18.1% in incubation phase and 14% in AIDS phase, was AIDS (p≤ 0.001).
Conclusion: The most prevalent of simultaneous infective disease in incubation phase was hepatitis C and in AIDS phase was TB. Clearly simultaneous Hepatitis C and TB in AIDS phase had more prevalent. The most prevalent cause of death in incubation phase was drug intoxication and in AIDS phase was AIDS, but death due to AIDS had the most prevalent in both phases.
Volume 23, Issue 143 (5-2016)
Background: Along with the rapid development in technology and Internet-Based education, combined learning methods have been extended and traditional classes have been propelled toward the virtual learning environments. The purpose of this study was the survey of two traditional and virtual teaching methods in learning of the course of “Introduction to Dental equipment and their maintenance” for the students of PhD General Dentistry at Shahid Beheshti University of Medical Sciences.
Methods: In this semi experimental study, by randomized allocation, the incoming students were divided into two groups of observation and intermediacy; 41 students from the September-Entrance in 2011 and 41 students from the January-Entrance in 2012were selected as observation (were taught by the professor of corresponding course) and intermediacy group (were taught in virtual learning by CD), respectively. After the end of the semester, the effect of the two above-mentioned methods on the knowledge of the students was assessed by using the awareness questionnaire. The face and content validity evaluation of questionnaire was done by the qualitative methods based on the standard methods and in the quantitative methods it was done by using content validity ratio CVR= +1 and content validity index CVI= +1 referring to Lawshe table. The reliability of the final exam was done based on Cronbach's alpha coefficient. The amount of the effect of the two above-mentioned methods on performance of students was done by using OSCE (Objective Structured Clinical Evaluation), its face and content validity was confirmed based on reference books and experienced professors’ and Faculty members’ comments. The reliability of the final exam was confirmed based on Pearson Correlation Coefficient. The SPSS statistical software was used in order to analyzing the data.
Results: Content validity ration was CVR= +1 and content validity index was CVI= +1. Moreover, the reliability of the final exam was calculated and confirmed as 0.98, based on Cronbach's alpha Coefficient. The reliability of the final exam was in the method of determining correlation performance test scores with the average of theoretical and experimental scores based on Pearson Correlation Coefficient and they were: (0.117) p=0.429) and 0.376(p=0.008), respectively. Also, the amount of the correlation of each skill with the total score of performance assessment test was 0.84 (p= 0.001) in order to determine the internal structure and the total reliability of the final exam was the final scores of awareness testing in the students of traditional groups which was higher than the students of virtual group, (p= 0.177). In the performance assessment scores, the average of virtual group was 8.05 that showed no significant difference with the average of traditional group [8.02 (p= 0.907)].
Conclusion: This study revealed that virtual teaching method, similar to the traditional teaching method, gained enough success in teaching program which included increase in the knowledge and performance of students in the area of the course. This success is in a way that it can be used as an alternative method in dentistry faculties.
Volume 24, Issue 159 (9-2017)
Background: The assessing of distance education learning environments is the key to high-quality student-centered curriculum. A comprehensive, valid and reliable tool is essential in order to lead such evaluation. One of the patterns to measure the learning environment is DELES (distance education learning environments survey) measurement tool which is a specialized questionnaire to assess distance learning environment setting.
Methods: This is a descriptive and analytic study. The study population is the distance medical education students of Iran University of medical science in master of sciences. The method of collecting data on the implementation of this project was census sampling method and the sample size included 150 students. Content and face validity was evaluated with 20 experts familiar with clinical education and structural validity evaluated using factor analysis method. Reliability stability was assessed through test - retest and internal consistency reliability was measured using Cronbach's alpha co-efficiency and whole data analyzed using SPSS 16 Software.
Results: The DELES Questionnaire with an average score of 77.10 ± 17.8 (64%) of 120 was obtained good rating in the assessment. The content validity of the questionnaire was confirmed. Average content validity of the ratio (CVR) 0.30 was calculated, and 12 questions eliminated at this stage. Content validity of the Index (CVI) was calculated 0.42. In exploratory factor analysis of KMO, 0.856 was achieved, and the Bartlett test was significant: (p≤0.0001) Seven factors were confirmed that basis of a few questions was changed (coverage of variance=73.739%). Cronbach's alpha coefficient of the questionnaire was 0.937.
Conclusion: The modified "DELES" Questionnaire in Persian language including 30 questions was presented with appropriate psychometric conditions that could be applied to assess distance education learning environments in medical education students of our country.
