نوع مقاله : مقاله پژوهشی

نویسندگان

1 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی قزوین، قزوین، ایران

2 عضو هیات علمی، گروه انگل شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی قزوین. قزوین، ایران

3 عضو هیات علمی، گروه بیماری‌‌های عفونی، دانشکده پزشکی، دانشگاه علوم پزشکی قزوین، قزوین، ایران

4 عضو هیات علمی، گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی قزوین، قزوین، ایران

5 دکترای مدیریت آموزشی، دانشکده بهداشت و پیراپزشکی، دانشگاه علوم پزشکی قزوین، قزوین، ایران

10.22118/edc.2022.324708.2001

چکیده

مقدمه: آموزش بالینی نقش عمده ای در شکل دهی توانمندی های حرفه ای فراگیران دارد. برای دستیابی به آموزش بالینی مطلوب، لازم است ارزیابی و پایش مستمر صورت پذیرد. در این پژوهش دیدگاه دانشجویان پزشکی دانشگاه علوم پزشکی قزوین در رابطه با جو آموزشی دانشکده پزشکی در سال 1398-1399 مورد ارزیابی قرار گرفت.
روش کار: پژوهش حاضر از نوع اپیدمیولوژیک توصیفی می باشد و دانشجویان رشته پزشکی دانشگاه علوم پزشکی قزوین در 4 مقطع تحصیلی علوم پایه، مقطع فیزیوپاتولوژی، کارورزی و کارآموزی در این نظرسنجی شرکت داشتند. ابزار مورد استفاده ، پرسشنامه DREEM حاوی 50 سوال با مجموع نمره 200 و امتیازدهی سوالات بر اساس مقیاس پنج گزینه‌ای لیکرت بود. داده ها در نرم‌افزار SPSS نسخه 25 با استفاده از آزمون تی و آنوا مورد تجزیه ‌و تحلیل قرار گرفته اند.
نتایج: میانگین نمره فضای آموزشی 168 دانشجوی مورد بررسی 68/22±02/96 بوده است که در وضعیت نسبتا‌مطلوب قرار داشت. اختلاف معناداری در نمره فضای کلی و نمره زیرمجموعه های حاکم بر محیط های آموزش بر حسب جنسیت مشاهده نگردید (P>0.05). اما میانگین نمره ادراک فراگیران مقطع فیزیوپاتولوژی، در حیطه‌های ادراک دانشجو از محیط یادگیری (p=0.001)، اساتید (p=0.002)، ادراک دانشجو از توانایی علمی خود (p=0.015) و جو آموزشی (p=0.005)، از فراگیران سایر مقاطع بالاتر بوده است، کمترین نمره‌‌‌ی جو آموزشی متعلق به مقطع کارورزی است (محیط یادگیری، اساتید و موقعیت اجتماعی).
نتیجه گیری: نتایج این مطالعه نشان داد که جو آموزشی در دانشگاه علوم پزشکی قزوین در وضعیت نسبتا‌مطلوب قرار دارد و به ویژه دانشجویان در مرحله بالینی درک مناسبی از محیط یادگیری و اساتید ندارند که نیازمند بررسی بیشتر می باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Perceptions of medical students in different phases about educational environment: Qazvin University of Medical Sciences

نویسندگان [English]

  • Kimiya Rahmani 1
  • Mehrzad Saraei 2
  • عباس Allami 3
  • Navid Mohammadi 4
  • Fariba Zahedifar 5

1 General Physician, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

2 Faculty member, Department of Parasitology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

3 Faculty member, Infectious Diseases Department, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

4 Faculty member, Department of Community Medicine, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

5 PhD in Educational Management, Faculty of Health and Paramedical Sciences, Qazvin University of Medical Sciences, Qazvin, Iran

چکیده [English]

