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Table of Contents   
ORIGINAL ARTICLE  
Year : 2017  |  Volume : 10  |  Issue : 6  |  Page : 1668-1672
A study of the views of bachelor students in operating room on evaluation of clinical performance using paper logbook, Isfahan University of Medical Sciences


1 Department of Operating Room, Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Critical Care Nursing, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 MSc in Nursing, Hojatie Hospital – Head Nurse of Operating Room Ward, Isfahan, Iran
4 Department of Operating Room, Ulcer Repair Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

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Date of Web Publication11-Jan-2018
 

   Abstract 


Introduction: Evaluation is the most efficient way to enhance the quality of education. The quality of education cannot be understood without it. Enhancing the quality of clinical education requires continuous assessment of the current situation, identification of strengths, and correction of weaknesses. The present study aimed to investigate the bachelor students in operating room on evaluation of clinical performance using paper logbook, Isfahan University of Medical Sciences. Methods: In this descriptive cross-sectional study, 60 bachelor students in operating room in the School of Nursing and Midwifery, Isfahan University of Medical Sciences, were selected by simple randomly sampling. The data collection tools were self-made questionnaires. Their validity and reliability were confirmed. Descriptive statistics(frequency, percentage of frequency, mean and standard deviation) was used to analyze the data. Results: About 56.7% of students believed that current logbook did not create necessary motivation of learning for them. According to 58.3% of the students, evaluation based on logbook was not entirely fair. About 63.3% of them fully believed that there was not proper physical space to keep and transport logbook in operating room. According to 70% of them, the contents of logbook were not in accordance with educational objectives. Furthermore, the results showed that 83.3% of students believed that the contents were not designed in an appropriate order in the logbook and 66.3% believed that evaluation with logbook can create stress. Conclusion: The results suggest the need to review the content of the current logbooks, to create more interest through change and variety in evaluation methods. It is recommended to use updated methods such as electronic methods, especially in the operating room environment, to reduce pollution.

Keywords: Evaluation, operating room, paper logbook, students

How to cite this article:
Hosseini M, Irajpour AR, Hayrabedian A, Khusravi M, Rarani SA, Ghadami A. A study of the views of bachelor students in operating room on evaluation of clinical performance using paper logbook, Isfahan University of Medical Sciences. Ann Trop Med Public Health 2017;10:1668-72

How to cite this URL:
Hosseini M, Irajpour AR, Hayrabedian A, Khusravi M, Rarani SA, Ghadami A. A study of the views of bachelor students in operating room on evaluation of clinical performance using paper logbook, Isfahan University of Medical Sciences. Ann Trop Med Public Health [serial online] 2017 [cited 2018 Aug 15];10:1668-72. Available from: http://www.atmph.org/text.asp?2017/10/6/1668/222694



   Introduction Top


Clinical education is one of the critical sections of medical and allied sciences education which plays a major role in building student professional capabilities. Education and learning are vital aspects of working in a clinical setting that lead to the development of knowledge, skill and attitudes. Operating Room students link their theoretical knowledge with skill in such an environment.[1] In Iran, the students receive a bachelor's degree in operating room after 4 years. Operating room is a complex system in which staff, technology, and patients are organized in a physical environment to achieve favorable outcomes in patients.[2] Operating room is considered as risky environment for patients. Some problems that may occur for patient after surgery are in connection with performance merit of operating room staff.[3] Certainly, if this group of people are taught, especially in the area of clinical skills, well, they can play the role effectively. During the period of study, in addition to theoretical instruction, students must gain the ability to function effectively in a real environment. In other words, clinical education should prepare students for playing their clinical role effectively.[4] Evaluation is the most efficient way to enhance the quality of education. The quality of education cannot be understood without it.[5] At each stage of education, particularly clinical education, there is need for evaluation.[6] Evaluating students' learning in clinical environments requires observing students' performance in real environment and it is more difficult than evaluation in a class.[6],[7] Different evaluation tools have been designed to achieve the mentioned objective.One of these tools is an observation, which is a functional test to evaluate educational objectives and learning outcomes in psychomotor-cognitive area and includes logbook, portfolio, and diagnostic-therapy techniques workbook.[8]

