Development Strategies in Medical Education

Introduction
In the field of education, there are many criteria, the most important of which is the evaluation system [1], which is based on evidence of how the target population has demonstrated its activity [2]. In other words, the goal of this system is to determine the advantages and disadvantages of the implemented educational programs in order to repair, provide alternative programs, or continue the programs [3]. Considering the importance of education and its role in development, it should be done with great attention [4]. Educational programs are important due to their great role in improving the professional, scientific, and communication skills of people in society [5]. Evaluation in education is a judgment of the value of educational phenomena [6], and its most important role is to evaluate students’ performance in various fields and also the organizational structure of educational systems [7]. As a result, if it is done correctly, higher education organizations can introduce more efficient and specialized workers to society [7].
Basic sciences field of study is the primary field of study for every student in the medical sciences universities [10, 11, 12, 13]. This field of study can be challenging for some medical students and even reduce their previous interest in medical sciences [16-18]. Unsuccessful students in this field can suffer from a decline in clinical practice and self-confidence to treat patients in teaching hospitals [19], which finally leads to their academic failure in the clinical course [20]. This failure causes problems in their future career as well, which can increase the risk of medical errors (for example, prescribing wrong drugs) [21-23]. Medical errors can damage the health of society and increase health costs [23]. The present study aims to evaluate the educational performance of basic sciences students in Semnan University of Medical Sciences (SUMS) in Iran. DSME$#hums@123

Methods
This is a cross-sectional study that was conducted in 2021. All the students of SUMS, who participated in the basic science comprehensive exam from 2011 to 2020, were selected by the census method (n=316). Their data were analyzed in SPSS software, version16 using descriptive statistics, multiple regression analysis, and analysis of variance (ANOVA). The Pearson correlation test was also used to measure the relationship between the evaluation scores in different years. P<0.05 was considered as statistically significant.

Results
The highest number of participants was related to those who had exams in September 2017 (n=32), and the lowest number was related to those in September 2016 (n=3). The best status was related to those in March 2017 (Average grade: 145), and the worst was related to those in September 2017 (Average grade: 100). Overall, the average grade of students in the March exam (128.8) was better than the average grade of September exam (114.2), and the average grade of students in the first 5 years (125.7) was better than in the second 5 years (117.1).
The highest grades were observed in the courses of pathology, bacteriology, physiology, and immunology, while the lowest grades were observed in the courses of medical physics, embryology, and public health. The results showed a weak to moderately positive correlation between the average grades in the basic science comprehensive exam in different years, and this correlation was statistically significant (P=0.023). The highest correlation coefficient was between students’ average exam grades in years close to each other.
The results of repeated measures ANOVA on the average grades of the comprehensive basic sciences exam showed that the educational performance of students had not changed significantly during ten years. In this regard, we used another method for analysis. First, based on the type of courses, the grades were divided into two groups of September and March. The repeated analysis of variance test results with the interaction of the exam time and the average exam grade showed that the educational performance of the students in different years and in the two groups of September and March had a logical trend; the test results between September and March groups (F=1.40, P=0.18) and considering the interaction of exam time and exam grade (F=1.23, P=0.19) were not significant.

Conclusion
The findings of this study showed a relatively variable trend in the grades of basic sciences students of SUMS. Consistent with our results, Haghdoost’s study [27] on medical students of Kerman University of Medical Sciences from 1995 to 2003, women were more successful in all courses except for the national comprehensive exams. Although the internal correlation of male students’ grades was more than that of females, the grades of males in specialized basic science courses were more related to their basic sciences grades. In our study, the highest grades were observed in the courses of pathology, bacteriology, physiology, and immunology. One of the reasons for this can be the higher importance of these courses for the students. The lowest grades were observed in the courses of medical physics, embryology, and public health. Another result was the relative uniformity of grades in the ten-year period. One of the reasons for this can be the fact that the teachers of basic science courses in SUMS had not been changed during this period, such that in courses such as bacteriology and immunology, for which the teachers had been changed, a diverse trend was observed. The officials of the SUMS are recommended to identify students’ progress or regress in different basic sciences courses. Also, the long-term evaluation of students’ educational performance at other universities is recommended.

Ethical Considerations
Compliance with ethical guidelines
In this study, there were no experiments on human and animal samples; therefore, there was no need for ethical considerations and IRB code.

Funding
This article was extracted from a research proposal and was funded by Semnan University of Medical Sciences (Grant No.: 642).

Authors' contributions
Design, writing and editing: Mohammad Mirzayikhah; Data collection, initial draft preparation, and methodology: Hamed Rezaee;  Writing: Alireza Javadi; Data analysis and interpretation: Samira Mehralizadeh and Alireza Dehdashti; Data collection: Sajad Heshmati Far.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank the officials of the Faculty of Medicine, University Research Council, and Student Research Committee of Semnan University of Medical Sciences for their cooperation.


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