Introduction: Clinical education plays a major role in shaping the professional abilities of learners. In order to achieve the desired clinical education, it is necessary to perform continuous evaluation and monitoring. In this study, the views of medical students of Qazvin University of Medical Sciences (QUMS) regarding the educational atmosphere of the medical school in 2019-2020 were evaluated.
Method: The present study is a descriptive epidemiological study and medical students of QUMS in 4 levels of basic sciences, physiopathology, stager, and intern participated in this survey. The instrument used was the DREEM questionnaire based on a five-point Likert scale that contains 50 questions with a total score of 200. The collected data were analyzed in SPSS 25 using T-test and ANOVA.
Findings: The total mean score of the educational space of 168 students surveyed was 96.02±22.68, which was in a semi-optimal condition. There was no significant difference in the score of general space and the score of subgroups governing educational environments by gender (P>0.05). But the mean score of physiopathology students' perceptions, of learning (p=0.001) teaching (p=0.002) educational atmosphere (p=0.005), and academic self-perceptions (p=0.015) were significantly higher from other levels of learners. The lowest score belongs to the internship level (student’s perceptions of learning, teaching, and social self-perceptions).
Conclusion: This study showed that the educational atmosphere at QUMS is in a partially favorable condition and interns have a more negative understanding of the learning environment and professors, hence needs further investigation.
 
Perceptions of medical students in different phases about educational environment: Qazvin University of Medical Sciences
Introduction: The researchers showed that the educational atmosphere is one of the important components in students' learning (El Mahai Moeed-2013). The educational atmosphere is more related to how the curriculum is implemented, the teachers' attitude towards learning, the behavioral and organizational culture of the educational institution, and the student's view of the learning environment (Atapatu, Kumari et al. 2016). An appropriate educational environment creates opportunities for effective learning (Ikeda, Kubta et al. 2019). The DREEM model has been proposed to measure the educational atmosphere (Bakhshi Aliabad et al. 2019) is designed independently of cultural contexts and provides a comparison between different courses (Farough, Rahman et al. 2018). This study was conducted on the medical students of Qazvin University of Medical Sciences (QUMS) using the DREEM questionnaire. The results of this study can help teachers and managers enhance the learning experiences of medical students (Whittle, SR 2018).
Materials and methods: This cross-sectional study was conducted on 168 medical students in QUMS in 2019-2020 after being approved by the Ethics Committee of QUMS (ethics code IR.QUMS.REC.1397.414). Sampling was based on the census. The DREEM questionnaire was used. Students at the end of the semester of internship, physiopathology, and basic sciences were questioned. This questionnaire contains demographic information and 50 questions in five areas of learning, teachers, students' academic self-perception, educational atmosphere, and student's social self-perception.
Questionnaire scoring is based on a five-item Likert scale. The items are scored as follows: (4) strongly agree, (3) agree, (2) unsure, (1) disagree and (0) strongly disagree. However, 9 items out of the total of 50 items are negative expressions and their scores were calculated in reverse. The overall score is classified into four categories: unfavorable (0 to 50), relatively favorable (51 to 100), favorable (101 to 150) and completely favorable (151 to 200). The statistical tests used include analysis of variance and t-test. Also, the standardized score of 100 was also calculated. The data were analyzed using SPSS v25. Ethical considerations such as completing the informed consent form, voluntary participation, explaining the research objectives, and ensuring the confidentiality of information were observed.
Findings: The mean DREEM score was calculated as 96.02±22.68, which is in a relatively favorable range. Based on the standardized score of the five areas, the highest score was related to their academic self-perception (54.56). The educational atmosphere with 49.64 and the learning environment with 36.95 has the lowest grade.
There was no difference between the mean DREEM score of the two genders in total and the 5 sub-areas of educational environments.
The mean scores of physiopathology students in the learning environment (p=0.001), teachers (p=0.002), and their academic self-perception (p=0.015) and educational atmosphere (p=0.005) were significantly higher than the students of other levels (table 3). From the students' point of view, the course of physiopathology is practical, and the course of basic sciences is impractical. Also, this desirable result is most likely due to the appropriate timing of this course. In QUMS, the course of physiopathology has been offered in an integrated form, but in the apprenticeship period, the theory classrooms are not coordinated with the schedule of the related clinical departments.
The lowest score belongs to the internship level (learning environment, teachers, and social self-perception). This result is similar to Peretti et al.'s study (Pai, Menzes et al. 2014). High work pressure, resident-oriented training in some clinical departments (Ikeda, Kubta et al. 2019), the inappropriate feedback especially in the morning report of some educational groups causes interns to feel that their personality is not respected. In fact, the clinical environment is not suitable for effective learning unless it is well-planned and organized (Demirren, Peleglu et al. 2008). Students' perception of clinical teachers can indicate that these teachers still do not use comprehensive methods. Internship students have the most negative impression of teachers. Active participation of students, accountability, effective supervision, and giving positive feedback are vital (Khorsandi and Khosravi 2002). The lowest score in the subcategory of students' understanding of social self-perception was related to internship level due to stresses related to bedside activities and worries about the future of employment. It seems that there is no good support system for stressed learners.
One of the limitations of this study was regarding physiopathology students. The collection of information for this group coincided with COVID-19 restrictions, and as a result, the questionnaire was completed online. Also, due to the cross-sectional nature of the study, generalization of the results should be done with caution.
Conclusion: The result of the study showed that the educational atmosphere is partially favorable. Among possible changes that may be useful are periodic surveys of students and accurate evaluation of their results, holding workshops on medical ethics and how to provide correct educational feedback to students for teachers, careful monitoring of teachers students' feedback, and creating support systems for students. Also, hidden curriculum effects may be important in explaining the relatively low DREEM scores of internship students. It is necessary to continuously monitor the learning environment. It is also recommended to use student-centered learning-teaching methods, more interaction between students and teachers, and psychological support for students in order to reduce their anxiety and stress and improve their social self-perception.

