Comaprision of midical education.pdf

J. Fac. Med. (Baghdad), 2002, Vol, 44 No. 21
306
Comparison between students’ perspectives about medical education in innovative and
conventional schools of medicine in Iraq
Alim Yacoub*& D.D Salman, Narjis Ajeel**, Ghanim Mustafa***
‫مختلف‬ ‫منهجين‬ ‫تتبعان‬ ‫كليتين‬ ‫في‬ ‫الطبي‬ ‫التعليم‬ ‫في‬ ‫الطلبة‬ ‫نظر‬ ‫وجهات‬ ‫بين‬ ‫ما‬ ‫مقارنة‬
‫ي‬
‫العراق‬ ‫في‬ ‫ن‬
‫الخالصة‬
‫أ‬
‫طلبة‬ ‫واتجاهات‬ ‫آراء‬ ‫لمعرفة‬ ‫دراسة‬ ‫جريت‬
‫المنتهية‬ ‫الصفوف‬
‫الدراسي‬ ‫للعام‬
1998
/
1999
‫من‬ ‫كليتين‬ ‫في‬ ‫الطبي‬ ‫بالتعليم‬ ‫م‬
‫كليات‬
‫ال‬ ‫الطب‬
‫عر‬
‫اقية‬
‫تتبعان‬
‫م‬
‫مختلفين‬ ‫نهجين‬
‫التي‬ ‫البصرة‬ ‫طب‬ ‫كلية‬ ‫وهما‬
‫تعتمد‬
‫التقليد‬ ‫المنهج‬
‫ي‬
‫ط‬ ‫وكلية‬
‫تكريت‬ ‫ب‬
‫تع‬ ‫التي‬
‫تمد‬
‫ال‬
‫منه‬
‫ج‬
‫المع‬
‫تمد‬
‫المشك‬ ‫حل‬ ‫على‬
‫الت‬
.
‫بين‬
54
‫من‬ %
‫ط‬ ‫كلية‬ ‫طلبة‬
‫بـ‬ ‫مقارنة‬ ‫كافية‬ ‫غير‬ ‫كانت‬ ‫األساسية‬ ‫الطبية‬ ‫العلوم‬ ‫في‬ ‫النظرية‬ ‫الساعات‬ ‫ان‬ ‫تكريت‬ ‫ب‬
17
‫من‬ %
‫طلبة‬
‫كلية‬
‫طب‬
‫البصرة‬
‫ذلك‬ ‫اعتقدوا‬ ‫الذين‬
.
‫االتجا‬ ‫وكان‬
‫نفسه‬ ‫ه‬
‫الموا‬ ‫الطبية‬ ‫العلوم‬ ‫على‬ ‫ينطبق‬
‫ز‬
‫ي‬ ‫فيما‬ ‫وكذلك‬ ‫السريرية‬ ‫ية‬
‫خ‬
‫الساعات‬ ‫ص‬
‫العملية‬
‫ل‬
‫ولم‬ ‫المواضيع‬ ‫نفس‬
‫ي‬
‫كن‬
‫هنالك‬
‫في‬ ‫فرق‬
‫ا‬
‫الكل‬ ‫بين‬ ‫الطلبة‬ ‫راء‬
‫يتين‬
‫فيما‬
‫يت‬
‫ع‬
‫ل‬
‫بك‬ ‫ق‬
‫فا‬
‫وال‬ ‫العملية‬ ‫الساعات‬ ‫ية‬
‫نظ‬
‫رية‬
‫ل‬
‫لدروس‬
‫السريرية‬
.
‫ا‬ ‫من‬ ‫كبيرة‬ ‫نسبة‬ ‫بين‬ ‫كما‬
‫ل‬
‫طل‬
‫بالممار‬ ‫قناعتهم‬ ‫بة‬
‫ال‬ ‫سات‬
‫الكليتين‬ ‫في‬ ‫تجري‬ ‫التي‬ ‫ميدانية‬
.
‫بين‬
71
‫ط‬ ‫كلية‬ ‫طلبة‬ ‫من‬ %
‫لب‬
‫بال‬ ‫عام‬ ‫بشكل‬ ‫قناعتهم‬ ‫تكريت‬
‫منهج‬
‫ال‬
‫ت‬
‫للك‬ ‫دريبي‬
‫لي‬
‫بـ‬ ‫مقارنة‬ ‫ة‬
95
‫البصرة‬ ‫طلب‬ ‫طلبة‬ ‫من‬ %
.
‫ا‬ ‫على‬ ‫الضوء‬ ‫الدراسة‬ ‫سلطات‬
‫همية‬
‫س‬
‫ب‬
‫وا‬ ‫أراء‬ ‫ر‬
‫تجاه‬
‫الط‬ ‫ات‬
‫الجديدة‬ ‫المناهج‬ ‫ادخال‬ ‫عند‬ ‫لبة‬
‫ال‬
‫ال‬ ‫التعليم‬ ‫في‬ ‫مبتكرة‬
‫من‬ ‫طبي‬
‫اجل‬
‫الت‬ ‫االجراءات‬ ‫اتخاذ‬
‫قو‬
.‫يمية‬
Abstract:
This study was carried out to explore the opinions and attitudes of final year medical students
towards various issues related to medical education in two medical colleges in Iraq employing two
different educational approaches. Basra Medical College employs the traditional subject-based
approach. Tikrit Medical College employs the innovative problem-based approach. A self-
administered questionnaire was distributed for randomly selected final (sixth) year medical
students in both colleges, at the end of the academic year (1998-1999). Around 54% of Tikrit
medical students (which follows PBL) thought that theoretical hours in basic medical sciences
were not adequate compared to only 16% among Basra students (which follows the conventional
approach who thought so. The corresponding figures for paraclinical subjects were 68% vs. 3%.
---------------------------------------------------------------------------------------------------------------------
*Coll. Of Med, University of Mustansiriyah, Baghdad, **Coll. Of Med., University of Basra
***Coll. Of Med., University of Tikrit, Tikrit

