Explaining Resident Medical Students’ Experiences of Performance During COVID-19: A Qualitative Study

Background: The COVID-19 crisis has created many problems, including a negative impact on student education. Objectives: The study aimed to understand the resident medical students' performance experiences during the COVID-19 pandemic, which is essential for future planning. Methods: The present qualitative study was performed on 15 resident medical students in Alborz University of Medical Sciences, Iran, from September to November 2020. Data were analyzed using conventional content analysis. Results: Analysis of the meaning units of interviews showed four categories describing the resident students' experiences of performance during COVID-19 as follows: Fear and anxiety, the need for support, the sense of responsibility, and the lack of educational facilities. Conclusions: The present study showed that the COVID-19 pandemic had posed incredible new challenges for resident students. Assessing the mental health of residents, providing adequate protective equipment, and support from authorities and community members can create empathy, reduce the feeling of fear, and increase their accompaniment with pandemic managing programs. Due to the problems created in the training of residents during the pandemic, it seems necessary to propose rehabilitation courses to improve the training program for residents in various fields.

Establishing New Curriculum of Pathology and its Challenges at a New Medical College

Background: A competency-based curriculum is the key highlight of medical transformation in India, which provides an outcome-based framework requiring the integration of knowledge, skills, and values, unlike an old curriculum that did not provide a cohesive and comprehensive outlook. Objectives: We aimed to discuss and evaluate in detail the process and setup of a new competency-based medical curriculum in the Department of Pathology and enlist the assets and challenges while doing the same. Methods: The new curriculum was set up under the guidelines of competency-based undergraduate curriculum for the Indian Medical Graduate, state university guidelines, articles from the internet, and discussions with other universities all over the country. Conclusions: As compared to the previous curriculum, the new curriculum introduces many positive changes and requires a revolutionary change in the outlook of institutions, faculty, and students. Prior preparedness, flexibility to adopt new changes, consistency, and long-term commitment to transition from facilitators will go a long way in producing an excellent Indian medical graduate.

Effect of Simulation-based Medical Education in Small Groups on Improving the Quality of Nursing Care in Patients Under Electroconvulsive Therapy

Background: Considering the high risk and vital nature of electroconvulsive therapy (ECT) process, as well as the subsequent intensive, essential, and life-saving cares, it is necessary to promote the skills of nurses providing this kind of care. Objectives: This study aimed to determine the effect of simulation on developing the quality of care in nurses working in the ECT department. Methods: This experimental study compared two groups before and after the intervention. Fifty nurses who met the inclusion criteria were randomly allocated into two groups of intervention and control. Low-tech (static) task trainer was used for simulation-based medical education (SBME) in the intervention group. Data were collected using a checklist to investigate the quality of nursing care before and after the intervention. Results: The mean scores obtained from initial preparation subscales, preparation of tools and equipment, measures during ECT, post-ECT measures, and checking patient’s status in pre-test and post-test in the intervention group were significantly different. This suggests that simulation intervention in small groups is effective in improving the quality of nursing care in ECT (P < 0.05). Conclusions: Our results showed that promoting ECT nursing care knowledge among the nurses in small groups by simulation method is an effective intervention.

Performance of Undergraduate Medical Students in Formative and Summative Evaluations in Community Medicine in a Medical College in India

Background: Assessment and evaluation should be a continuous activity associated with curriculum development. Continuous formative examinations are the stepping stone for good learning and better performance in summative examination. However, the correlation or predictability of formative examinations has not been quantified in the Community Medicine subject in the bachelor of surgery (MBBS) course in India. Objectives: The objective of this study was to explore the correlation of performance in continuous assessments and final summative evaluation in third-year professional MBBS students in Community Medicine and the predictability of formative scores for the final examination marks. Methods: An institution-based retrospective longitudinal study was conducted in the Medical College of Kolkata, India. A total of 237 undergraduate medical students were followed up for two years to track their results in three successive examinations. The scores obtained in formative and summative evaluations in third-year professional MBBS students in Community Medicine were analyzed to find out the correlation between them, and multiple linear regression was also performed in SPSS. Results: The strong and significant correlation (0.64) between the sixth semester and internal examination results suggests the importance of the sixth semester examination for the preparation of finals. The third semester examination, although conducted two years prior to the finals, still had significant correlation with the finals, but the correlation was weak (0.17). Conclusions: Formative examination in Community Medicine, which spans for overall three and half years, plays an essential role in the preparation of students for the finals, more so for achieving good scores. Performance in these two examinations can only explain more than one fourth of the variability of the performance in the finals.