کلیدواژه‌ها [English]

  • Educational atmosphere
  • DREEM questionnaire
  • medical students
  • learning
Al-Mohaimeed, A. (2013). "Perceptions of the educational environment of a new medical school, Saudi Arabia." International journal of health sciences ; VOL.7, NO. 2 , pp. 150-159.
Arabshahi, S. K. S. and J. Kohpaye Zadeh (2009). "University Teachers Point of View about Educational Environment in Major Clinical Wards in Educational Hospitals of Iran University of Medical Sciences Based on Modified DREEM Model." Strides in development of medical education ; VOL.6, NO. 1 , pp. 29-33.
Atapattu, N., K. Kumari, K. Pushpakumara and S. Mudalige (2016). "Adoption of dundee dreem questionnaire to assess the educational environment of an agriculture degree programme." Tropical Agricultural Research and Extension; VOL.18, NO.1, pp.22-30.
Bakhshialiabad, H., G. Bakhshi, Z. Hashemi, A. Bakhshi and F. Abazari (2019). "Improving students’ learning environment by DREEM: an educational experiment in an Iranian medical sciences university (2011–2016)." BMC medical education ; VOL.19, NO. 1 , pp. 1-10.
Bavdekar, S., S. Save, A. Pillai and A. Kasbe (2019). "DREEM Study: Students Perceptions of Learning Environment in a Medical College in Mumbai, India." The Journal of the Association of Physicians of India ; VOL.67, NO. 4, pp. 50-54.
Demiroren, M., O. Palaoglu, S. Kemahli, F. Ozyurda and I. Ayhan (2008). "Perceptions of students in different phases of Medicai education of educational environment: Ankara University Facuity of medicine." Medical education online ; VOL.13, NO. 1 , pp. 4477.
Fallah kheiri Langroudi, S., A. Badsar, Z. Hosseini and M. Rouhi (2012). "Validation of the Persian version of the Dundee Ready Educational Environment Measure (DREEM)." Research in Medical Education ; VOL. 4, NO. 2 , pp. 24-33.
Farooq, S., R. Rehman, M. Hussain and J. M. Dias (2018). "Comparison of undergraduate educational environment in medical and nursing program using the DREEM tool." Nurse education today; VOL.69, pp.74-80.
Gosak, L., N. Fijačko, C. Chabrera, E. Cabrera and G. Štiglic (2021). "Perception of the Online Learning Environment of Nursing Students in Slovenia: Validation of the DREEM Questionnaire." Healthcare ; VOL.9, NO. 8 , pp. 998.
Ikeda, Y., Y. Kubota and A. Hiraide (2019). "Relationship between evaluation of the teaching environment using DREEM scores and students’ school learning scores." MedEdPublish ; VOL.8.
Khoursandi, M. and S. Khosravi (2002). "Investigation of the view of nursing and midwifery students about clinical education condition in nursing and midwifery college of Arak University of Medical Science." Arak Med Univ J ; VOL.5, NO. 1 , pp. 29-32. [In Persian].
Kim, H., P. Jeon, S. Kim, J. Hong and Y. Kang (2021). "Cross-Cultural Adaptation and Validation of the Korean Version of the Dundee Ready Education Environment Measure (DREEM)." Evidence-Based Complementary and Alternative Medicine ; VOL.2021 , pp. 5591911.
