Introduction:

Universities must train students who are able enough to prevent, treat and enhance health in the community. Students acquire required knowledge and information in theoretical classes in order to having maximum efficiency, and gain necessary capabilities in clinical settings by practice and experience (1).

Ironside et al (2010) classified barriers of effective clinical education in five important factors: loss of qualified clinical settings, lack of experienced faculties, ratio of faculty to students, difficulties related to students number, negative modeling of clinical settings and students who are working in different policy get exposed to various clinical settings (2).

Clinical settings play an essential and key role in students' learning (3), as it gives them the opportunity to work with clients and deal with the real problems. Furthermore, clinical settings are suitable for applying students' knowledge in practice and development of psychomotor skills (4). Clinical teachers play a fundamental role in quality of students' clinical learning. Conducted studies

indicate that there are problems such as underrate the clinical training, lack of availability of sufficient numbers of clinical teachers, lack of proper coordination between clinical training of faculty and practice facilities at the hospital, etc (5).

Vallent et al declared that students' learning in clinical education setting is an essential component of teaching and helps the students to link theory with practice at the bedside (6).

In recent decades, it is felt to revise traditional teaching methods and use of modern and active methods of learning by educational systems and the application of these methods in various fields including medical sciences expanded (7).

Various teaching methods have different outcomes and functions. Study the effectiveness of teaching methods has been the focus of education professionals in higher education for more than half a century. Teaching behavior reflects the beliefs and values of the teacher to the learner in the teaching and learning activities (8, 9).

The learning rate and learners' behavior are also affected by the interaction of learners with learning environments, teaching methods and their expectations of what happens during the learning (9, 10). One way to improve education is to determine the effect of teaching methods on student success and teaching efficiency in faculties. Nowadays, it is emphasized to change from traditional teaching methods to new methods that make students' active learning. Besides teachers' interest in improvement of student achievement and assessment teaching quality has increased (11, 12). So, the present study aimed to investigates the effect of holding special training rounds on performance of pediatric residents.

Methods:

This quasi-experimental study was conducted on all residents of Pediatric Gastroenterology Department in Ghaem Hospital of Mashhad, Iran. Sample size was 30 residents determined by census. Written informed consents were obtained from all participants. The residents were randomly allocated into two groups case (n=15) and control (n=15). In control group, the residents were tested with a 65-question specific taxonomy pretest (20% difficult questions, 40% moderate questions, 20% simple questions, 10% very easy and 10% very difficult questions) at entry time to Department of Pediatric Gastroenterology. Then, at the end of this period, the residents were tested with a 65-question specific taxonomy posttest (the questions were matched and were almost identical with pretest).

The method was implemented in the intervention group; the residents were tested with a 65-question specific taxonomy pretest at entry time to Department of Pediatric Gastroenterology. Then they received a period of one month of special training rounds by professors besides to conventional general rounds (Trainee-Intern and Resident). Special training round was one hour training a day by professors with training methods including Question-Answer, problem-solving, lecture).

Finally, at the end of this period, the residents completed a 65-question specific taxonomy posttest (the questions were matched and were almost identical with pretest).

Validity of used questionnaires were confirmed by four faculties of Pediatric Gastroenterology department and their reliability confirmed by test retest (r=0.84).

Data were analyzed using SPSS 13 and descriptive (mean ± S.D) and analytic (independent T test) statistical tests. P < 0.05 was considered significant.  

Results:

15 residents participated in each group. 100% of all residents in case group were satisfied with training round. Demographic characteristics such as age and gender were not significantly different between two groups (P < 0.05). 60% of participants were female.

According to the findings, mean scores of control residents were as followed: pretest 37.9+5.1 and post-test 55.2+7.0 (P >0.05). Mean scores of intervention residents were as followed: pretest 37.5 +3.7 and post-test 65.6 +6.7 (P<0.05) (Table 1). There was a significant increase in residents' scores after holding a training round (P<0.05) (Table 2).

Tables 1- Mean of pretest- posttest score in pediatric residents in two groups

Tables 2- Mean difference of residents' scores after holding special round 

Discussion:

Nowadays, teachers investigate teaching methods which enable students to learn actively (13).

Experts believe that teaching and learning of medical sciences at all levels requires educational planning, experienced teachers, suitable educational environment and required technical equipment and facilities. Mentioned factors interact with and influence on each other. The purpose of clinical teaching is to get competencies and professional skills in order to guarantee the quality of care provided with graduates of medical professionals for various patients. Hence, the clinical competence has been proposed as a key element in providing medical and nursing care (14). Clinical competence is to provide necessary cares in accordance with professional standards of performance (15, 16).

The present study showed that holding special educational round has had a positive effect on enhancing learning and satisfaction of residents. Lander believes that a solution to eliminate the gap between education and practice is the presence of effective teachers in the learning environment who use their time the best way in clinic to educate the students and integrate theoretical knowledge with practical skills (17).

Karimi Munaghi (2010) emphasized the use of a model for clinical teaching by teachers. He also defined components of modeling for a clinical teacher as a clinical instructor should be competent in carrying out the procedures and show his efficiency and self-confidence at the bedside. He must have a professional behavior and show a sense of professionalism with the students (18).

Anbari et al (2010) also introduced applying educational policies based on experience and learning objectives of students, formative assessments continuously throughout the course, and provide effective and timely feedback to students, as the most effective strategies in order to enhance the quality of medical education and growth capabilities (19).

The present study showed that the residents were satisfied with this educational round and they know it effective in enhancing their learning. Richardson also believes that the essential key of effective teaching method is active participation of learner in learning process (20). Furthermore, active learning of students makes learning more enjoyable for student, causes more motivation and finally makes deep learning (21).

Schaefer et al believed that effective teaching requires teachers change teacher-centered teaching to student-center approach. This innovation causes students' indecency in learning and helps to develop creative skills in Problem-Solving and Critical Thinking (22).

Conclusion:

The findings confirmed the efficacy of special training round on achievement and increase of residents' satisfaction with learning in Pediatric Gastroenterology Department. So it is proposed to increase residents' learning by a goal-based training with coordinating teachers in addition to the general round.

Acknowledgements

The authors would like to acknowledge all professors and residents who participated in this study.