ABSTRACT
Introduction: we evaluated the effects of implementing Team-Based Learning [TBL] on student engagement, accountability, satisfaction, and preference for lecture or team-based learning. Moreover, we assessed the effect of TBL on knowledge retention and application over time through short answer questions based on clinical scenarios addressing history taking and diagnosis skills in medical students
Methods: the study was conducted in a quasi-experimental design. The study population were all of the third-year medical students [n=84] participating in a course of rheumatology in Shariati Hospital, which is a teaching hospital affiliated to Tehran University of Medical Sciences. We compared TBL with the conventional lecture-based method. The assessments were performed after implementation of TBL by the Classroom Engagement Survey [CES] and Team-Based Learning Student Assessment Instrument [TBL-SAI]. The assessment for application of knowledge was conducted in 3 time-points through short answer questions on rheumatic diseases. The comparison of results was made by Student's t-test and repeated-measures analysis of variance [RMANOVA] using SPSS software, version 16
Results: the CES scores indicated a high level of engagement in TBL [Mean +/- SD=26.7 +/- 3.70, p=0.0001] but not in the lecture-based sessions [Mean +/- SD=23.80 +/- 4.35, p=0.09]. The total mean score [SD] for TBL-SAI was 159.68 [14.14] for TBL sessions indicating a favorable outcome [p=0.0001]. The student scores obtained from the short answer questions showed that over time the students' scores had declined significantly less for the TBL sessions in comparison to the lecture-based sessions, F [2, 166]=4.624, p=0.011
Conclusion: the results indicated higher student engagement, satisfaction and long term learning by TBL
ABSTRACT
The hospitals are the most significant providers of health care services. According to more health funds spending by hospitals, economic management in hospitals is necessary. Determining the causes and rates of insurance under reimbursement bills was the objective of this study. This research is a descriptive cross-sectional survey was done in 2008. The samples of study were the al records' patients who undertaken of social security insurance system in the teaching hospitals of Shahid Sadoughi University of Medical Science. The data complied in SPSS 16 software and then analyzed. In this study, 9.8% cases of all hospitalization bills were deducted. The highest rates of under reimbursement bills was in Afshar hospital [12.7%], followed by burn hospital [12.5%], Shahid Sadoughi hospital [10%], and Shahid Rahnemoon hospital [8.2%]. The highest rates of under reimbursement bills imposed to the surgeon fees [28.4%], treatment fees [15.06%], and medicine [14.3%] costs. However assistant surgeon fees had no under reimbursement. The most important causes of under reimbursement were defects in the insurance records of patients and noncompliance with insurance organization regulations. Training of human resources and optimized use of hospital information systems could be helpful to hospitals for reducing insurance reimbursement to ultimately improve hospitals to financial statements