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Background & Objective: Clinical education stands as a critical domain for enhancing clinical skills. Evolving global demands, marked by an information explosion and dynamic shifts in disease patterns, coupled with deficiencies in clinical training and its disconnect from theoretical knowledge, pose significant challenges in patient care. This study aims to explore the obstacles and challenges associated with applying theoretical knowledge from the general medicine course in clinical practice. Materials & Methods: This qualitative research employed a conventional content analysis approach. Twenty participants, each with a minimum of one year of clinical education experience, were purposefully selected to ensure maximum diversity. Data were collected and analyzed through individual semi-structured interviews. Results: The data analysis identified five main categories as the primary challenges in applying theoretical knowledge in the clinical environment. These include "weakness of inputs," "weakness of policy," "ineffective training and novice practitioners," "ethical lapses, unprofessional conduct," and "challenges while studying." Additionally, 14 subcategories were derived, collectively representing the main challenges faced. Conclusion: The application of theoretical knowledge acquired in various aspects of clinical education is hampered by diverse challenges. These challenges manifest at different levels, encompassing management, policy, infrastructure, and human and material resources. Prioritizing identified issues and implementing corrective actions based on existing capacities is the initial step in overcoming these challenges.

BACKGROUND: The institutional accreditation standards were revised after the initial round of institutional accreditation and gaining experience while scrutinizing issues and complications. This research covers the steps needed to update and then compile the new standards, making the necessary changes in regulations, self-evaluation guides, external evaluation, ethics, and the required forms. MATERIALS AND METHODS: This comprehensive developmental study, conducted in two main phases from 2019 to 2022 at Isfahan University of Medical Sciences, employed a variety of rigorous methods. These included a thorough literature review, analysis of previous documents, gathering of gathering experts' opinions, and consensus techniques. In the first phase, standards were revised through meticulous steps such as a literature review, expert meetings, and a survey study among managers and faculty members of medical universities. In the second phase, regulations, forms, and guidelines were compiled during experts’ meetings. RESULTS: In the first phase, a draft of the standards, prepared based on previous accreditation experiences, universities feedback on standards, and review of 14 accreditation institution websites, in eight domains, 23 subdomains, and 94 standards. Notably, 75 of these standards were deemed mandatory, while 19 were classified as preferred. The prepared draft of the standards was then subjected to a three-stage survey. During this process, the National Accreditation Commission proposed one modification to the regulations and four alterations to the standards, along with accompanying explanations. Afterward, during the second and third review stages involving universities and managers, 14 standards were revised, two new standards were introduced, and seven explanations were appended. The finalization of mandatory and preferred standards was contingent upon attaining a 70% consensus on their necessity and clarity. Following approval by the Secretariat of the Council for Development, these standards were formally ratified. The regulations, self-assessment guide, external evaluation guide, ethics guide, and necessary forms were prepared and approved by the National Accreditation Commission in the second phase using data from literature reviews and experiences gained from the first round of accreditation. CONCLUSION: This study focused on developing standards and processes commissioned by the National Accreditation Commission, which will serve as the national institutional accreditation standards for evaluating medical universities. Additionally, these standards could be used as a basis for development of accreditation standards of those universities affiliated with the Ministry of Science, Research, and Technology.

Letter To Editor

Letter To Editor

Background and Objective: Considering the importance and necessity of virtual education, this study aims to outline the current status of virtual education studies in Iran's universities of medical sciences from the frame of approved scientific research journals. Methods: The present study is based on the scoping method and by searching the keywords "virtual education", "electronic education", "electronic learning", "web education", "online education", and "distance education". It was done in the information bank of the country's publications (Mag Iran). All the articles available until September 2019 resulting from the research in the medical sciences universities of the country were selected and analyzed based on the studied variables (university of research location, journal, year of publication, statistical population, type of study, instrument, topic, and sampling). Findings: After removing duplicate and unrelated articles, 115 articles were included in the study. In terms of location, Tehran University (19.1 percent); In terms of the statistical population, nursing students (24.3%); In terms of subject, comparison of traditional and virtual education (27%); and theory courses (77.8%) were studied the most. Most of the research conducted between 2015 to 2018 (51.3%) was conducted, descriptive method (34.8%) was the most used type of study, questionnaire was the most used tool (49.6%) and randomness (39.1%) was the most used sampling method. Conclusion: Dealing with virtual education has found a special place in universities and it intensified during the corona pandemic. Determining the distribution of research subjects and identifying shortcomings to achieve the effectiveness and adequacy of studies is one of the results of this study. It is recommended to evaluate the student; the type of tools needed and available to the student; Family, cultural, social, and economic dimensions effective in virtual education, especially in second and third-type universities of medical sciences, should be paid more attention in future studies.

