Curriculum leadership in the postgraduate: Gap between current and optimal status.

BACKGROUND: Identifying the strengths and weakness points is one of the effective methods to analyze current status, and prioritizing actions based on the gap between current and optimal status is necessary for short-term and long-term planning in departments and colleges. The aim of this study was to determine the gap between current and optimal status of curriculum leadership in the postgraduate courses in two Iranian universities. MATERIALS AND METHODS: In this cross-sectional study, a sample of 212 faculty members from the two Iranian universities (one medical and one nonmedical) was randomly selected through stratified random sampling method. Data were collected by using a researcher-made questionnaire, with 55 items categorized in four areas of main dimensions in curriculum leadership. The validity of the questionnaire was determined by curriculum studies scholars, and the reliability was confirmed as the Cronbach's alpha calculated 0.969. Data were analyzed using descriptive and inferential statistics according to the variables. RESULTS: There was a gap in all dimensions and roles. The maximum gap (-1.70) with the highest frequency (98%) were related to "improving the educational atmosphere" dimension. As for items, the maximum gap (-2.41) was related to "society needs and expectations and the labor market" in "curriculum development and revision" dimension. CONCLUSION: The negative gap between all dimensions of curriculum leadership implies faculty members' dissatisfaction. Curriculum leadership at universities, colleges and departments of the study in all aspects need to be improved. Hence, it is necessary for managers to make use of the viewpoints of the faculty members to decrease the gap.

Assessing critical thinking in medical sciences students in two sequential semesters: Does it improve?

OBJECTIVES: Critical thinking is an important outcome criterion of higher education in any discipline. Medical and paramedical students always encounter with many new problems in clinical settings and medicinal laboratory, and critical thinking is an essential skill in obtaining a better approach for problem solving. We performed a pre-and post-test to evaluate the change of critical thinking skills in medical sciences students who enrolled in Isfahan University of Medical Sciences in Iran during the academic years 2008-2010. METHODS: In a longitudinal design study, the critical thinking skills were compared in medical sciences students in two sequential semesters using the California Critical Thinking Skills Test. The test is divided into two parts (parts 1 and 2), including 17 items in each part. Based on proportional stratified sampling, a groups of students (group 1, n=159) were selected from the university population, who enrolled in medicine, pharmacy, nursing, and rehabilitation colleges. The students in group 1 were asked to complete the part 1 of the test (phase I). After one semester, another group (group 2, n=138) from the same population was randomly selected, and they were asked to complete the part two (phase II). The students' demographic data also were recorded. The California critical thinking skills test was translated and it validity and reliability were approved before. RESULTS: No significant difference was observed between the two groups in the demographic data. The students critical thinking scores in phase II significantly reduced in comparison with phase 1 (p<0.05). The phase II scores in subdivisions of analysis, inference, inductive reasoning, and deductive reasoning also failed to demonstrate improvement. CONCLUSION: It seems curriculum reform is necessary to improve the students' critical thinking.

Autologous ring vs. flexible prosthetic ring for ischemic mitral regurgitation.

Ring annuloplasty is the most common strategy for correction of ischemic mitral regurgitation. When a commercial prosthesis is unavailable or too expensive, an autogenous annuloplasty ring can be handmade by the surgeon. The aim of this study was to compare short-term results of mitral valve repair with autologous annuloplasty rings and the SJM Tailor flexible prosthesis. Between March 2004 and April 2006, 100 patients undergoing coronary artery bypass grafting and mitral ring annuloplasty for ischemic regurgitation were randomly assigned to either type of prosthesis. Transesophageal and transthoracic echocardiography showed no significant differences between these techniques in terms of immediate success of the repair and its durability at 3, 6, and 9 months postoperatively. Autogenous rings are easy to make, cost-effective, and always available. Our short-term results suggest that they may be an acceptable alternative to a commercially produced prosthesis for patients with ischemic mitral regurgitation.

Postoperative pericardial effusion and posterior pericardiotomy: related?

Large pericardial effusions develop in 30% of patients after cardiac surgery, and reach their maximum size after 10 days, with tamponade in 1%. The aim of this prospective randomized case-controlled study was to assess the effectiveness of a posterior pericardiotomy in preventing early and late (>30 days) development of pericardial effusion. Between April 2005 and May 2006, 410 patients with a mean age of 68.4 +/- 9.2 years undergoing coronary artery bypass grafting alone or combined with valve surgery were divided into 2 groups of 205 each. In the pericardiotomy group, a 4-cm longitudinal incision was made parallel and posterior to the phrenic nerve. Echocardiography was performed at discharge and 15 and 30 days after the operation. At 15 and 30 days postoperatively, 90.2% and 97% of patients in the pericardiotomy group were free of effusion; while none in the control group were free of effusion. A posterior pericardiotomy is easy to perform and seems to be a safe and effective means of preventing postoperative effusion and its adverse consequences.

Postoperative pericardial effusion and posterior pericardiotomy, related or not?

INTRODUCTION: Large pericardial effusions after cardiac surgery develop in 30% of patients and reach their maximum size on approximately day 10 postoperatively. Tamponade develops in approximately 1% of patients with large pericardial effusions. Effusion may be prevented by posterior pericardiotomy, but its role and possible adverse consequences are controversial. We sought to further investigate the effectiveness of this technique. METHOD: This prospective randomized case-control study was carried out on 410 patients, mean age 68.4 +/- 9.2 years, who underwent coronary artery bypass graft surgery alone or combined with valve surgery during the period between April 2005 and May 2006. A 4-cm longitudinal incision was made parallel and posterior to the phrenic nerve in the pericardiotomy group. Echocardiographic study was performed at the time of discharge and 15 and 30 days after surgery. RESULTS: After 15 and 30 days postsurgery, respectively, 178 (90.2%) and 192 (97%) of patients from the pericardiotomy group and none from the conventional group were free of effusion (P < .05). CONCLUSION: Posterior pericardiotomy is easy to perform and is a safe and effective means to prevent postoperative effusion and its early and delayed adverse consequences.