Recommendations to guide Vice Chairs for Education in serving as effective leaders

Background: Vice Chairs for Education play an increasingly important role in academic medicine. They often serve in supportive roles overseeing educational initiatives and faculty development, ensuring that education remains prioritized. Literature in this area is limited, especially in obstetrics and gynecology. Prior literature has not been sufficiently directive in identifying best practices in role, mission, and scope for Vice Chairs for Education. Methods: We developed and facilitated a workshop at the Association of Professors of Gynecology and Obstetrics - Council on Resident Education in Obstetrics and Gynecology (APGO-CREOG) annual meeting in February 2020. We brought together a national group of medical education faculty to elucidate the role of Vice Chairs and offer recommendations. After utilizing a previously described technique for gathering and reporting group recommendations, notes from small- and large-group discussions were collated, coded, and collapsed. Results: Four broad recommendations resulted. First, role clarity must be ensured, ideally with co-developed guidelines for responsibility. Second, the Vice Chair for Education should be charged with identifying departmental educational initiatives, including faculty development, utilizing best educational practices. Third, Vice Chairs for Education should implement and evaluate educational initiatives to enhance faculty well-being and promote a robust clinical learning environment. Finally, they should integrate with other Vice Chairs for Education within their institution and as part of national organizations to collaborate and develop best practices. Conclusion: These serve as guidelines to establish success and increase impact and suggest the potential for a national body of Vice Chairs for Education leaders to improve local and national educational outcomes.

The prevalence of chronic fatigue syndrome and depression in Guilan medical students in 2020

Background: Chronic fatigue syndrome (CFS) and depression are specific mental disorders that can negatively affect college students’ social, occupational, and academic performance, especially medical students. This study aimed to investigate the prevalence of CFS and depressive symptoms and their relationship with medical students. Methods: This cross-sectional analytical study was conducted with 175 medical students at the Guilan University of Medical Sciences in 2020 in Guilan in the north of Iran. Three levels of medical students, including basic sciences and physiopathology, externship, and internship students, participated. A demographic information questionnaire, the Beck Depression Inventory-II (BDI-II), and the Chalder Fatigue Questionnaire (CFQ) were used to collect data. SPSS 22 was used to analyze the data, including Mann-Whitney, KruskalWallis, and Spearman tests. Results: The mean age of the participants was 23.92 ± 2.04 years. Of 175 participants, 50.9% were males. In all, 11.4% of subjects reported levels of CFS, and 38.8 % of them showed levels of depression. The rates of CFS and depressions were not associated with age, gender, marital status, educational level, geographic area, or student habitation (P>0.05). The use of cigarettes (P=0.002), alcohol, and substances (P<0.0001) showed a significant relationship with higher levels of CFS and depression scores. The relationship between the CFS score and depression was significant (r=0.523, P<0.0001). Conclusion: The prevalence of CFS and depression among medical students were 11.4% and 38.8%, respectively. There was a positive association between CFS and depression. Implementing screening policies is recommended, along with programs to help promote mental and physical health among students.

Students’ perception of effective learning experiences at an Iranian dental school: A qualitative study using the critical incident technique

Background: Dental students need to learn effectively to promote their professional services as a part of their daily activities. This study is conducted to determine dentistry students’ experiences of factors that influence their learning. Methods: This qualitative study was conducted using the critical incident technique and content analysis approach to examine dental students’ experiences with factors that influence an effective learning process. Data were collected by individual in-depth semi-structured interviews with dental students at the Kurdistan University of Medical Sciences. Results: In all, 104 primary codes were obtained from the interviews and group discussions, classified into two major themes. The factors facilitating effective learning encompassed three categories: teacher-related perceived experiences (8 subcategories), learning-related perceived experiences (5 subcategories), and compelling student-related perceived experiences (3 subcategories). Two factors inhibited learning: practical teacher-related perceived experiences (3 subcategories) and learning-related perceived experiences (3 subcategories). Conclusion: The results showed that several instructor characteristics, such as being experienced in teaching methods, having the required clinical skills, and "interacting with students and patients" lead to effective learning. Several other factors involved in the learning process, such as student characteristics, a comprehensive curriculum fitting the theoretical and clinical needs of this field, interacting with peers, and keeping calm and being focused are the some of the most critical factors involved in effective learning.

