B. H. Rashidi et al. / Health 5 (2013) 175-178
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docrinology and infertility are still evo lving in Iran. Here,
reproductive medicine lectures are often placed within
the general obstetrics and gynecology syllabus with no
practical application of material specific to the advanced
reproductive technologies being routinely provided. Us-
ing a traditional teaching methodology mainly composed
of didactic classroom lectures is one way to accomplish
this, although bringing medical students into the clinical
setting should augment this learning experience. Recent
research in Iran has shown how innovative teaching ap-
proaches in related disciplines can positively impact
learning at the residency training level [4], as well as
peer/community settings [5]. Yet, the belief among me-
dical school leadership that students would find early
clinical exposure to reproductive medicine unhelpful
may explain why such an approach may not yet have
found widespread application in Iran. Given the paucity
of published data on this topic, the current pilot investi-
gation was launched to measure acceptance and effec-
tiveness of a new hospital-based reproductive endocri-
nology curriculum among Iranian medical students.
2. METHODS
Following affirmative review from the department
chair for medical student educational affairs at Tehran
University of Medical Sciences, approval was granted
for this voluntary, anonymous question naire cohort study
in association with a new teaching initiative which also
received independent approval.
2.1. Structure of Study
This pilot assessment was designed as part of a quality
audit for the new clinical teaching module for reproduc-
tive endocrinology, offered during an ambulatory clinic
rotation for infertility and endocrinology disorders dur-
ing a mandatory gynecology clerkship. Students were
randomly allocated to one of tw o groups for reproductiv e
endocrinology instruction. Students in the experimental
module (n = 19) were assigned to Vali-e-Asr Hospital, an
academic teaching affiliate of Tehran University of
Medical Sciences. Students in the control group (n = 34)
received a series of lectures and traditional exposure to
infertility clinics. In both study arms, the duration of
each module was one week.
2.2. Study Sample and Allocation
All participants were in their fifth year of medical
school, with appraisals occurring during the 2010-2011
academic term. Students in the experimental group par-
ticipated in a reproductive genetics laboratory, pelvic
ultrasonography clinic, and observed procedures carried
out in the IVF laboratory. The techniques of controlled
ovulation induction, in vitro fertilization and embryo
transfer were described (and subsequently demonstrated)
to the students in a clinical context with the assistance of
patients who had specifically consented to participate in
medical student teaching. The module also presented
information concerning reproductive medical ethics em-
phasizing the role of pre-treatment patient counseling.
Rather than structured lectures in large classrooms, in-
formal small group reproductive medicine discussion
sessions were offered each day. A laboratory component
offered opportunities to observe intracytoplasmic sperm
injection, assisted embryo hatching, human embryo cry-
opreservation/thaw, and extended blastocyst culture. To
show how these various elements integrate practically
with clinical practice, medical students observed faculty
during patient consultations in the office for new and
follow-up appointments. Students in the control group
received a series of standard lectures covering the same
material. Although audio-visual teaching aids were occa-
sionally used in the control module, instruction occurred
mainly in the classroom during th e one week session.
2.3. Assessment Methods and Statistical
Analysis
Student data were obtained from an anonymous seven-
item questionnaire based on a previously published
methodology [6], and refined by a multidisciplinary edu-
cational team here. The questionnaire was administered
to all participants at study entry and again at the conclu-
sion of their reproductive endocrinology module. Likert-
scaled questions were used to measure student accep-
tance of their assigned module, student attitudes toward
this field, and the level of familiarity related to the prac-
tice of reproductive medicine in general. Students were
also queried about the module’s likely impact on their
own selected area of professional practice in the future.
Fisher ’s exact test was used to compare baseline vs. post-
module questionnaire data, as well as post-module re-
sults between groups. Matched pair analysis by McNe-
mar’s test was also performed. A p < 0.05 was consid-
ered statistically significant.
3. RESULTS
Completed pre- and post-module questionnaires were
returned from all 53 medical students enrolled in this
study (19 in the experimental group plus 34 in the con-
trol group). There were no significant differences in
mean age between the two study groups; the gender mix
was similar across the two groups as well. Overall, the
questionnaire did not identify any significant differences
between groups in the seven parameters investigated.
More students in both groups responded affirmatively
that reproductive endocrinology was “important in the
university medical curriculum” at the conclusion of their
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