Address for correspondence: Dr. Laila Bazrafcan, Education Development Center of Shiraz University of Medical Sciences, 3 th Floor, Sina Sadra Halls tComplex, Neshat Ave, Shiraz, Iran. E-mail: moc.liamg@nacfarzab
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To be more successful in medical education and identify the strengths and weaknesses of the curriculum in this field, assessment of the students’ views, graduates, professors, and experts is essential. The aim of this qualitative assessment was to identify the strengths and weaknesses of the medical education curriculum.
This research is a qualitative study using the Eisner's educational connoisseurship and criticism model that was conducted in Shiraz Medical Sciences University in 2014. In this research, graduate medical education curriculum was criticized by a team of educational experts. Fifteen professors in the first stage of the focus group meeting addressed the three stages of educational criticism. In the second stage, several interviews were conducted with the above-mentioned people. In the third phase, the implementation of video recordings from the focus group meeting was performed in written form. In the fourth stage, conventional content analysis was used to analyze the qualitative data.
This curriculum has advantages and disadvantages in the constituent elements of the program. Its weaknesses include lack of written a guide for practical courses, lack of consideration of joint practical exercise to make integrate between lessons, lack of sufficient attention to aspects of practical and functional knowledge in this field, lack of attention to performance evaluation and development, and lack of routine review of the curriculum. On the other hand, the strengths of this study include the suitability of this field for professors and its positive impact on professors and students performance in the classroom.
As medical education is partly an emerging field in Iran and considering the weaknesses, reviewing the curriculum based on the main part of program, the outcomes, curriculum content, teaching strategies, student assessment, and course management are recommended.
Keywords: Connoisseurship and criticism, curriculum, Eisner's model, medical educationMedical education is a new emerging and established field of medical science universities in Iran which has about 20 years’ experience.[1] The mission of medical education is that with the selection and recruitment of faculty members, talented and professionals interested in the issues of medical education, training some graduates that have the ability to identify educational problems, offer logical solutions, and assistance in the planning and management of educational issues and transfer of appropriate technologies and methods.[2] They are also able to play their roles to identify the universities’ strengths and weaknesses and recognize the progress and development of the universities in the world to promote the status of Medical Sciences University in Iran.[3] Educational managers are trying to create a set of knowledge, thinking, attitude, and skills in graduates.[4] All changes in the behavior of learners occur through a comprehensive curriculum including both formal and informal content, content processes and explicit, and hidden training and learner attainment.[5] Accordingly, the aim of developing a curriculum must be training qualified graduates who have the necessary knowledge and sufficient ability to apply these skills to improve the effectiveness of their system. Effectiveness of teaching and curriculum has a high importance and sensitivity since training manpower will be subject to it.[6]
Evaluation of training programs is as part of the educational system and one of the four essential components of any curriculum that seeks to identify the problems and shortcomings; because despite their shortcomings and lack of identification, the results will be suboptimal, and elimination of shortcomings will follow the promotion of an educational program.[1,2,7] Curriculum evaluation is a procedure done to decide about acceptance, change, and elimination of the program and has gone in different ways, such as goal-oriented model, context evaluation, input evaluation, process evaluation, product evaluation model, Stake's case study model, and Scriven's consumer-oriented model. One of the recent methods for evaluation of training programs is reviewing their effectiveness by Eisner's educational connoisseurship and criticism model.[8,9] The word “connoisseurship” comes from the Latin word cognoscere (Eisner 98,6).[9,10] These include the ability to see, not just look up. It must be able to provide a wide range of information. You should also be able to put the experiences and perceptions in a wider context and connect them with our commitment and values. Connoisseurship is something that we need to use. It is the art of criticism and assessment. In each area that characteristics importance or valuable objects, opportunities and functions can be considered to exemplify and changing educational performance (Eisner 98,63).[9,10]
Connoisseurship and criticism model are two basic and original concepts of criticism and educational expertise model. Criticism means the art of revealing quality of events or objects. To share professional knowledge, expertise criticism is necessary. Contrary to common sense, criticism that is offering negative views refers to rebuilding our understanding from a thing.[11,12] Educational criticism has three important aspects: describe, interpret, and evaluate what we see.[13] In other words, this model is based on three aspects that reflect the three qualitative activities. These aspects include[11,12] descriptive aspect of educational criticism which is to describe the current state of the curriculum and interpretative aspect which is related to the attempts for understanding the significance of many activities that occur in a social setting. The last aspect of educational criticism is assessment and evaluation. In the dimension of the importance and impact of activities, interpreted experiments can be evaluated. During this process, the criteria for judging educational experience are required. Several studies have been conducted with this approach which are briefly mentioned here.[12]
Hosseini Shahidi et al. conducted an evaluation study in the nursing and midwifery school of Mashhad in 2013 to assess the effective educational components in professional identity of nursing students, using the criticism and expertise model of Eisner. The mentioned model was used for the quality assessment of nursing education system. The results of the evaluation by this model show that it is necessary to revise the educational content in a manner that is consistent with the students’ needs and is useful for the introduction of this field.[14]
A study was conducted by Yuksel in 2010 entitled, “How can we direct the program qualitative evaluation in the light of the criticism and educational expertise model of Eisner?” - to investigate how qualitative assessment of the programs is done according to the evaluation model of Eisner. The results state that using criticism and expertise model of Eisner, the evaluation of educational programs can achieve a quality status, and as a result, process and product of curriculum will be reviewed from a broader perspective and without dependency on the number of restrictions.[12]
Mahram also in a case study at Ferdowsi University of Mashhad in 2008 entitled, “The role of curriculum components in religious identity of students” assessed the impact of each curriculum's components in reducing religious identity by utilizing the expertise and criticism method of Eisner and using observation and interviews. Content, student, professor, teaching methods, and regulations’ components were the elements of the curriculum whose role in the loss of religious identity in students was explored. The results showed a significant decrease in religious identity among students.[12] In another case, the research was done by Mahram and Farokhzade; the evaluation was done through the Eisner's model; in this study, the role of teacher, students, teaching methods, evaluation methods, contents, physical environment, rules and regulations, and the timing was examined as the eight components of the curriculum.[15]
Educational assessment intends to improve the quality of education as their definitive goal. According to the subjects expressed, this qualitative study aimed to evaluate the curriculum in Master of Medical Education and used Eisner's method of criticism and expertise, to identify possible shortcomings in the program, and provided practical suggestions for improving the present situation.