Comparison of hidden medical curriculum of Tabriz University of Medical Sciences and Tabriz Azad University of Medical Sciences from the students’ perspectives

Background: Considering components of the hidden curriculum in medicine in the higher education system is a useful adjunct to the formal curriculum since the learning and function of medical students are strongly affected by these components. The current study compares the hidden medical curriculum of Tabriz state and non-state Universities of Medical Sciences from the students’ perspectives. Methods: In the current descriptive-comparative study, the statistical population included the total students of Tabriz state and non-state Universities of Medical Sciences. The statistical sample of the given study consisted of 400 students from senior and higher academic levels at the Tabriz state and non-state Universities of Medical Sciences based on Morgan’s table. Two hundred students from each university were selected using stratified random sampling. The data collection tool was a researcher-created valid questionnaire. The validity and reliability of the given questionnaire in respect to its components were 0.94 and 0.76, respectively. In the analysis of data, an independent inferential T_test was utilized. Results: The results of the analysis found that from the students’ perspectives, the mean scores of the hidden curriculum in medicine in the Tabriz state university of medical sciences ranked the following components higher than the Tabriz non-state university of Medical Sciences: (1) Education, including curriculum and goal-setting, clinical education and content, (2) Socialphysical environment, (3) Regulations and rules, including reward and punishment system, organizational structure, respect for rights and value system and (4) Relations, including moral behavior, approach, participation, and responsibility. However, in the fifth component of contexts and perspectives, including personal-environment/family context and professional financial perspectives, there was no significant difference between the hidden curriculum of Tabriz state and non-state Universities of Medical Sciences. Conclusion: The components of the hidden curriculum in medicine affect the learning richness and function of students and should be taken into consideration by universities of medical sciences, particularly non-state universities.

Problem-solving with clinical reasoning: A case report of coronavirus in immunosuppressive condition

Background: One of the most interesting parts of medical science is using clinical reasoning to solve clinical problems. In today’s world of medicine, with increasing amounts of scientific information and new diagnostic and treatment facilities, physicians’ responsibility in managing the condition of patients becomes weightier. Making the correct decision is an important goal that can be achieved by having adequate information and using it appropriately. At this stage, we should follow the thought process of successful doctors and use information from books and articles to solve clinical problems. The purpose of this article is to improve the skills of physicians in the effective use of knowledge and experience to solve clinical problems to increase our success in fulfilling our responsibility to patients. Methods: Clinical reasoning enhances the quality of learning and increases the ability of medical students in clinical problem-solving. In this article, a patient with rheumatoid arthritis in the COVID-19 pandemic developed respiratory distress, is identified by the clinical reasoning method and is treated, with his treatment then discussed. This article includes the following: prepare a list of differential diagnoses based on the list of signs and symptoms of the patient; modify the initial list to reflect findings from history and examinations; specify additional information to make a correct diagnosis; and, finally, decide when the information is obtained is sufficient to make the proper diagnosis. Results: In recent years, clinical reasoning has received more attention in student Olympiad competitions. Professors in medical sciences should pay special attention to teaching this skill to students. It is necessary to plan for teaching this type of training and to design tests for evaluating students’ clinical reasoning. This article can thus be a useful guide for those who enjoy working on a problem to get an answer. Conclusion: This article shows how insidious and life-threatening a coronavirus infection can be, and how useful clinical reasoning can be when present in all stages of dealing with the patient, from the initial stages of taking the patient history to the end of treatment.

A comparative study of community medicine and public health curriculum at medical schools in Iran and North America

Background: Community medicine and public health are the core subjects in medical education. One of the main competencies of general physicians in the national curriculum is having knowledge and skills in health promotion and disease prevention in the health system. Any curriculum revision in community medicine departments needs to incorporate the evidence and use pioneer countries’ experiences in this issue. This study aims to compare community medicine and public health courses in medical schools between Iran and selected universities in North America. Methods: The elements of a community medicine curriculum for medical students were compared in a descriptive-comparative study using the Bereday model. These elements included objectives and competencies, educational strategies, teaching and learning methods, assessment, and educational fields in a community medicine curriculum in Iran and in selected universities in North America. A literature search was conducted in CINAHL, SCOPUS, MEDLINE, Web of Science, EBSCO, and on university websites. Results: Essential aspects of community-based strategies among community medicine and public health curriculum of general medicine in universities in Canada and the United States included a longitudinal approach, training in urban and rural primary care centers, teaching by family physicians and health center staff, a spiral curriculum, focus on social determinants of health, taking of social and cultural histories and social prescriptions, learning teamwork, and using LIC (Longitudinal Integrated Curriculum). Conclusion: The objective of community medicine and public health curriculum in selected North American universities was to prepare general practitioners who work in Level 2 and 3 hospitals and to improve their skills to provide high-quality services to the community. Some of the successful points in the selected universities that could be replicated in Iranian faculties of medicine included using integration strategy, a spiral curriculum, and an LIC approach.