307
The same opinion was expressed with respect to the adequacy of practical hours in the above
mentioned subjects. There was no difference in the opinions of students in both colleges with
respect to the adequacy of theoretical and practical hours in clinical training. Field practice was
reported to be carried out satisfactorily by high percentage of students in both colleges (100% for
Tikrit Medical College and 84% for Basra Medical College). Around 71% of Tikrit students
expressed their satisfaction with the educational approach compared to 95% among Basra students.
The study highlighted the importance of exploring students' opinions and attitudes when
innovative approaches are introduced in medical education so that corrective measures are needed.
Introduction
Medical colleges are under pressure to reform their curricula and method of learning to produce
doctors who will promote the health of people. This has been reiterated in various world
conferences and workshops on medical education in 1993(1,2) which had emphasized the need for
such reform. The forty-eighth World Health Assembly in 1995 called for the development
guidelines and models that enabled medical schools improve the relevance of medical education
programs and enhance their contribution to the implementation of changes in health care delivery
(3).
Problem-based learning is an educational concept that has been applied in some medical schools
in Europe, America and Middle East. It is based on integration of clinical and basic medical
sciences right from the beginning of medical education. The advocates of problem-based learning
believe that such innovation would overcome many of the shortcomings of the traditional "subject
based" medical education. Results of Haward Medical school's evaluation of its new problem-
based pathway programme showed that students of the new pathway felt more stimulated,
challenged as compared to the traditional pathway. However, there was no difference in terms of
biomedical knowledge between the two groups. In Iraq, there are ten medical colleges all except,
Tikrit University College of Medicine (TUCOM) follows the traditional subject-based approach.
TUCOM has applied the problem-based learning right from its inception in 1998. Basra Medical
College (BMC), on the other hands, was established in 1967 and although it follows the traditional
subject-based education has incorporated a strong community based component.