Logbook is a simple tool for directing and informing students about educational goals and what skills should be achieved by the end of that period, and it provides the possibility of feedback about the accuracy of practical measured for trainers.[9] In other words, it can be said that logbook is a learner-centered recording tool. In this document, there is a report of formal educational experiences in addition to a list of cases observed.[10]Logbooks, like any other evaluation tool, have advantages and disadvantages, and its advantages can be benefited only if its information is kept up-to-date and tries to reduce students' anxiety.[8] Mohammadi et al. in their study entitled “evaluation method of education and feedback strategy in nursing” showed that logbook is one of the evaluation tools and since it reduces the gap between theory and practice, it can help instructor and student to achieve educational and clinical purposes and also, it can be used to give feedback to students and teachers.[9] In a study by Ghanbari and Monfared entitled “a study of clinical evaluation process based on logbook,” they showed that given the impact of logbook on learning and its greater attention to the details in student evaluation process and little use of it in clinical training, it is better to hold educational workshops for teachers and students involved in clinical training to promote education and also to raise the knowledge and skills required to develop this method better and to implement it practically.[11]

Dolmans et al.in their study showed that based on views of majority of students about logbook, it was not powerful enough to create motivation of learning about the main activities and to give feedback of their performance.[12] In a study of clinical skills in nursing, many issues were raised. This shows different problems in this field. Some of these problems are lack of same tools from year to year and from one period to another, inconsistencies in the evaluation process by clinical instructors, and lack of a proper framework to show students' progress.[13] Amini et al. wrote that evaluation of clinical practice among nursing is often faced with problems including current methods have little credibility in evaluating students' performance and majority of students in nursing believed that clinical evaluation is not able to identify their theoretical and practical knowledge.[14]

Despite similar studies performed in Iran and given that the following reasons: there are different logbooks, instructors, education system, and students at each university unit, promoting the quality of clinical training is important and requires continuous investigation of the current situation and identification of strengths and correction of weaknesses, and in this regard, students are the most important source of availability of information; this study aimed to investigate the views of bachelor students in operating room on evaluation of clinical performance using paper logbook, Isfahan University of Medical Sciences.


   Methods Top


This study is a descriptive cross-sectional research and was conducted in the second semester in 2015–2016, in the School of Nursing and Midwifery, Isfahan University of Medical Sciences. Population included all bachelor students in operation room(n = 108); 60 of them were selected by simple randomly sampling method. Inclusion criteria were the bachelor students in operating room who used logbook to record their clinical activities and consented to participate in research. One of researchers explained the research objectives to participants and drew their consent. The data were gathered by researcher-made questionnaire, consisting of two parts. First part was related to demographic information and second part consisted of 20 questions in the areas of being fair(2 questions), motivation and learning(4 questions), proper physical space for keeping and transporting(3 questions), being stressful(2 questions), being in accordance with the educational goals(3 questions), and good arrangement of content(2 questions). The questions were scored based on 5-point Likert scale(from 1: Completely disagree to 5: Completely agree). Anumber of questions were scored in reverse. Its content validity was confirmed by 10 faculty members of the Department of Operating room and Nursing in the School of Nursing and Midwifery, Isfahan, and its reliability was estimated by calculating Cronbach's alpha(α = 0.84); this confirms the high reliability of the questionnaire.

After data collection and input inSPSS Statistics 19 software (IBM), descriptive statistics(frequency, percentage of frequency, mean and standard deviation) was used to analyze the data.


   Results Top


Since the questionnaires were distributed in person by the researcher, all 60 questionnaires were returned and analyzed, and response rate was 100%. Average age of participants was 23.01±1.57years; 73.33% of them(n=44) were females and 26.67% of them(n=16) were males. About 71.42% and 28.58% of them were single and married, respectively. About 11.67%(n=7), 25%(n=25), and 63.33%(n=38) of them were 4thterm, 6thterm, and 8thterm students, respectively. Their mean GPA(GradePoint Average) was 16.64±0.99.

Nearly, 56.7% of students believed that current logbook did not create necessary motivation for learning. About 58.3% of the students' evaluation based on logbook was not entirely fair. Nearly, 63.3% of them fully believed that there was no proper physical space to keep and transport logbook in operating room. According to 70% of them, the contents of logbook were not in accordance with educational objectives. Furthermore, the results showed that 83.3% of students believed that the contents were not designed in an appropriate order in the logbook and 66.3% of them believed that evaluation with logbook can create stress in them[Table1].
Table 1: Frequency distribution of the views of bachelor students in operating room on evaluation of clinical performance using paper logbook, Isfahan University of Medical Sciences

