What competencies do environmental health graduates need to manage social determinants of health?

BACKGROUND@#Graduates of environmental health engineering should be able to manage Social Determinants of Health (SDH) and acquire the essential competencies during their studies at university. This study was performed to determine the expected competencies of environmental health graduates in a way to be able to manage environmental and Social Determinants of Health according to their job description.@*METHODS@#This descriptive cross-sectional study was performed using Delphi technique. First, the literature review was done and the Delphi technique was performed in three rounds. The purposeful sampling was used and 50 people were selected among the specialists in the field of environmental health engineering and SDH. Participants answered an open-ended question, for the first round. Then, a questionnaire with 8 areas was designed based on the results of the first round and distributed for the second round. Data analysis was performed using descriptive statistics. The third round was done to reach the agreement on final items.@*RESULTS@#The agreement on the items of the third round of Delphi was more than 70%. The final results showed eight competency areas under which 29 competencies were defined. Competency areas included expert knowledge, reasoning and planning, advocacy, system-based practice, professionalism, instructional expertise, social and personal skills and, research and self-development. The first three priorities of the required competency areas were expert knowledge (4.46 ± 0.55), professionalism (4.42 ± 0.64), and advocacy (4.32 ± 0.77).@*CONCLUSIONS@#It is necessary that environmental health engineers achieve necessary competencies regarding managing SDH, upon their graduation. It is suggested to integrate these competencies into the curriculum of environmental and health engineering in Iran universities.

Impact of a narrative medicine program on reflective capacity and empathy of medical students in Iran / 보건의료교육평가

Purpose@#Narrative medicine consists of the expression of medical experiences and the reflection on narratives to foster empathic communication with patients. Reflecting on narratives increases self-awareness and recognition of the feelings of the narrator or the story’s main character, which in turn affects the audience. This study was conducted to examine the impact of a narrative medicine program on the reflective capacity and empathy of medical students. @*Methods@#A quasi-experimental study was performed during the 2018–2019 academic year at Isfahan University of Medical Sciences in Iran involving 135 medical interns in 2 groups (control [n=66] and experimental [n=69]). Interns in the experimental group took part in seven 2-hour reflective practice sessions, while those in the control group underwent no educational intervention. Pre-test and post-test assessments were conducted for both groups using 2 valid and reliable tools for the assessment of reflective capacity and empathy. Mean reflection and empathy scores were compared within groups (between pre- and post-test values) and between groups (using the paired-t test and the t-test; P≤0.05). @*Results@#The mean reflection and empathy scores of the experimental group significantly increased from pre-test to post-test, but those of the control group did not. Moreover, the mean post-test scores were significantly different between the 2 groups (P<0.001). @*Conclusion@#Narrative medicine is an effective teaching method that can improve reflective capacity and empathy, thereby ultimately promoting professionalism as a core competency in medicine. Consideration of learning conditions and interdisciplinary teaching are necessary for implementing a narrative medicine program.

Development of a checklist to validate the framework of a narrative medicine program based on Gagne’s instructional design model in Iran through consensus of a multidisciplinary expert panel / 보건의료교육평가

Purpose@#Narrative medicine is a patient-centered approach focusing on the development of narrative skills and self-awareness that incorporates “attending, representing, and affiliating” in clinical encounters. Acquiring narrative competency promotes clinical performance, and narratives can be used for teaching professionalism, empathy, multicultural education, and professional development. This study was conducted to develop a checklist to validate the framework of a narrative medicine program through consensus of a panel. @*Methods@#This expert panel study was conducted from 2018 to 2019 at Isfahan University of Medical Sciences, Iran. It included 2 phases: developing a framework in 2 steps and forming an expert panel to validate the framework in 3 rounds. We adapted a 3-stage narrative medicine model with 9 training activities from Gagne’s theory, developed a framework, and then produced a checklist to validate the framework in a multidisciplinary expert panel that consisted of 7 experts. The RAND/UCLA appropriateness method was used to assess the experts’ agreement. The first-round opinions were received by email. Consensus was achieved in the second and third rounds through face-to-face meetings to facilitate interactions and discussion among the experts. @*Results@#Sixteen valid indicators were approved and 100% agreement was obtained among experts (with median values in the range of 7–9 out of a maximum of 9, with no disagreement), and the framework was validated by the expert panel. @*Conclusion@#The 16 checklist indicators can be used to evaluate narrative medicine programs as a simple and practical guide to improve teaching effectiveness and promote life-long learning.

