Razi Journal of Medical Sciences

fa ارزیابی رضایت‌مندی و درک دانشجویان از محیط یادگیری طی دوره آموزش تلفیقی سمیولوژی عملی در پاندمی کوید ۱۹ در دانشگاه علوم پزشکی ایران Evaluation of Students' Satisfaction and Understanding of the Learning Environment during the Integrated Training Course of Practical Semiology in the Covid-19 Pandemic at Iran University of Medical Sciences آموزش پزشکی medical education پژوهشي Research <div style="text-align: justify;">زمینه و هدف: شیوع بیمار کروناویروس COVID-19 (coronavirus disease 2019) آموزش پزشکی را در سراسر جهان به چالش کشیده است و باعث تغییر در شیوه‌های انجام آموزش‌های پزشکی در زمینه‌های مختلف شده است. هدف این مطالعه ارزیابی رضایت و درک دانشجویان از محیط یادگیری در دوره عملی سمیولوژی در طول شیوع کووید-۱۹ بود. روش کار: در این مطالعه مقطعی، 325 نفر از دانشجویان پزشکی ورودی سال‌های 1396 و 1397 که دوره عملی سمیولوژی را <a name="_Hlk177833534">خواهند </a>گذراند، وارد مطالعه شدند. سپس دانشجویان به دو گروه شامل گروه‌های آموزش مجازی و حضوری تقسیم شدند. در این مطالعه، در پایان دوره آموزشی یکپارچه، سطح درک دانشجویان از محیط یادگیری و سطح رضایت آن‌ها بین دو گروه مجازی و حضوری با استفاده از پرسشنامه استاندارد جوامع آموزشی DREEM (Dundee Ready Education Environment Measure) با مقیاس لایکرت بررسی شد. یافته‌ها: میانگین سن کلی دانشجویان 75/2± 65/22 سال بود. 3/54% از دانشجویان مرد بودند. در دوره‌های مجازی و حضوری به ترتیب 74 و 251 نفر شرکت کردند. رابطه بین نوع دوره آموزشی دانشجویان (حضوری یا مجازی) و میزان رضایت آنها بررسی شد. تجزیه و تحلیل آماری رابطه معنی داری بین این دو متغیر نشان نداد. سطح رضایت از شرکت در کارگاه بیش از 90% بود. امتیاز میانگین پرسشنامه DREEM  برابر با 14/20 ± 77/178 بود. میانگین کلی امتیاز رضایت از جو آموزشی بر اساس پرسشنامه DREEM به ترتیب برابر با 16/21 ± 36/163 و 9/17 ± 96/183 برای گروه‌های مجازی و حضوری بود که این اختلاف به صورت آماری معنی‌دار بود  (0.001P=) و همچنین نتایج مقایسه امتیاز میانگین در زیربعدهای این پرسشنامه نشان داد که میانگین امتیاز برای تمام بعدها در گروه حضوری بالاتر از گروه مجازی بود. نتیجه‌گیری: نتایج این مطالعه نشان داد که میانگین کلی امتیاز رضایت از جو آموزشی بر اساس پرسشنامهDREEM ، برای گروه دانشجویانی که در روش حضوری شرکت کردند، در تمام بعدها نسبت به گروه مجازی بیشتر بود.</div> <div style="text-align: justify;">Background & Aims: An emerging disease surfaced in China in December 2019, manifesting as acute respiratory syndrome, rapidly evolving into a global pandemic (1-3). The cause was identified as the severe acute respiratory syndrome coronavirus (SARS-CoV-2), designated COVID-19 by the World Health Organization on January 30, 2020 (4). In response to its high fatality rate and contagiousness, countries worldwide implemented widespread closures, including Iran, where all administrative, commercial, and educational activities ceased. Consequently, virtual education gained prominence to mitigate academic setbacks and ensure continuity (5). This shift necessitated educators, many inexperienced in virtual teaching, to adapt quickly (6). Medical education also adapted to these conditions, with significant impacts on student learning in hospital settings. Face-to-face teaching in hospitals and clinics was curtailed due to the disease burden in Iran, leading to substantial changes in medical education (7, 8). Studies in Iran have yielded conflicting findings on the pandemic's effects on medical education, highlighting both the efficacy of online and virtual medical courses and varying outcomes (8-12). Recognizing the significance of the semiology course for medical students, crucial for learning clinical examinations and patient interaction skills before entering hospital departments, emphasizes the need for structured training in semiology. This foundational unit underpins medical and clinical education, playing a vital role in future patient care and healthcare management (13). The current research was designed with the aim of investigating the level of students' satisfaction and students' views on different aspects of practical semiology unit courses in two groups of students who completed the course in person and virtual. Methods: This study was a meticulous examination conducted among medical students enrolled at Iran University of Medical Sciences (IUMS) in Tehran throughout the year 2022. To ensure ethical standards, the study commenced following approval from the IUMS Ethics and Research Committee (approval number: IR.IUMS.REC.1401.490).  