Volume 29, Issue 9 (12-2022)
Background & Aims: Measuring the learning environment is one of the necessities to improve the quality of students' learning. Therefore, in the curriculum planning based on competence, it is necessary to use the measurements to ensure the quality of education. Nowadays, international centers pay special attention to the issue of cultural competence, and since the beginning of the 1960s, they have investigated the theoretical foundations and definitions of the issue and have designed various models for quantitative and qualitative evaluation of cultural competence in world’s reputable medical sciences universities. Despite that the international scientific community has addressed this issue and in spite of the cultural diversity in Iran, it was only in the last few years that some review articles have emphasized the necessity of cultural competence in medical education and some studies have investigated and evaluated the learning environment using international tools.
Also, reviewing the studies on new teaching approaches in Iran shows that although cultural competence is not considered in clinical education and they are not academically trained in the field of culturally competent care, the medical team fulfill the cultural needs of their patients based on their cultural intelligence and initiative. In this situation, only a small part of this culture would be officially transferred to students during the curriculum hours, and the acceptable values, beliefs and behaviors would be transferred through the covert curriculum.
Accordingly, considering its importance and necessity, it is recommended that this issue should be taken into consideration in clinical education approaches, especially new approaches, and quantitative and qualitative studies should be used to measure and improve the education of this important notion.
Therefore, the purpose of this research is to evaluate the cultural competence status of medical graduates in Tehran in order to provide a model that is appropriate for the background and context of Iran’s universities.
Methods: This research is descriptive and analytical. The data collection tool in this research was a valid and reliable researcher-made questionnaire. The first part of the questionnaire included demographic information and the second part had 64 valid and reliable questions in 4 main subgroups as: cultural awareness, cultural knowledge, cultural skills and transcendental motivation. This questionnaire was conducted on a statistical sample of 800 graduates of medical sciences, working in hospitals and medical centers in Tehran, using random sampling method. Quantitative data was analyzed using SPSS-24 and internal correlation, independent t-test and analysis of variance were analyzed.
Results: Out of 800 questionnaires, 542 were returned, of which 507 questionnaires were thoroughly completed; which is an acceptable 67% return rate. Also, 82.6 percent of the respondents were women which indicates that women cooperate more in filling out the questionnaires as they participate more in the activities and were more in number.
Cronbach's alpha coefficient for the whole instrument (64 questions) was 0.96. The highest value for the domain of transcendental motivation was 0.89 and the other domains were 0.88.
The results of the independent t-test show that although there is no significant difference between male and female medical students regarding the status of cultural competence, the average scores of men were higher than women in the domains of transcendental motivation, knowledge and cultural skill. But women had a higher score in the domain of cultural awareness. Also, the results of the independent t-test based on marital status show that there was a significant difference between the average scores in 4 domains (transcendental motivation, cultural awareness, knowledge and skills) in which the average scores of married people were higher than single respondents.
The results of the one-way ANOVA analysis showed that there is no significant difference between cultural competencies based on the university, but there is a significant difference in accordance to age, field of study, degree, work experience and workplace. According to age, in all the 4 domains, the average score increases while aging. Also, based on the field of study, the average of 3 domains (cultural awareness, knowledge and skills), nursing students had a higher average, and in the domain of transcendental motivation, midwifery and then nursing students had a higher average than other fields. Finally, the average score increases with the increase in work experience.
The final average of the questionnaire was calculated as 3.92+0.48 out of 5, in which the highest score was for the domain of transcendental motivation with a score of 4.15+0.48 out of 5, followed by awareness and skill; the knowledge domain had the lowest average with a score of 3.68±0.59 out of 5. According to the averages obtained in different domains, the general statue of cultural competence of medical students in Tehran is higher than average and is acceptable.
In the field of the transcendental motive, respecting values and beliefs, giving priority to humanity and paying attention to God's consent had the highest average, and to enjoy serving different people had the lowest average. In the domain of cultural awareness, the awareness of one's own cultural beliefs and attitudes had the highest average, and familiarity with the differences in health behaviors of different cultures had the lowest average; in the domain of cultural knowledge, knowing spiritual and religious beliefs had the highest average, and knowing common methods of traditional treatments, knowing the history of traditions and knowing the nutritional beliefs of different cultures had the lowest average. In the domain of cultural skills, serving without bias and practicing communication skills had the highest average, and generating new knowledge had the lowest average.
Conclusion: This study showed that the graduates' evaluation of the cultural competence of the educational environment is positive, therefore, it is recommended to emphasize using appropriate methods to enhance the factors that have positively affected the evaluation of students.
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