Breaking down barriers and building up facilitators of lecture free curriculum in medical education: An interpretive structural modeling.

INTRODUCTION: The field of medical education has seen a growing interest in lecture free curriculum. However, it comes with its own set of challenges and obstacles. In this article, we aim to identify the prerequisites, facilitators, challenges, and barriers of lecture-free curriculum in medical education and examine their interrelationships using interpretive structural modeling (ISM) technique. METHODS: In this mixed-method study initially, we performed a scoping review and semi-structured interviews and determined the main prerequisites, facilitators, challenges, and barriers of lecture-free curriculum in medical education using qualitative content analysis approach. The interrelationships among these components were investigated using ISM. Therefore, self-interactive structural matrices were formed, initial and final reachability matrices were achieved, and MICMAC analysis was conducted to classify the factors. RESULTS: Finally, two ISM models of prerequisites and facilitators with 27 factors in 10 levels and challenges and obstacles with 25 factors in eight levels were developed. Each of the models was divided into three parts: key, strategic, and dependent factors. 'Providing relevant evidence regarding lecture free curriculum' emerged as the most important prerequisite and facilitator, and 'insufficient support from the university' was identified as the most critical barrier and challenge. CONCLUSIONS: The study highlights the significant importance of lecture-free curriculum in medical education and provides insights into its prerequisites, facilitators, challenges, and barriers. The findings can be utilized by educational managers and decision-makers to implement necessary changes in the design and implementation of lecture-free in medical education, leading to more effective improvements in the quality and success of education.

An analysis of the challenges in recruiting clinical teachers in Iranian medical universities: A qualitative analysis.

BACKGROUND: Employing appropriate and deserving staff is goal of human resource management (HRM). A group of staff at medical science universities are clinical teachers. Considering the position and importance of these peoples, this study addresses the challenges of recruiting clinical teachers. MATERIALS AND METHODS: This is a qualitative study of the conventional content analysis done in Isfahan medical university in 2018. The participants were selected through intensity sampling of purposive sampling method, and data were obtained through semi-structured interviews conducted to survey 23 experts and clinical faculty members concerning the challenges involved in employing clinical teachers. Data were analyzed using conventional content analysis method and OneNote 2013. RESULTS: Two main categories and ten subcategories were classified as follows: HRM inadequacy in educational departments with six subscales such as indefiniteness of the workforce status for HR managers, reluctance of educational departments to increase human resources, nonproportionality of the teacher-student ratio, recruitment of faculty based on the needs in the treatment sector, weakness of the infrastructure to use nonfaculty teachers, and reduced public interest in employment as a faculty and weakness of the selection process with four subscales based on data analysis such as undesirable manner of selection, recruitment based on the score given by the national board of medical examiners, purpose-based calls to recruit predefined individuals, and personal and emotional issues, rather than managerial standards, governing cooperation with teachers. CONCLUSION: Recruitment process is part of HRM tasks. Employment system in a medical sciences university must be considered to improve the clinical faculty recruitment. HRM inadequacy in educational departments and weakness of the selection process are challenges that affect the employment system. According to these findings, it is necessary to review the regulations and tasks of HRM in medical sciences universities.

Clinical instructors' recruitment callenges: Interpretive Structural Modeling approach.

CONTEXT: Universities of medical sciences are responsible for educating and training human resources (HRs) that provide services to all members of the community. Clinical educators play a significant role in the promotion of health and education in medical sciences universities. AIMS: The aim of this study was to prioritize and develop a model to illustrate the relationship between faculty recruitment challenges in medical sciences universities. SETTINGS AND DESIGN: Interpretive structural modeling (ISM) is a system design method initially introduced by Warfield (1974). This method helps create order in the complex interconnections between components of a system by interpreting the opinions of a group of experts. It both determines the priority of elements influencing one another and uncovers the association between the elements of a multipart set in a hierarchical structure. SUBJECTS AND METHODS: In this method, the identified challenges were built into a paired comparison questionnaire to be completed by policymakers and experts. By the same token, the obtained results were analyzed with the ISM technique. STATISTICAL ANALYSIS: The four steps include identified variables related to the issue, structural self-interaction matrix, initial reachability matrix, and final reachability matrix was used for analysis. According to these steps, the ISM model was portrayed. RESULTS: The ISM model was developed in ten levels that divided into three parts including key challenges, strategic challenges, and dependent challenges. CONCLUSION: Health promotion and quality of education in medical sciences universities is dependent on quality of faculty recruitment system. According to the results, it is imperative that HR managers and policymakers improve existing rules and develop policies to solve the challenges in this area.

Improving the medical records department processes by lean management.

BACKGROUND: Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. AIMS: The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. MATERIALS AND METHODS: This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. STATISTICAL ANALYSIS USED: The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. RESULTS: The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. CONCLUSION: The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. ORIGINALITY/VALUE: The study represents one of the few attempts trying to eliminate wastes in the MRD.