Hassanabadi M, Zare-Bidaki M, Rezaeian M (2017). “Medical Students’ Perceptions of the Educational Environment in Rafsanjan University of Medical Sciences in 2016.” JRUMS; VOL.16, NO. 5, pp. 465-478. [In Persian]
Heidari Hengami, M., Naderi, N., Nasery, B (2016). “Assessment of the Educational Environment of Major Clinical Wards in Educational Hospitals Affiliated to Hormozgan University of Medical Sciences Iran from the Perspective of Medical Students.” Strides in Development of Medical Education; VOL.13, NO.1, pp. 49-60. [In Persian]
Lumsden, R. and S. Schofield (2011). "Perceptions of educational climate in a Canadian medical radiation science programme." Journal of medical imaging and radiation sciences ; VOL.42, NO. 3 , pp. 124-129.
Moosavi, M., J. Koohpayehzadeh, S. K. Soltani Arabshahi, S. Bigdeli and K. Hatami (2015). "Assessment of educational environment at main clinical wards in teaching hospitals affiliated to Iran University of Medical Sciences: stagers and Interns viewpoints based on modified DREEM." Razi Journal of Medical Sciences ; VOL. 21, NO. 129 , pp. 58-67. [In Persian].
Pai, P. G., V. Menezes, A. M. S. Srikanth and J. P. Shenoy (2014). "Medical students’ perception of their educational environment." Journal of clinical and diagnostic research: JCDR ; VOL. 8, NO. 1 , pp. 103-107.
Patil, A. A., & Chaudhari, V. L. (2016). “Students’ perception of the educational environment in medical college: a study based on DREEM questionnaire.” Korean Journal of Medical Education, VOL.28, NO. 3, pp. 281.
sayyadi M, vahabi A, vahabi B, sayyad S, moradi M, rasoulabadi M et al . A survey of Kurdistan University of Medical Sciences students' perceptions of educational environment based on DREEM model in 2015. SJNMP; 2017; VOL. 2, NO. 4, pp.56-67. [In Persian]
Soltani Arabshahi, K., J. Kouhpayezade and B. Sobuti (2008). "The educational environment of main clinical wards in educational hospitals affiliated to Iran university of medical sciences: Learners' viewpoints based on DREEM model." Iranian Journal of Medical Education ; VOL.8, NO. 1 , pp. 43-50.
Tokuda, Y., Goto, E., Otaki, J., Jacobs, J., Omata, F., Obara, H., Ohde, S. (2010). Undergraduate educational environment, perceived preparedness for postgraduate clinical training, and pass rate on the National Medical Licensure Examination in Japan. BMC medical education, VOL.10, NO. 1, pp. 35.
Varma, R., E. Tiyagi and J. K. Gupta (2005). "Determining the quality of educational climate across multiple undergraduate teaching sites using the DREEM inventory." BMC medical education ; VOL.5, NO. 1 , pp. 1-4.
Whittle, S. R. (2018). "The second-year slump–now you see it, now you don’t: Using DREEM-S to monitor changes in student perception of their educational environment." Journal of Further and Higher Education; VOL. 42, NO. 1, pp. 92-101.
Zolfaghari, S. H. and B. Bijari (2015). "Medical students' perspective of Clinical Educational Environment of Hospitals Affiliated with Birjand University of Medical Sciences, Based on DREEM Model." J Birjand Univ Med Sci ; VOL.22, NO. 4 , pp. 368-375. [In Persian].