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   Discussion Top


This study aimed to investigate the bachelor students in operating room on evaluation of clinical performance using logbook at Isfahan University of Medical Sciences. According to 56.7% of students, current logbook did not create necessary motivation of learning for them. Many studies have been performed in this regard in Iran. Logbooks, like any other evaluation tool, have advantages and disadvantages, and its advantages can be benefited only if its information is kept up-to-date and tries to reduce students' anxiety.[8] Using new electronic methods can motivate students to complete the logbooks. In Zahmatkeshan and Amoozgar's study entitled “comparison the medical students' views on evaluation method based on booklet and electronic logbook, in children's ward”, which was conducted on 90 medical students, the results showed increased students' participation and motivation in completing electronic logbook.[15]Talebi et al.'s study evaluated the views of students in physiotherapy and concluded that logbook will improve self-evaluation spirit and participation in educational evaluation. It is not consistent with the result of this study which can be due to the different specific objectives of each logbook.[7]

About 58.3% of students completely disagreed with the fairness of evaluation based on logbook. Asadi Lari et al. in their study showed that the majority of students disagreed and completely disagreed with the fairness of evaluation.[16] This result is consistent with the result of this study. In a study by Talebi et al., 65.2% students believed that logbook was a reasonable and fair tool and evaluation based on it was fair.[7] This result is inconsistent with the result of this study which can be attributed to the differences between the contents of logbook used in their study and the one used at Isfahan University. Nearly, 63.3% of students fully believed that there was no proper physical space to keep and transport logbook in operating room. The results of a study by Talasaz showed that the majority of students(49.9%) assessed clinical equipment and facilities as poor.[17] It is consistent with the result of this study. The results of a study by Salmani et al. showed that 77% of students assessed educational environment as moderate. This result is not consistent with the results of our study and it can due to the different physical spaces of clinical environment at Yazd and Isfahan hospitals. On the other hand, operating room is not a proper place to keep paper logbook because of observing principle of sterility and infection control. According to 66.3% of students(n=40), evaluation with logbook can create stress in them. The study by Hosseini et al. showed that most of the students in midwifery(47.1%) believed that evaluation with logbook creates stress.[18] This is consistent with the result of this study. Having stress in completing logbook can be associated with the concerns about the lack of timely completion,lack of quick access to record the items, possibility of losing logbook, dirtiness of logbook, and so on. Our study showed that 70% of students believed that the contents of logbook were not in accordance with educational objectives. Asadi Lari et al. in their study showed that the majority of students disagreed with the concordance of the contents of logbook with educational objectives.[16] It is consistent with the result of this study.Bahrami, in his study, showed that for the students in anesthesiology, the concordance of the contents of logbook with educational objectives and program was desirable(in average, 74%).[19] This result is not consistent with the result of this study, and this can be due to the different nature of educational objectives in anesthesiology. Furthermore, the results showed that 83.3% of students believed that the contents were not designed in an appropriate order in the logbook. Azizi et al. in their study showed that most of students were satisfied with the order of contents.[20] This result is not consistent with the result of this study and it can be due to the different contents of logbook used in their study compared to the logbook used at Isfahan Hospital. Unwillingness of some students to participate in the study and the limited number of samples can be noted as the limitations of our study which results in cautions in generalizing the results.


   Conclusion Top


Students' satisfaction of using logbook in recording and evaluating clinical performance of bachelor students in operating room in the School of Nursing and Midwifery, Isfahan has decreased. Hence, reviewing and revising different aspects on the contents of the current logbook seems necessary to make students satisfied. It is recommended to put evaluation of the quality of activities on the agenda of this evaluation method because it seems that number-based approach is not enough and competence-based evaluation of skills is more valuable than it. Furthermore, it is recommended that given the advances in technologies, development of electronic logbooks would be motivating factor to students; therefore, measures should be provided to replace paper logbooks with electronic versions.

Acknowledgment

Finally, researchers thank all the students who participated in the present study.

Financial support and sponsorship

The authors would like to thank those who assisted them in this study, particularly. Their special thanks also go to the Nursing and Midwifery Care Research Centre at Isfahan University of Medical Sciences for providing financial support to the authors The present research is based on ID Code:295199 Nursing and Midwifery Care Research Center (NMCR) of Isfahan University of Medical Sciences).

Conflicts of interest

There are no conflicts of interest.



 
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Correspondence Address:
Ahmad Ghadami
Assistant Professor, PhD in Nursing, Ulcer Repair Research Center, Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ATMPH.ATMPH_576_17

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