qualitative inquiry into the challenges and complexities of research supervision: viewpoints of postgraduate students and faculty members

Introduction: The supervision of academic theses at the Universities of Medical Sciences is one of the most important issues with several challenges. The aim of the present study is to discover the nature of problems and challenges of thesis supervision in Iranian universities of medical sciences

Methods: The study was conducted with a qualitative method using conventional content analysis approach. Nineteen faculty members, using purposive sampling, and 11 postgraduate medical sciences students [Ph.D students and residents] were selected on the basis of theoretical sampling. The data were gathered through semi-structured interviews and field observations in Shiraz and Isfahan universities of medical sciences from September 2012 to December 2014. The qualitative content analysis was used with a conventional approach to analyze the data

Results: While experiencing the nature of research supervision process, faculties and the students faced some complexities and challenges in the research supervision process. The obtained codes were categorized under 4 themes based on the characteristics; included [Conceptual problem], [Role ambiguity in thesis supervision], [Poor reflection in supervision] and [Ethical problems]

Conclusion: The result of this study revealed that there is a need for more attention to planning and defining the supervisory, and research supervision. Also, improvement of the quality of supervisor and students relationship must be considered behind the research context improvement in research supervisory area

suggested tasks for Master's graduates in reproductive health by experts in Iran

Reproductive health is an important health topic. There are many challenges in reproductive health and it is necessary to train experts to manage them. The aim of this study was to define the tasks of Master of Science [MSc] graduates in reproductive health through comprehensive needs assessment to establish the course. The study comprised of three steps. In the first step, through literature review, the draft and basic fields of main tasks were defined. In the second step, by establishing a focus group of 10 experts, the tasks were extracted on the basis of the country's needs. In the third step, a Delphi study was carried out among 51 experts who were selected to finalize the list of tasks and their priorities using three criteria of "importance", "feasibility" and "availability". 57 tasks were extracted with regard to the four main functions of management and planning, education, consultation, and screening in reproduction age of men and women. According to Delphi's results and their priorities, 45 tasks were important and feasible but not available, and they were higher-priority tasks. The tasks extracted are consistent with the framework of reproductive health provided by the World Health Organization [WHO] and the American Guideline of Educational Planning. However, considering the differences of problems in Iran comparing with other countries, the list is not exactly similar to any list prepared for other countries. Therefore, it is necessary to consider the results of this research in university curriculums.

[Comparing educational, research and administrative activities of Faculty members completing their PhD degree either using scholarship funds or not]

Introduction: Every year some faculty members continue their education to get their PhD in the form of scholarship, educational assignment, or other ways. Granting scholarship for studying inside or outside the country imposes many problems and high costs to the Ministry of Health and medical universities in Iran. This study aimed to compare the educational, research and administrative performance of faculty members taking advantage of scholarship funds or using other sources to continue their studies for PhD degree

Methods: This descriptive study was done on faculty members of Isfahan University of Medical Sciences who completed their PhD degree during the years 1986-2006. Data gathering tool was a researcher-made questionnaire including three parts asking about faculty members educational, administrative and research performances. The obtained results were analyzed by SPSS software using descriptive statistics, t-test, and ANOVA

Results: In total 82 faculties were studied among which 39 had used external scholarship, 16 had internal scholarship, 12 were on educational assignment, and 13 had continued their studies without using any mentioned procedures. There was a significant difference [p=.01] between the 4 groups in evaluation scores [educational performance]. But, no significant difference was observed in their administrative performance. Regarding their research activities, a significant difference was observed in some research areas such as conducting research [p=.002], articles published in Iranian journals [p=.004], and in journals outside the country [p=.04]

Conclusion: According to the results, faculty members using external or internal scholarship had a lower performance in their research activities compared to the other groups. Also, the administrative activities of faculty members with external scholarship were less than the others. Therefore, it is recommended that through more detailed and extensive studies, re-examine the policies and regulations regarding scholarship or educational assignments