Effect of Clinical Skills Evaluation by Direct Observation of Procedural Skills (DOPS) Method on Clinical Performance of Operating Room Students

Background: Evaluation is an essential and integral part of medical education. Based on the evidence, the current common methods are less effective due to the lack of accurate assessment of students' clinical skills. Clinical evaluation of students in the form of direct observation in practical situations will increase their ability to deal with clinical events in specific patient situations. Objectives: In this study, the effectiveness of the direct observation of procedural skills (DOPS) method was compared with the common method in the clinical performance of operating room students. Methods: This quasi-experimental study was performed on 30 final-year operating room students in 2019 who had an internship course. Students were randomly assigned to two groups of control (n = 15) and intervention (n = 15). The evaluation of clinical skills was done by the traditional method in the control group and the DOPS method in the intervention group. Data collection was performed by a researcher-made checklist whose validity and reliability were confirmed. Statistical analysis of data was performed by SPSS-20 software using descriptive statistics and chi-square test, independent t-test, and Mann-Whitney test. Results: There was no significant difference between the two groups in terms of demographic characteristics including age, internship score, and gender (P > 0.05). Based on the results of the Mann-Whitney test, the mean rank of procedural techniques and clinical performance score was higher in the intervention group than in the control group (P < 0.05). Conclusions: The DOPS method can be more effective than routine methods for improving the clinical performance of operating room students. Therefore, it is suggested that the DOPS method be used as an alternative to traditional methods or even as a complementary method for evaluating the clinical performance of operating room students.

Evaluating Technical Knowledge of Using Inhalation Devices Amongst Medical Students and Pediatrics Residents in Iran

Background: Asthma is a common chronic respiratory disorder in children and adults worldwide. Inhalers are vital medications that are prescribed to control the disease and reduce its mortality and morbidity. Objectives: This study aimed to assess the knowledge and skills of Medical Students (MSs) and pediatric residents (PRs) in using different inhaler devices (IDs). Methods: This cross-sectional study included 243 MSs and PRs at Shiraz University of Medical Sciences, Iran, from March 2018 to March 2019. The MSs were divided into the senior medical students (SMSs) and junior medical students (JMSs). Data regarding participants’ knowledge on metered dose inhalers (MDIs), dry powder inhalers (DPIs), and nebulizers (NBs) were gathered using questionnaires and a face-to-face interview. Results: Of the 243 participants in the study, 113 (46.5%) were SMSs, 87 (35.8%) were JMSs, and 43 (17.7%) were PRs. The mean age of the participants was 26/20 ± 4/25 years. There was no significant difference between studied groups regarding recognition of MDI device (P = 0.072). PRs were more familiar with the DPIs than MSs (P < 0.001). They also could recognize the NBs better than the MSs (P < 0.001). In terms of using DPIs correctly, PRs executed all the steps better than MSs (P < 0.001) except for the third step which all the participants had the same knowledge (P = 0.13). Regarding correct use of NBs, PRs had better performance compared to MSs (P < 0.001). Conclusions: According to our results, there was an educational vacancy in training MSs regarding using IDs correctly, which can lead to poor compliance in asthmatic patients and deteriorating their lifestyle. The current research supports the need to redesign the educational curriculum of MSs and PRs in Iran to teach them sufficient knowledge and skills about how to use different types of inhalers properly.

Changing Preferences for Scientific Meetings Platform Among Doctors During the COVID-19 Pandemic: A Questionnaire-Based Survey

Background: The World Health Organization declared the outbreak of the COVID‑19 as a global pandemic in early 2020. Lockdown was declared by the Indian government across the country. No recommendations were laid down for academic scientific meetings. Despite precautions, there is a high risk of infections in the physical meetings. Therefore, the scientific community resorted to virtual meetings. Objectives: This study was done to determine the doctor's preferred platform for scientific meetings during the COVID-19 pandemic. Methods: We conducted this cross-sectional survey among doctors using Google forms. It consisted of a questionnaire consisting of 17 validated questions related to the preference of scientific meetings. Results: We had 314 responses from doctors. The virtual meeting was preferred by 154 (49%) doctors during the COVID-19 pandemic. Convenience (103, 44.2%) was the most important reason for preferring virtual meetings. We did not find a statistical association in preference for the type of meeting with age, gender, and seniority during the pandemic. However, a significantly higher number of doctors practicing super-specialty (P = 0.005) and private practitioners (P = 0.027) preferred virtual meetings. All age groups preferred physical meetings in the future, but it was preferred to large extent by doctors aged more than 50 years (P = 0.059) with broad specialty (P = 0.005) and medical college doctors (P = 0.002). Conclusions: Most doctors preferred virtual meetings during the COVID-19 pandemic. The super-specialist and private practitioners preferred virtual meetings during the pandemic and even in the future. Hence, the virtual platform should stay along with physical scientific meetings.