This study was performed by a full professor who had passed the postgraduate medical education courses and was a lecturer of this field, and also a PhD medical education student who taught these courses, and she was an educational assistant of Research and Development Centre of Shiraz University of Medical Sciences, Shiraz, Iran, with 30 years of experience in medical education and the corresponding authors of this article and also with a postgraduate student in medical education (to prepare a thesis).
This paper is an applied evaluation, and qualitative was used as the suitable design to allow all of the participants to describe their experiences by connoisseurship and criticism Model to improve the curriculum of Master of Medical Education.
Therefore, this qualitative study was designed in Shiraz University of Medical Sciences in 2014 based on the Eisner's educational connoisseurship and criticism model (including three phases, description, interpretation, and evaluation) about the curriculum of MS Medical Education discipline. The participants in this research included 15 professors of medical education and educational scholars of medical universities in Brigade, one of the countries who implemented senior medical education programs or passed it and had not participated in similar studies were selected by purposive sampling, and complete by theoretical sampling to conduct the research. Eisner's connoisseurship and criticism model was carried out in four steps: convene Delphi meeting in focus groups method with five professors of medical education and ten educational experts of the country (total 15), the first step was done in the describe, interpret, and evaluate curriculum phases. Before starting the research, the professors and educational experts were informed about the research and the confidentiality of the received information, and they were given a consent form. The meeting was timed and managed by a professor of medical education in three stages (description, interpretation, and evaluation of curriculum). At the beginning of the meeting, the professors and experts of medical education described (first step of criticism) the strengths and weaknesses of medical education curriculum in nominal group technique. For example, the professors were asked: What do you think about the goals of postgraduate course of medical education? All of them responded in written form, and their comments were written on the board. Again, the participants were asked to be aware of other comments, and according to them adjust their responses, this lasted for three rounds. Then, the interpretation (the second stage of criticism) of the curriculum's strengths and weaknesses was on the agenda of the meeting, and snowballing technique was used for this section to the extent that interpretations were discussed first in pairs and then in larger groups. Finally, at the evaluation stage (the third stage of review) of the curriculum's strengths and weaknesses, two groups were formed by the participants, and the interpretations of previous stage were evaluated, and the correlation between the two groups was assessed about 80%. During the session, all the meeting times were videotaped by camera. In the second phase, 15 interviews were done individually with the medical education professors and educational experts of the country as a targeted sampling and the data were recorded in written form. The participants were sure about the confidentiality of the information. Participants were quite free to respond or not respond all or part of the questions. To ensure, the accuracy of data was used some methods such as rigor check member, researcher creditability, prolonged engagement with participants (with profound and prolonged interviews), and peer debriefing. Second, the researcher implemented all the video recordings of the focus group sessions in written form. In the fourth stage, the qualitative content analysis which is a study method for the subjective interpretation of the textual data content through a systematic classifying process, coding, and design themes or known patterns was used to analyze the date.[16] The applied qualitative content analysis was the conventional type. Conventional content analysis is usually applied for studied projects and its purpose is the description of a phenomenon. This type of project is most appropriate when the existing theories or research literature about the studied phenomenon is limited. In this case, the researchers avoided from using preconceived categories, and they made an order that the categories will be induced from data, instead. In this case, the researchers were floating themselves on the waves of the data until they reached a new understanding.[17] Therefore, by categories will emerge from the data by induction. The information gathered through focus groups and interviews was analyzed by means of meaning association. That is, data analysis began by reading them repeatedly to obtain a thorough understanding of them. Based on her own perception and understanding of the text being read, the researcher began to write the initial analysis to create the backgrounds for the emergence of codes. This led to the planning of passwords emerging from the text. In other words, we determined the meaning unit and compressed it to specify the codes [ Table 1 ]. Then, the initial codes were 446, and the codes were categorized based on the similarities and differences. This categorization was created by the organization and grouping of passwords in a meaningful clusters form. Then, according to the quality of communication between subcategories, the researcher was able to convert them to a smaller number of categories by combining and organizing the subcategories. In other words, the overall concept that was the resulting sum of these categories (themes) was obtained. To maintain the reliability, content review was done in two stages, one after categories were completed between 10% and 50% and the other one at the end of the work. Then, researcher according to the obtained themes compiled the report about the strengths and weaknesses of the curriculum [ Table 2 ].
Examples of the units of meaning, compressed meaning, and the codes