Abstract Background In the last few decades, the need to change the curriculum of basic medical science has been further emphasized. The purpose of this study was to evaluate the effects of teaching integrated course of physical examination and radiological anatomy in practical limb anatomy on medical students’ learning outcomes. Methods This was an experimental study. Medical students (of the 4th semester of medical education) were divided into intervention and control groups. Related topics of physical examination and radiological anatomy were added to the practical limb anatomy courses of the intervention group. Practical knowledge of anatomy, clinical applications of anatomical knowledge, students ‘satisfaction, and students’ attitude toward the anatomy course were assessed at the end of the study. Knowledge retention was assessed three months after the semester. Results The intervention group scored significantly higher mean scores in practical knowledge of anatomy test, clinical applications of anatomical knowledge test and knowledge retention test (P-value

Introduction: Departments are the major sub-system of university and quality improvement of the universities rides on the quality improvement of the departments. The researchers developed, implemented, and evaluated the appropriate components based on the results of self-assessment and external evaluation of institutional accreditation. Methods: In a case study on 32 departments of Medical Schools, based on accreditation standards, department promotion components were identified. The components were prioritized in terms of importance, measurability and viability with proper scale and weighted by the experts with a focus group. The components' validity was determined by the expert opinion and implemented in the departments after training. A valid and reliable instrument was developed for monitoring and evaluating the fulfillment of the components. Results: The components of improvement in the department performance including formulation and implementation of the operational plan, website, training areas, faculty members' viewpoints about the department leader, faculty management viewpoints on department accountability, along with a gudline for measuring these components were reached. The mean of the components was 79%. The lowest achievement was related to the component of school participation in the activities of the department and timely presentation of the operational plan (72%) as well as the achievement highest was observance of clinical education standards (92%). Conclusion: Promotion of website, operational plan, areas of education, increased faculty participation, increased order in the formation of department councils, and increased department accountability were the main results of this study. Evaluation of the department was done on the basis of the realization of the interventions as a chief factor for promoting the executive guarantee. Due to the continuous follow-up and direct supervision of the Faculty Board, the results revealed that the components were in a favorable condition.

INTRODUCTION: Higher education plays an important role in the development of countries in social, economic, cultural, and scientific aspects. Also, the field of healthcare is changing rapidly, and to provide better care, health professional students need to be trained at a higher level. This situation has placed demands on academic and clinical settings responsible for training professional health students. The main objectives of this research project can be defined as 1 —to investigate important issues of accreditation and assessment process of health professional education worldwide and 2—to design and develop a uniform, transparent, and scientific accreditation framework for health professional programs in Iran.METHODS AND MATERIAL: The research methodology for the design of a generic accreditation framework in health professional education is outlined by the following step-by-step (1 to 7) procedure according to the developmental research methodology and three phases considering analysis, development, and evaluation.RESULTS: The findings of the analysis phase showed that there is no specific structure and process for accreditation in Iran compared to other countries. The three most common actions of the accreditation include the following: 1. self- assessment, 2. peer-review and site visits, and 3. evaluation and reports. A review of the relevant literature and websites indicate that various assessment frameworks have been developed regionally, as well as internationally, to accredit professional health programs. However, most of these frames seem to be non-uniform, too complex, and non-transparent. In addition to these results, three themes were extracted from the interview analysis, “accreditation barrier,” “theoretical foundation of accreditation,” and “specific structure and process of accreditation” which indicates the need for education at various levels of educational managers and faculty members. Therefore, these issues were taken into consideration in the design of the accreditation framework of health professional educational programs. After two stages of evaluation from the point of view of specialists and experts of the educational secretariats of the Ministry of Health and Medical Education, the final version of the program's accreditation framework and policy will be finalized.CONCLUSION: In Iran, despite the challenges and valuable activities in different educational secretariats, there was no coherent process that can be considered accreditation. In this study, self-study evaluation guide, external evaluation, standard development, and ethical guide for the programs accreditation were developed. The results of this study can help the educational secretariats of the Health and Medical Education Ministry that is based on the documents developed and operationalize their accreditation process and structure.

BACKGROUND: This study was conducted on accountability, aiming to design components for monitoring the curricula of universities of medical sciences. MATERIALS AND METHODS: This study was a developmental one, conducted in Isfahan University of Medical Sciences with the document and literature review, a focus group, and a survey from 2018 to 2020. The first version of the components was designed by the library research and content analysis method. Following developing the initial tool, its validity was evaluated with a focus group, and the questionnaire was prepared according to face and content validity. RESULTS: In this study, 73 components were designed in eight domains for curriculum supervision, including requirements (12), needs and goals (6), content (10), teaching–learning strategies (10), educational materials and resources (5), educational time (2), educational setting (10), and evaluation (18). CONCLUSION: The components of curriculum supervision were designed due to their importance in the evolution and innovation of medical sciences, particularly accountability in the education system, and lack of relevant research. With these components, the current and optimal status of curricula can be determined in universities.