Professional Socialization of Nursing Students and Its Relationship with Self-Esteem

Background: Nursing students must have the desired level of professional socialization to acquire the necessary roles and values to participate in the health care system. The process of socialization is part of the self-concept. Objectives: The aim of this study was to determine the level of socialization of nursing students and its relationship with self-esteem. Methods: This was a cross-sectional descriptive study. Data were collected from 166 nursing students. Data collection tools were demographic, professional socialization, and self-esteem questionnaires. The collected data were analyzed using descriptive and inferential statistical methods by SPSS 16. Results: The average scores of professional socialization and self-esteem were 174.87 ± 19.5 and 5.65 ± 5.10, respectively. Professional socialization was moderate in the majority of the participants (54.80%). The dimensions of “valuation and knowledge of the profession” and “management and organizational policies” had the highest and lowest averages, respectively. There was a positive and significant relationship between professional socialization and all its dimensions with self-esteem (P < 0.05). Also, there was a significant relationship between “professional socialization” and “interest in the field” as well as “the adaptation of the field to the ideas after entering the university”. Conclusions: By considering strategies, such as creating a positive attitude towards the nursing profession in students, professors can create a sufficient sense of self-esteem in different clinical settings and, consequently, strengthen professional socialization.

The Clinical Effectiveness of Virtual Nursing Process Education During the COVID-19 Pandemic: An Educational Evaluation and a Quasi-experimental Longitudinal Study

Background: The COVID-19 pandemic has changed the mode of education, causing universities to shift from face-to-face to online delivery mode for offering various courses and programs. Thus, it is essential to focus on the curriculum content to tackle the challenges caused by the COVID-19 pandemic and provide methods to effectively educate nursing students in nursing practice. Objectives: This study aimed to determine the clinical effectiveness of virtual nursing process (NP) education in undergraduate nursing students during the COVID-19 pandemic. Methods: This educational evaluation study with a quasi-experimental longitudinal design was applied in four educational steps over six months for first-year undergraduate nursing students (n = 30) using Iran's national learning virtual environment. Results: The paired t-test results showed a significant difference in the mean and overall scores of nursing diagnosis and nursing outcomes/goals before and after the virtual intervention (P < 0.001). Six months after virtual education, the students registered for the ‘clinical nursing process (CNP) unit in the third semester. In the final step of the study, the overall mean score of the students' nursing care plan was 16.59 ± 2.31, which was higher than the mean score, meaning virtual NP education was effective in a clinical setting. Conclusions: Virtual mode of teaching can be effective for theoretical and CNP education.

Barriers to Effective Utilization of Teaching-Learning Methods: A Qualitative Study Using Focus Group Discussions among First-Year Bachelor of Medicine, Bachelor of Surgery Students in a South Indian Medical College

Background: Lecture, practical, and dissection classes have been the mainstay of teaching in first-year bachelor of medicine, bachelor of surgery (MBBS) courses. Competency-based medical education (CBME) implemented by the National Medical Commission (NMC) in 2019 aims to improve teaching-learning experiences and outcomes. A clear idea about attitudes and perceptions of students toward the present teaching-learning methods will help better implement CBME. Objectives: (1) To find the attitudes and practices of first-year MBBS students toward lecture, practical, and dissection classes, using a focus group discussion (FGD) as a tool of a qualitative study. (2) To analyze the factors that prevent active students from participating in different teaching-learning methods in pre-clinical subjects. Methods: This qualitative study using an FGD was performed after obtaining the Institutional Ethics Committee (IEC) approval in 36 first-year MBBS students, both female and male, divided into six groups. Written informed consent for the audio recording was obtained. A semi-structured interview guide with open-ended questions was used. The FGD was recorded, transcribed in spoken language, and converted into English. Content analysis was performed, key concepts were extracted and coded manually, and common themes were generated. Results: The following seven themes emerged: (1) Attendance being prioritized by students, (2) Note-taking done as a chore during lecture classes, (3) The time duration of the lectures as a hindrance to effective learning, (4) Inadequacy of self-directed learning, (5) Preference of practical sessions over theory sessions, (6) Cell phone usage as a reason for not being attentive in the class, and (7) Interest in interactive methods. Conclusions: This study identifies factors that impede the utilization of teaching-learning methods by medical students. The CBME model addresses many of these problems. Further studies on students under the new curriculum will help refine our teaching-learning methods. The strength of this study is the FGD sessions conducted by a medical student, which would have put the participants at ease.