308
This is achieved by offering the student opportunities to get trained in primary health care
programmes and to carryout extensive field training during the 4th
and 6" year education.
The present study was carried out to explore the opinions and attitudes of final year medical
students in TUCOM and BMC towards various issues related to medical education within the
context of the different educational approaches of the two colleges.
Methodology
A self-administered questionnaire form was distributed to 75 randomly selected students in Basra
Medical College of whom there were 19 who were final (6th
) year Medical students. The results of
the later (e. BMC final year) were compared with 58 final your medical students selected from
TUCOM. The students were asked about their opinion regarding:
-Adequacy of the theoretical and practical hours of the basic medical, paraclinical and clinical
sciences.
-Opinions of students about the benefit derived from field practice and training in primary health
programmes
-Frequency of use of library facilities.
-Grand satisfaction of students with the educational approach used in their colleges.
Results
Table-1 shows The adequacies of the theoretical hours from students’ perspective, of the basic
medical, paraclinical and clinical subjects. It can be seen that the percentage of TUCOM students
who thought that teaching theoretical hours in the basic medical and paraclinical sciences, which
were not adequate were 54% and 68% respectively. The corresponding figures for BMC students
were 16% and 5% respectively. With respect to clinical hours, the percentages of TUCOM and
BMC students who though that such hours were inadequate were 29% and 37% respectively.

309
Table (1)
Adequacy of theoretical hours according to students’ opinions
1-Basic Sciences
More than adequate adequate Inadequate No answer
BMC 31.6% 63.2% 5.3% 0.0%
TUCOM 29.3% 22.8% 45.3% 2.6%
2-Basic Medical Sciences (Anatomy, Biochemistry, physiology)
BMC 0.0% 84.2% 15.8% 0.0%
TUCOM 4.0% 39.1% 54.0% 2.9%
3-Paraclinical Sciences
BMC 0.0% 94.7% 5.3% 0.0%
TUCOM 1.7% 28.7% 67.8% 1.7%
4- Clinical Sciences
BMC 0.0% 63.2% 36.8% 0.0%
TUCOM 15.5% 48.3% 29.3% 6.9%
N.B: In this and subsequent tables percentage are worked out of total number of students of BMC
(19) and TUCOM (75)
TUCOM: Tikrit University College of Medicine, BMC: Basra Medicine College.

310
Table -2 shows the adequacy of practical hours from students' perspective of the same sciences
shown in Table-1. The same trend can be observed whereby a higher percentage of TUCOM
students than BMC students thought that such hours were inadequate for basic medical and
sciences. However, with respect to practical hours in clinical training, 53% of BMC compared to
21% of TUCOM students thought that such hours were inadequate.
Table (2)
Adequacy of practical teaching according to students’ perspectives.
1-Basic Sciences
BMC 36.8% 63.2% 0.0% 0.0%
TUCOM 28.4% 24.6% 42.8% 5.2%
2-Basic Medical Sciences (Anatomy, Biochemistry, physiology)
BMC 5.3% 78.9% 15.8% 0.0%
TUCOM 8.6% 46.0% 42.5% 2.9%
3-Paraclinical Sciences
BMC 5.3% 84.2% 10.5% 0.0%
TUCOM 4.6% 28.7% 64.4% 2.3%

311
4-Clinical Sciences
BMC 5.3% 42.1% 52.6% 0.0%
TUCOM 8.6% 65.5% 20% 5.2%
Table -3 shows that 100% of TUCOM students and 84% of BMC students thought that field
practice was satisfactorily carried out during their training.
Table (3)
Satisfaction of students with field training
Satisfied Not Satisfied
BMC 84.2% 15.8%
TUCOM 100% 0.0%
Table -4 shows the adequacy of training in PHC programmes from students’ perspective. 55%
TUCOM students compared to none of BMC students thought that such training was more than
adequate. On the other hand, 32% of BMC students compared to only 5% of TUCOM students
thought that their training in this respect was inadequate.
Table (4)
Adequacy of training in primary health care according to students’ opinions
BMC 0.0% 68.4% 31.6% 0.0%
TUCOM 55.1% 39.7% 5.2% 0.0%

312
Table-5 shows from students’ perspective, the relevance of their training in PHC for future career;
90% of BMC students compared to 57% of TUCOM students thought such training is relevant.
Table (5)
Relevance of training in PHC to future career according to students’ opinions
Relevant Irrelevant No answer
BMC 89.5% 5.3%
TUCOM 56.9% 41.4%
Table -6 shows the frequency of use of library facilities by students of both colleges, 26% of BMC
students and 24% of TUCOM students visit the library more than once a week.
Table (6)
Frequency of library visit by medical students
Once a month Once a week More than once
a week
No answer
BMC 36.8% 36.8% 26.3% 0.0%
TUCOM 17.2% 39.7% 24.1% 18.0%
Table -7 shows the extant of satisfaction of students in the educational approach followed by those
two colleges. A lower percentage of BMC students compared to TUCOM students felt frustrated
(5% and 24% respectively). The majority of BMC students (95%) completely or just satisfied
while about 71% of TUCOM students felt so.

