A comprehensive "real need" assessment, a step toward improving the quality of faculty development programs: A survey-based study in Hormozgan University of Medical Sciences.

Background and Aims: Developing a framework to identify the "real" needs of faculty members, the gap between the current and desired conditions, would lead to an effective faculty development program (FDP) and improve higher education quality and health system promotion. For the first time in Iran, instead of needs assessment based on faculty members preferences or assessing needs only in a few areas, this study aimed to assess the difference between "self-rated level of skill" as the current condition and "perceived importance" as the expected condition, regarding all faculty roles and levels at Hormozgan University of Medical Sciences (HUMS). Methods: This study used a research-made questionnaire that included 73 items within nine domains. The content validity of the questionnaire was confirmed, and Cronbach's alpha coefficient ranged from 0.86 to 0.96 for domains. The census method was applied. Participants rated their current skill level and perceived importance for professional development of each item on a 10-anchor scale. Statistical software, SPSS 19, analyzed the data using descriptive statistics and analytic tests. Results: Significant differences existed among participants' ratings of skills and the importance of further training in various areas. Priority professional development domains were e-learning, curriculum development, personal development, program evaluation, leadership and management, student assessment, learning theories and teaching strategies, research and scholarship, and ethics and communication. Conclusion: Additional formal training is required, especially in e-learning and curriculum development, for most faculty members at HUMS to enhance their academic performance. This study is the first needs assessment in Iran based on gaps between current and desired conditions. Conducting a "real needs" assessment before initiating an FDP is necessary for its feasibility.

Clinical reasoning assessment through medical expertise theories: past, present and future directions.

Exploration into the concept of "medical expert" dates back to more than 50 years ago, yet yielding three leading theories in the area of clinical reasoning, namely, knowledge structure, hypotheticdeductive, and dual process. Each theory defines "medical expert" in a dissimilar way. Therefore, the methods of assessment through which the experts are identified have been changed during the time. In this paper, we tried to categorize and introduce some widely used tests for identification of experts within the framework of existing main theories. Implementation of the proposed categorization for providing future assessment tools is discussed.

Effects of morning report case presentation on length of stay and hospitalisation costs.

CONTEXT: The primary goal of discussing patient cases during the morning report is to teach appropriate clinical decision making. In addition, the selection of the best diagnostic strategy and application of evidence-based patient care are important. Reducing hospital costs is fundamental to controlling inflation in health care costs, especially in university hospitals that are subject to budget constraints in developing countries. The goal of this study was to explore the effect of morning report case presentation on length of stay (LoS) and hospitalisation costs in a university teaching hospital. METHODS: A total of 54 patients whose cases had been presented at morning report sessions in the department of internal medicine during a 3-month period (presented group) were selected and their medical records reviewed for data on final diagnosis, hospital LoS and detailed hospital costs. A control group of 104 patients, whose cases had not been presented, were selected on the basis that their final diagnoses matched with those of the presented group. In addition, the groups were matched for age, sex, occupation, comorbidities and insurance coverage. Final diagnoses were based on International Classification of Disease 10 (ICD-10) diagnostic code criteria. RESULTS: The mean ± standard deviation (SD) hospital LoS was 8.32 ± 4.11 days in the presented group and 10.46 ± 4.92 days in the control group (p = 0.045). Mean ± SD hospitalisation costs per patient were significantly lower in the presented group (US$553.43 ± 92.16) than the control group (US$1621.93 ± 353.14) (p = 0.004). Although costs for paraclinical services were similar, there were very significant reductions in costs for medications used during hospitalisation and bed-days (p = 0.002). CONCLUSIONS: Discussing clinical aspects of patient cases in morning report sessions facilitates the management process and has a significant effect on LoS and hospitalisation costs in patients admitted to hospital.