RESUMO
BACKGROUND: Critical thinking is one of the goals of education. It is a criterion for academic accreditation in medical education by concentration on students' soft skills. Due to lack of basic information on critical thinking tendency in undergraduate medical program, this study aimed to determine the trend of tendency toward critical thinking of medical students in two phases: basic science (year 1) and preinternship (year 5) at Tehran University of Medical Sciences. MATERIALS AND METHODS: This longitudinal descriptive-analytic study has been conducted in two phases (2010 and 2015); all 105 medical students were selected by accessible sampling method. Years of entrance to college was the inclusion criterion. The psychometric properties of The California Critical Thinking Dispositions Inventory (CCTDI) were confirmed, and then, the instrument was completed twice by participants. Data were analyzed by SPSS: 16 using student t-test, and paired t-tests. RESULTS: There was a significant difference between genders of students (P < 0.05). Males were more disposed toward critical thinking than females. The significant increase was found between mean of truth-seeking in the second test compared to the first test; instead, the mean of inquisitiveness, analyticity and self-confidence and inquisitiveness was significantly decreased (P < 0.05). However, in other subscales, there were no significant differences between the 1st and the 5th year students (P > 0.05). The total score of the test in the second phase was lower than the first phase, which was not significant. CONCLUSION: According to the findings, there is necessary to consider the critical thinking dispositions in medical students training programs and break down the barriers. Tendency toward critical thinking seems to be as prerequisite of critical thinking skills in undergraduate medical program.
RESUMO
BACKGROUND: Given the lack of consistency in the literature regarding the reliability of the ankle-brachial index (ABI) as a valid screening tool and an independent risk indicator of cardiovascular events and mortality, we compared it with angiography as a reference standard test. METHODS: This case-control study, conducted between 2010 and 2011 in Tehran Heart Center, recruited 362 angiographically confirmed cases of coronary artery disease (CAD) and 337 controls. A standard protocol was used to measure the ABI and different CAD risk factors. RESULTS: A low ABI had specificity of 99.7%, positive predictive value of 95.8%, negative predictive value of 49.8%, sensitivity of 64%, likelihood ratio of 24.07, and odds ratio (OR) of 22.79 (95%CI: 3.06-69.76). The role of the associated risk factors was evaluated with OR (95%CI), with the variables including gender 3.15 (2.30-4.30), cigarette smoking 2.72 (1.86-3.99), family history 1.72 (1.17-2.51), diabetes 1.66 (1.15-2.4), and dyslipidemia 1.38 (1.02-1.88). In a multivariate model, the following variables remained statistically significantly correlated with CAD [OR (95%CI)]: ABI 13.86 (1.78-17.62); gender 3.69 (2.43-5.58); family history of CAD 2.18 (1.41-3.37); smoking 1.69 (1.08-2.64); age 1.04 (1.02-1.06). CONCLUSIONS: A low ABI had specificity of 99.7%; however, because of its low sensitivity (64%), we should consider CAD risk factors associated with a low ABI in order to use it as a first-line screening test.