313
Table (7)
General satisfaction of students with education approach Completely satisfied
Completely satisfied Just satisfied Frustrated No answer
BMC 26.3% 68.4% 5.3% 0.0%
TUCOM 34.5% 36.2% 24.1% 5.2%
These results suggest that students involved in the problem-based learning felt more than students
involved in traditional subject-based learning that the theoretical hours in the basic medical hours
in the basic medical and paraclinical sciences were inadequate.
With respect to satisfaction of students with field training, the majority of students of BMC (84%),
and all students of TUCOM thought that field practice was satisfactory carried not during their
training (Table 3).
The adequacy of training in PHC programmes from students’ perspective is shown in Table-4.
These results indicate that, from students’ perspective, that training in PHC programmes in BMC
with the traditional approach was inadequate.
Discussion
The world Summit on Medical Education in 1993 called for involvement of medical students
planning and evaluation of medical curricula (3). Exploring student's opinion regarding various
aspects of the educational process, as has been attempted in this study, is a step in that direction.
Relatively higher percentage of students of TUCOM, which follows the problem-based learning,
felt that theoretical and practical lectures in basic medical and paramedical subjects were
inadequate and felt more frustrated compared to students of BMC, which follows the traditional
approach. However, students of both colleges, felt that field training in PHC is relevant to their
future career. They both used library facilities to the same degree which is a reflection of
involvement in self-learning.

314
The results of the Haward Medical School's evaluation which was referred to in the introduction,
showed that students of the new pathway which follows the problem-based learning, reflected
more on their learning, memorized less and preferred active learning (4). However, they reported
some tutorial work caused frustration and anxiety similar to what was reported in the present study.
The demand of TUCOM students for more teaching hours in paraclinical and basic medical
sciences and the relatively higher proportion of students who felt frustrated compared to BMC
students might have also resulted from the poor performance of TUCOM in the National
Summative examinations among other Iraqi medical colleges which have been carried for the last
three years (4). This might demonstrate the steering effect evaluation methods on what students
prefer to study. Assessment exerts an important on curriculum and invites student to study the test
(5). Because both TUCOM and BMC incorporate community based teaching in their curricula,
this has been reflected positively on the attitudes of the students towards field practice training in
primary health care programmes
In this study the questionnaire used to explore students’' attitudes was simple and straightforward.
An in-depth interview to measure various dimensions of attitudes would be more illuminating.
In addition, tutor's attitudes need also to be explored to evaluate innovative approaches in medical
education. Such a study was carried out will be reported elsewhere.
References
1- World Health Organization. Edinburgh Declaration. World Conference on Medical Education
World Federation for Medical Education Edinburgh, 1988, p: 8-9.
2- World Federation for Medical Education for Eastern Mediterranean changing Medical
Education. World Summit on Medical Education. Edinburgh, 1993, P: 7.
3-World Federation for Medical Education Reorienting medical education and medical practice
for health for all. Forty-Eighth world Health Assembly. Edinburgh, 1995, P: 1-2.
4- Editorial. Problem based, small group learning. BMJ 1995; 311:342-343

315
5- Al-Rawi M. Comparison of traditional and non-traditional medical colleges in Iraq, Journal of
Faculty of Medicine, Baghdad 2000; 42: 13-17
6- Nendaz M & Teleian K. Assessment in Problem based learning medical schools: A literature
review. Teaching and learning in Medicine 1999;11: 232-243.
Acknowledgment
The authors world like to express their thanks to Miss ELHAM ALTOM for her excellent efforts
in tabulations and typing the manuscript.

Comaprision of midical education.pdf

Recommended

Recommended

More Related Content

Similar to Comaprision of midical education.pdf

Similar to Comaprision of midical education.pdf (20)

More from Alim A-H Yacoub Lovers

More from Alim A-H Yacoub Lovers (20)

Recently uploaded

Recently uploaded (20)

Comaprision of midical education.pdf