BACKGROUND: Learners have various processing and understanding of the environment and issues and choose different strategies for problem-solving considering learning and studying approaches. The purpose of this study was to examine medical students’ learning approaches and their association with academic performance and problem-solving styles. MATERIALS AND METHODS: This study was conducted using the descriptive-correlational method. The statistical population comprised medical students of Iran University of Medical Sciences during the academic year of 2019–2020. Of them, 168 subjects were chosen based on simple random sampling and Morgan Table. Study tools include the Standard Approaches and Study Skills Inventory for Students (ASSIST) Questionnaire, which includes 18 items and a Likert five-choice spectrum, and includes a deep, superficial, and strategic approach. Its reliability was determined by Cronbach's alpha of 0.81. Problem-Solving Style Questionnaire developed by Cassidy and Long was used. This instrument included 24 items and 6 components, and its reliability equaled 0.83, which was their grade point average. Data were analyzed using normality tests, paired t-test, Pearson correlation coefficient, and regression through SPSS 16 software. RESULTS: Results implied the positive and significant relationship between deep-strategic approaches, problem-solving styles, and academic performance of medical students ( P < 0.001); furthermore, there was no significant difference between learning approaches based on gender ( P > 0.001), while there was a significant difference between two groups in terms of problem-solving styles ( P < 0.001). CONCLUSION: Because deep and strategic approaches predict academic performance and problem-solving styles, the diagnostic assessment must be done at the beginning of the educational process to determine the type of learners’ approaches. Such an evaluation can be used to implement instructional strategies and educational designs to improve the academic performance of students.
BACKGROUND: Clinical decision-making is not only stressful to physicians, but also to patients and even their companions. Thus, managing uncertainty in clinical decision-making is essential which requires knowing its origins. Therefore, this study aimed to understand determinants of uncertainty in clinical decision-making from the perspective of clinical physicians. MATERIALS AND METHODS: This is a qualitative study which is done during October to November 2020. An in-depth interview is performed with 24 specialists of clinical groups including obstetrics, surgery, internal medicine, and pediatrics, working in teaching hospitals affiliated to Iran University of Medical Sciences. All the interviews were recorded, transcribed and analyzed according to the steps suggested by Graneheim and Lundman. The interviews were analyzed through comparative method. Then, the interviewer created initial codes, categories, and key concepts and sent them to fourteen physicians for member check. RESULTS: According to the participants’ view, determinants of uncertainty in clinical decision-making consisted of three themes: individual determinants, dynamics of medical sciences, and diagnostic and instrumental constraint. Individual determinants can be related to the physician or patient. The dynamics of medical sciences could be explained in two categories: variation of medical science and complexity. Diagnostic and instrumental constraint category could be also explained in subcategories such as lack of efficient diagnostic tests and unknown etiology. CONCLUSION: To curb uncertainty, the more accessible way is considering interventional programs with a focus on individual determinants related to physicians, such as strengthening doctor–patient relationships, and considering related mandatory retraining courses to reduce insufficient knowledge of physicians.
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