Introduction: For any medical student, bedside training plays a pivotal role that could integrate his clinical skills and theoretical knowledge. Every efficient educational system requires regular evaluation and medical education is not an exception. The purpose of this study was to assess major clinical training fields from the perspective of medical students in Isfahan School of Medicine. Methods: This descriptive, cross-sectional study assessed the clinical training fields (training round and outpatient training) of the surgery, internal medicine, gynecology, and pediatrics departments of teaching hospitals affiliated with Isfahan University of Medical Sciences from the perspective of medical students in the first semester of the academic year 2015-16. The study was conducted in the first week of the program on 61 groups of medical students selected by means of census method including 21 groups of internal medicine, 20 groups of surgery, 7 groups of gynecology, and 13 groups of pediatrics medical students. Data were collected by the notebook of clinical training monitoring to record the number of medical students attended, hours attended, hours of training by teachers, and the number of visited patients per day for a week categorized by the training fields. The data were analyzed in Excel using mean and standard deviation. Results: Daily training hours of the medical students (training rounds and outpatient training) were 2.5±0.53 (internal medicine), 2.75±0.32 (surgery), 2.04±0.3 (gynecology), and 2.17±0.24 (pediatrics) hours in the wards and 2.75±0.25 in the clinics. The medical students visited an average number of 5.54±1.55 inpatients and outpatients (internal medicine), 8.25±1.25 (surgery), 3±0.6 inpatients and 22.2±5.02 outpatients (gynecology), and 5.7±1.02 inpatients and 15.9±5.14 outpatients (pediatrics) per day. Conclusion: The information obtained in relation to the average number of medical students, interns and residents, the number of visited patients per day, and the hours of medical students’ attendance and training by teachers in the wards can show a realistic picture of the conditions of training fields and help program planners.

INTRODUCTION: The study aimed to design, implement, and evaluate the process of advisor and teaching assistant (TA) to increase the quality of cascade training in principal educational groups, presenting the obstacles and problems of this educational intervention and introducing them to educational planners. METHODOLOGY: This applied developmental research was conducted in Isfahan University of Medical Sciences in 2017–2018 in principal educational groups (internal medicine, surgery, pediatrics, gynecology, and cardiology). For this purpose, a working party called TAs was composed of managers, faculty members, and active and interested assistants, including 24 people. The action plan, bylaws, job description, and logbooks were completed by the method of the focus group. Getting the report, monitoring the activity, exchanging the ideas, and drawing up the various plans were continuously done through bi-monthly in-person meetings, and the virtual group was organized for monitoring, starting a training logbook, and doing semi-organized interviews to evaluate. RESULTS: In a total of 1131 h, various educational activities were conducted such as cooperating with the advisor, teaching some part of a class, holding a workshop, contributing to question design, preparing the educational resources, and organizing an educational round. CONCLUSION: Improving the knowledge, attitude, and practice of assistants in cascade training, regulating their activities, learning the teaching skills, and exercising them with the teacher were some of the most significant opportunities of this study.

Background: Identifying the strengths and weakness points is one of the effective methods to analyze current status, and prioritizing actions based on the gap between current and optimal status is necessary for short-term and long-term planning in departments and colleges. The aim of this study was to determine the gap between current and optimal status of curriculum leadership in the postgraduate courses in two Iranian universities. Materials and Methods: In this cross-sectional study, a sample of 212 faculty members from the two Iranian universities (one medical and one nonmedical) was randomly selected through stratified random sampling method. Data were collected by using a researcher-made questionnaire, with 55 items categorized in four areas of main dimensions in curriculum leadership. The validity of the questionnaire was determined by curriculum studies scholars, and the reliability was confirmed as the Cronbach′s alpha calculated 0.969. Data were analyzed using descriptive and inferential statistics according to the variables. Results: There was a gap in all dimensions and roles. The maximum gap (−1.70) with the highest frequency (98%) were related to "improving the educational atmosphere" dimension. As for items, the maximum gap (−2.41) was related to "society needs and expectations and the labor market" in "curriculum development and revision" dimension. Conclusion: The negative gap between all dimensions of curriculum leadership implies faculty members′ dissatisfaction. Curriculum leadership at universities, colleges and departments of the study in all aspects need to be improved. Hence, it is necessary for managers to make use of the viewpoints of the faculty members to decrease the gap.

Background: Advantageous times for different people are different to some extent, considering the effective physiological changes during the circadian rhythm, in terms of the peak time of physiological activities. The goal of this study is to compare the educational achievement of students, with different morning–evening habits, in completing difficult and easy courses. Materials and Methods: This research is a retrospective descriptive–analytical study, which has been conducted on students of the fifth semester of General Medicine in the Faculty of Medicine, Isfahan University of Medical Sciences. The morning–evening habits of the students were determined by the Horne-Strauss 19-item questionnaire. The students were asked to determine the courses that were 'difficult' and 'easy,' using a researcher-made questionnaire. The students' scores in the considered courses during the five semesters were obtained from the Education Department of the Faculty and analyzed using the descriptive t-test, analysis of variance (ANOVA), and the multivariate regression test in the SPSS software. Results: Sixty-three students (67% girls and 33% boys) participated in this study, of whom 11, 60, and 29% were morning, morning–evening, and evening students, respectively. The mean scores of the difficult courses in all five semesters were reduced in the evening pattern compared to the morning and morning–evening patterns. Reduction of the mean score in the difficult courses, in the evening group, compared with the morning–evening and morning groups was observed in all five semesters among girls, but in three semesters among boys. Conclusion: This study showed that evening students experienced academic failure in difficult courses, which required a more cognitive performance. It is recommended that difficult specialized courses be presented at hours when all student groups have a better cognitive performance