Competencies for dental public health specialists: A thematic analysis.

INTRODUCTION: Competency frameworks have been used to accurately guide the training and assessment of professionals. Dental Public Health professionals require a variety of skills beyond clinical aspects to meet ongoing social, economic, epidemiologic, technological, etc. developments. The purpose of this study was to develop a primary competency framework for dental public health (DPH) professionals by reviewing existing documents that can be modified by authorities based on their needs. MATERIALS AND METHODS: To identify DPH competencies, first a literature review of current postgraduate DPH competencies was conducted in PubMed, Scopus, Google Scholar, and Google from May to June 2021. All English language documents addressing DPH competencies were included and transferred to MAXQDA software. Next, DPH competency domains were extracted and defined, using Clarke and Braun's six-step qualitative thematic analysis method. RESULTS: In total, 206 English documents were retrieved. After exclusion of 201 documents due to being duplicate or not related in screening stages, five full-text English documents describing competencies of DPH specialists from the United Kingdom, the United States, Australia and New Zealand, Canada, and Ireland were reviewed. Thematic analysis led to the provision of a framework consisting of all mentioned competencies in the reviewed documents including nine domains in education, research, management, policy, communication, leadership, professionalism, oral health status, and oral health services. CONCLUSION: The proposed primary framework covers all competency domains and, as a comprehensive tool, can be used as a guide by local, national, and international authorities to develop their own frameworks for training and evaluating the DPH workforce.

Crossroads experiences for promoting self-authorship of clinical medical students: A qualitative survey.

BACKGROUND: The capacity of self-authoring one's own beliefs, identity, and relationships is core to many expected outcomes of future health-care professionals. Students' personal and professional development for self-authorship can be promoted by the variety of developmentally effective "crossroads" experiences that they encounter. Identifying the characteristics of the crossroads experiences in clinical rotations can provide a foundation for medical educators to provide an environment that can foster self-authorship. MATERIALS AND METHODS: A cross-sectional qualitative survey was conducted using a researcher developed semi-structured questionnaire which had three open questions and asked medical interns to describe their internship experiences that stimulated their thinking along the self-authorship dimensions of identity, relationships, and ways of knowledge acquisition. Data were analyzed using Braun and Clarkes' thematic analysis method. RESULTS: The survey was completed by 167 medical interns (response rate: 83%). The key features of significant crossroads experiences and their effects were created into six themes: Experiences by being respected and validated; experiences by involvement in patient management; experiences by participation in interactive learning environments; experiences by participation in authentic clinical work environments; experiences by the observation of professional behaviors; experiences through the uniqueness of different specialties. CONCLUSION: Authentic experiences of patient management in the real world of clinical settings with a high interactive environment have the potential to promote interns' self-authorship development. Educators can support learners by respecting and validating their capacities and by role modeling of professional behaviors.

Examining doctor-patient communication skills among senior medical students based on calgary cambridge observation guide.

Background: This study aimed to determine the level of communication skills in residents of Shahid Beheshti University of Medical Sciences in the final year of the main courses in accordance with the Calgary Cambridge Observation Guide for the purpose of improving their skills and improving the quality and correcting the existing problems. Methods: In this cross-sectional study, 190 residents of 14 majors were evaluated using a checklist of patient and physician communication skills based on the Calgary Cambridge Guide that has been localized in Persian language and culture using the cross-cultural adaptation standard in 6 stages. Content validity was verified by the primary author. The skills within the 71-item checklist were examined via a 3-point Likert-type rating scale, with scores ranging from 1 to 3 (good to poor) and the data were analyzed using the SPSS 16 software. Results: Of the190 residents, 161 were enrolled in the study. Of them 74 were internal and 87 surgical residents, and 89 were male and 72 were female. The mean score of the total communication skills in 14 major courses was 128.68±37.2264; it was 121.7±36.990 in the Department of Surgery, and 136.8±36.073 in the Department of Internal Medicine, with p=0.010, in female students 126.6 and in male student 130.3 with p=0.500. Conclusion: The score of 71 communication skills points in the list was prepared using the Likert scale option 3. In the overall skills, the weak score is 71 to 118.33, the average score is 118.34 to 165.66, and the good score is 165.67 to 213. Based on the findings of the study and examining the educational curriculum, it can be stated that unlike in psychiatry with an average score of 168.83, which is at a good level, the other fields are not well-developed and overall the communication skills in the residents, with a mean score of 128.68, are moderately poor and therefore further education and training is needed in these fields for resident students.

