Development Strategies in Medical Education

Introduction
Clinical education is the most important part of nursing education [1, 2, 3]. Clinical education is a facilitating activity for learning in the clinical environment, during which students gain experiences by being at the patient's bedside and apply the learned concepts in practice. In clinical education, an opportunity is provided for students to transform their theoretical knowledge into various mental, psychological and motor skills that are necessary for patient care [4]. The evaluation of clinical skills is considered one of the most important aspects of medical student evaluation [5]. Applying new educational techniques, increasing the productivity, and improving efficiency are the goals pursued by all educational settings in the world, especially medical universities [6]. Considering the importance of clinical education for medical students and the knowledge of using logbooks, and given the lack of research on the perceptions of medical students in this field, the present study aims to survey the perceptions of medical students regarding the use of logbooks in the clinical departments of teaching hospitals in Jahrom, Iran.

Methods
This descriptive cross-sectional study was conducted in 2023 on 94 medical students from Jahrom University of Medical Sciences who had a log book during their internship in clinical departments. They were selected by a census method. A logbook was designed and compiled separately based on the heading provided by the ministry of health and according to the educational needs of students in clinical departments, tailored to meet the goals of each department. The data collection tools included a sociodemographic form (surveying age, gender, local/non-local student, place of residence, marital status, educational level) and a questionnaire measuring the quality and necessity of the logbook. It consists of 36 items that surveys the perceptions of students in three areas: the necessity of using logbooks (8 items), the quality of the logbook content (21 items), and outcomes of using logbooks (7 items). The items were rated on a three-point Likert scale as yes (3 points), to some extent (2 points), and no (1 point). The total score ranges from 36 to 108. The validity and reliability of the questionnaire was confirmed in Najafi et al.'s study [20]. Data analysis was done in SPSS software, version 21 and using descriptive statistics (mean, standard deviation, frequency, percentage) and inferential statistics. The significance level was set 0.05.

Results
Out of 94 participants, 41.5% were students, 41.5% were externs, and 17.0% were interns. Most of them were under 25 years old (60.6%) and single (67%). Also, 69.1% were female and the rest were male. The mean total score of medical students' opinion about the logbook was 46.5±26.16 (out of 100), which is below the average level (cut-off point of 50). Their scores about necessity, quality, and outcomes of using logbooks were also below the average level. The results of the non-parametric test showed that medical students' opinions about the use of logbook in clinical departments was not significantly different based on the sociodemographic characteristics (P>0.05).

Conclusion
The purpose of this study was to survey the opinions of medical students regarding the use of logbook in the clinical departments of teaching hospitals affiliated to Jahrom University of Medical Sciences. The results showed that their opinions were below the average level. To improve the situation, it is necessary to pay special attention to the design and format of logbooks, the necessity of using the logbooks, and the quality of the logbook content.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Jahrom University of Medical Sciences (Code: IR.JUMS.REC.1402.080).

Funding
This study was funded by Jahrom University of Medical Sciences.

Authors' contributions
The authors contributed equally to preparing this article

Conflicts of interest
The authors declare no conflict of interest.

Acknowledgements
The authors would like to thank the Clinical Research Development Unit of Peymanie Hospital in Jahrom city for their cooperation.


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