Participants in this study were enrolled using convenience sampling into two groups: a virtual learning group and a face-to-face learning group, both meticulously matched in demographic characteristics such as age, gender, and academic semester. The sampling strategy employed convenience sampling, categorizing participants into two distinct groups: face-to-face and virtual learning environments. This stratification aimed to maintain demographic equilibrium concerning variables such as age, gender, and academic semester, thereby mitigating potential confounding factors. Adequate sample sizes were computed to uphold statistical power, mandating a minimum of 193 participants encompassing both groups: 65 in the virtual cohort and 128 in the face-to-face cohort. The practical semiology curriculum was tailored based on specific needs identified among students at Iran University of Medical Sciences (IUMS). For the virtual course, educational content included 57 carefully crafted instructional videos sourced from expert lectures and practical demonstrations. These resources were made available on the IUMS online platform prior to the course commencement, ensuring accessibility and preparation for virtual learners. Conversely, the face-to-face course was conducted in a spacious, well-ventilated facility equipped with 15 dedicated learning stations. Each station accommodated 5-9 students, an instructor, and occasionally a simulated patient actor when required. These stations were fully stocked with essential tools and educational aids, facilitating hands-on learning experiences under direct educator supervision. The curriculum spanned three intensive modules over 12 days, covering critical topics such as clinical history-taking, physical examinations, and technical competencies including surgical techniques and invasive procedures. Outcome measures centered on evaluating student perceptions of the learning environment and overall satisfaction levels. This assessment was conducted using the Dundee Ready Education Environment Measure (DREEM) (14) questionnaire, a validated tool designed to assess educational climate effectiveness across domains like learning, teaching quality, academic self-perception, educational atmosphere, and social conditions. The DREEM questionnaire assesses students' perceptions across several dimensions: learning, teachers, academic ability, educational atmosphere, and social conditions of education. Each component uses a 5-point Likert scale, with scores categorized into poor, moderate, and high levels based on predefined score ranges. Additionally, student satisfaction with the semiology course is evaluated through a separate 10-question online questionnaire, also using a 5-point Likert scale, with scores classified into poor, moderate, and high satisfaction levels. Statistical analysis of collected data utilized SPSS software, employing standard metrics such as mean ± standard deviation for continuous variables and percentages for categorical data. Comparative analysis included Mann-Whitney U tests, independent sample t-tests, and chi-square tests as appropriate, with significance set at P ≤ 0.05. These rigorous analytical approaches aimed to discern significant differences and draw robust conclusions regarding the efficacy of each educational modality in fostering student learning and satisfaction in semiology training at IUMS. Results: A total of 325 medical students were included in this study. 22/8% of the students (n=74) had participated in virtual training and 77.2% of the students (n=251) had participated in the face-to-face semiology course. The average age of students was 22.65 ± 2.75 years and ranged from 20 to 38 years (P=0.8). 54.2% (n=176) were male students and 45.8% (n=149) were female students (P=0.01). The relationship between the type of students' training course (face-to-face or virtual) and their level of satisfaction was investigated. Statistical analysis did not show a significant relationship between these two variables (P=0.1).  