A comparative study on the function and structure of medical development education office in world's top universities.

PURPOSE: It is essential to adjust the responsibilities and function of medical education offices (MEOs) in regard to the current societal requirements. Therefore, it is a good idea to learn lessons from the experiences about the establishment and function of these offices around the world. The aim of the present study was to carry out a comparative study to investigate the function and structure of MEOs at some of the medical universities from America, Europe, and Asia. SUBJECTS AND METHODS: This is a comparative, descriptive study that was conducted in 2015. Eleven offices around the world (in America, Europe, and Asia) were selected for the study. Expert group discussion and literature review were used in order to select research sample. The data were gathered using self-constructed checklists. Content and face validity of the checklist was assessed by gathering feedback from experts. The Kappa coefficient was used to determine the inter-rater reliability. RESULTS: All the 11 offices in our study (100%) dealt with the issues of faculty development and research and scholarship activities. Only one out of the 11 offices (27%) dealt with the issues of society and patient education. Five out of the 11 offices (36%) dealt with the continuing medical education and continuing professional development. Consultation services are provided at seven of the 11 offices (64%). CONCLUSIONS: This study revealed both commonalities and differences in the function and structure of MEO among the 11 offices we examined. Based on this study, effective goals and strategies for MEO can be recommended.

Models of clinical reasoning with a focus on general practice: A critical review.

INTRODUCTION: Diagnosis lies at the heart of general practice. Every day general practitioners (GPs) visit patients with a wide variety of complaints and concerns, with often minor but sometimes serious symptoms. General practice has many features which differentiate it from specialty care setting, but during the last four decades little attention was paid to clinical reasoning in general practice. Therefore, we aimed to critically review the clinical reasoning models with a focus on the clinical reasoning in general practice or clinical reasoning of general practitioners to find out to what extent the existing models explain the clinical reasoning specially in primary care and also identity the gaps of the model for use in primary care settings. METHODS: A systematic search to find models of clinical reasoning were performed. To have more precision, we excluded the studies that focused on neurobiological aspects of reasoning, reasoning in disciplines other than medicine decision making or decision analysis on treatment or management plan. All the articles and documents were first scanned to see whether they include important relevant contents or any models. The selected studies which described a model of clinical reasoning in general practitioners or with a focus on general practice were then reviewed and appraisal or critics of other authors on these models were included. The reviewed documents on the model were synthesized. RESULTS: Six models of clinical reasoning were identified including hypothetic-deductive model, pattern recognition, a dual process diagnostic reasoning model, pathway for clinical reasoning, an integrative model of clinical reasoning, and model of diagnostic reasoning strategies in primary care. Only one model had specifically focused on general practitioners reasoning. CONCLUSION: A Model of clinical reasoning that included specific features of general practice to better help the general practitioners with the difficulties of clinical reasoning in this setting is needed.

System based practice: a concept analysis.

INTRODUCTION: Systems-Based Practice (SBP) is one of the six competencies introduced by the ACGME for physicians to provide high quality of care and also the most challenging of them in performance, training, and evaluation of medical students. This concept analysis clarifies the concept of SBP by identifying its components to make it possible to differentiate it from other similar concepts. For proper training of SBP and to ensure these competencies in physicians, it is necessary to have an operational definition, and SBP's components must be precisely defined in order to provide valid and reliable assessment tools. METHODS: Walker & Avant's approach to concept analysis was performed in eight stages: choosing a concept, determining the purpose of analysis, identifying all uses of the concept, defining attributes, identifying a model case, identifying borderline, related, and contrary cases, identifying antecedents and consequences, and defining empirical referents. RESULTS: Based on the analysis undertaken, the attributes of SBP includes knowledge of the system, balanced decision between patients' need and system goals, effective role playing in interprofessional health care team, system level of health advocacy, and acting for system improvement. System thinking and a functional system are antecedents and system goals are consequences. A case model, as well as border, and contrary cases of SBP, has been introduced. CONCLUSION: he identification of SBP attributes in this study contributes to the body of knowledge in SBP and reduces the ambiguity of this concept to make it possible for applying it in training of different medical specialties. Also, it would be possible to develop and use more precise tools to evaluate SBP competency by using empirical referents of the analysis.