Empathy, quality of life and occupational burnout among medical students

Background: Empathy, quality of life, and occupational burnout are essential factors in medical sciences that affect the physicians’ and patients’ communication. Therefore, the purpose of this study was to investigate the association of these three factors among medical students. Methods: This descriptive correlational study was conducted among medical internship students. Participants were selected by using simple random sampling. The Jefferson Empathy Questionnaire, the WHO Quality of Life Questionnaire, and the Maslach Burnout Questionnaire were used for data collection. Data were analyzed using t test, Kruskal-Wallis, analysis of variance (ANOVA), and Pearson’s correlation coefficient. Results: A total of 167 students completed the questionnaires. The association of empathy and occupational burnout (P=0.005, r=-0.414) and between the quality of life and occupational burnout (P=0.005, r=-0.446) were both significantly negative. Independent t test showed the mean score of occupational burnout was significantly higher in male students than females. It was also significantly higher in married students than single (P<0.05). The results of the KruskalWallis test showed no statistically significant difference among the quality of life of different ethnic groups (P>0.05). One-way ANOVA showed that there was a statistically significant difference between the ethnic groups in terms of occupational burnout (P<0.05) Conclusions: The association of empathy and quality of life with occupational burnout was negative. The highest quality of life was related to older students. Among all of the studied variables, married status, ethnicity, and sex were most associated with occupational burnout where married and male students had the highest burnout.

Designing a therapeutic model of personality biopsychological approach for personality difficulty: A new setting for psychiatric residents’ clinical education

Subclinical personality difficulties are the source of many interpersonal problems, and it is necessary for psychiatry residents to gain a comprehensive knowledge of the concepts of personality and personality disorders, including subclinical disorders. Clinical education is one of the most important aspects of medical students’ training. Improving the quality of this course is of particular importance. The services provided at the Personality Modulation Clinic of Razi Educational and Medical Center in Tabriz have been designed based on available scientific evidence and experiences for individuals with personality difficulties. The current research evaluates the effects of a new treatment known as the "Personality Biopsychological Approach" for individuals with personality difficulty for the first time given the absence of such an integrated and coherent program in clinical education. There are five main phases of study design: assessing patients’ needs, assessing psychiatric residents’ needs, formulating educational goals, the design of treatment model, and implementation. The current study found that society’s mental health is a top priority for national growth and development. Therefore, training psychiatrists in this field plays a crucial role in ensuring both individuals’ and society’s health and well-being. This study indicates that psychiatry residents’ acquaintance with this issue can increase their ability in the correct diagnosis and intervention in preventing the exacerbation of psychiatric disorders.

Adapting to a new world through virtual medical education

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A brain-based model of language instruction: from theory to practice

Background: A recent trend in second language acquisition and learning has been oriented towards brain-based studies and its association with brain development and plasticity. There are currently unprecedented opportunities for contemporary understanding of the neurological basis of second language (L2) learning owing to recent advances in cognitive neuroscience. Brain functional and structural investigations have contributed remarkably to biological explanations of language acquisition in addition to behavioral explorations. Methods: This study used a meta-analysis of previous findings of functional neuroimaging studies to elucidate the neuroanatomy of language learning from a functional perspective. By synthesizing existing literature, brain activation areas associated with different language learning skills and their convergence and overlap with other areas of activation for other cognitive and motor skills are extracted to reveal consistent functional areas of the brain. The current study attempts to link psycholinguistic research and cognitive neuroscience in the mediation of L2 learning and teaching. This review paper begins with a theoretical view of brain structure and function and concludes with a practical model of brain-based language instruction, resulting in a deeper understanding of the field. Results: Organized, conjoining cognitive neuroscience findings and L2 acquisition and learning approaches provide an opportunity for collaboration in cross-disciplinary studies. They provide new insights into how our brain represents languages. This article reviews recent advancements in our understanding of the brain; structural and functional organization of the brain; the role the brain plays in emotion, cognition, and development; and its consequent implication in language instruction. In effect, taking neurocognitive findings into account may have potential in developing brain-based tasks for the benefit of second language instruction in educational settings. Based on the revealed structural and functional areas of the brain and their networks of connection and interaction, manipulating areas of demanded activity may be as efficient as doing physical exercise to strengthen muscles. Conclusion: Developing a systematic model of second language instruction compatible with brain functions and patterns can benefit the rate and proficiency of language learners, thus improving language teaching and learning outcomes. This paper will aid the quest for utilizing general information of brain functions and related methods in developing practical, efficient language instruction as well as enhancing interdisciplinary research studies in both language and cognitive neuroscience.