The dimensions of the DREEM questionnaire were examined, Overall, poor perception had a very low prevalence (0-1.4%). In contrast, high perception in students showed a prevalence of more than 90% in all dimensions in face-to-face education and between 77 and 91.9% in virtual education. Except for SPSCE, in other dimensions, the level of high perception was significantly higher in students with face-to-face education (P<0.05). Conclusion: In general, according to the DREEM index, the level of satisfaction with education in general and in all its dimensions was reported to be high and suitable for both learning groups. The overall score of satisfaction and perception with education based on DREEM, for a group of students who participated in face-to-face learning, in all dimensions including: SPL, SPT, SPAA, SPEA and SPSCE was more than the virtual group. This study showed that although virtual training has high satisfaction among students, the face-to-face training method caused higher academic satisfaction and perception. Therefore, considering the nature of the semiology course and its clinical importance, it is suggested that this course and, in general, courses that have a high clinical aspect, be taught face-to-face. It is recommended to compare the final test results of students in two face-to-face and virtual groups of semiology course in other studies.</div> کووید-19, آموزش پزشکی, آموزش حضوری, آموزش مجازی, DREEM COVID-19, Medical education, Virtual learning, Face-to-face education, DREEM 1 10 http://rjms.iums.ac.ir/browse.php?a_code=A-10-4932-1&slc_lang=fa&sid=1 Ali Tayebi علی طیبی 3900319475328460090153 3900319475328460090153 No Assistant Professor, Clinical Research development Unit Firoozabadi, General Surgery Department, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran استادیار، واحد توسعه تحقیقات بالینی فیروزآبادی (F A CRD U)، گروه جراحی عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران Shabahang Jafarnejad شباهنگ جعفرنژاد 3900319475328460090154 3900319475328460090154 No Associate Professor, Department Emergency Medicine, Ali Asghar Children's Hospital, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran دانشیار، گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، بیمارستان کودکان علی اصغر، دانشگاه علوم پزشکی ایران، تهران، ایران Mahya Naderkhani مهیا نادرخانی naderkhani.m@iums.ac.ir 3900319475328460090155 3900319475328460090155 Yes Assistant Professor, Emergency Medical Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran استادیار، مرکز تحقیقات مدیریت اورژانس پزشکی، پژوهشکده مدیریت سلامت، دانشگاه علوم پزشکی ایران، تهران، ایران Ali Arjmand Tajoddini علی ارجمند تاج الدینی 3900319475328460090156 0009-0006-1933-5136 No MD, Iran University of Medical Sciences, Tehran, Iran پزشک عمومی، دانشگاه علوم پزشکی ایران، تهران، ایران Fateme Nouri Abhari فاطمه نوری ابهری 3900319475328460090157 0009-0004-0833-2787 No Student, Pharmaceutical Department, Tehran University of Medical Sciences, Tehran, Iran دانشجوی داروسازی، گروه داروسازی، دانشگاه علوم پزشکی تهران، تهران، ایران Faranak Olamaeian فرانک علمائیان 3900319475328460090158 3900319475328460090158 No Assistant Professor, Clinical Research development Unit Firoozabadi, General Surgery Department, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran استادیار، واحد توسعه تحقیقات بالینی فیروزآبادی (F A CRD U)، گروه جراحی عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران Shahin Keshtkar Rajabi شهین کشتکار رجبی 3900319475328460090159 3900319475328460090159 No Assistant Professor, Clinical Research development Unit Firoozabadi, Internal Department, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran استادیار، واحد توسعه تحقیقات بالینی بیمارستان فیروزآبادی (FHCRDU)، گروه داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران Alireza Zakaryaei علیرضا ذکریائی 3900319475328460090160 3900319475328460090160 No Student, Student Research Committee, Medicine Faculty, Iran University of Medical Sciences, Tehran, Iran دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران