Quality assessment of clinical education services in teaching hospitals located in Kerman, Iran

Authors

  • Mohammadreza Amiresmaili Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

Keywords:

SERVQUAL, clinical education, quality assessment, teaching hospital, Iran

Abstract

Introduction: Clinical education is one of the most important components of the resource generation function of health systems, and it has a very important role in graduates' competency with respect to effective, practical education. This study aimed to assess the quality of clinical services in Kerman’s teaching hospitals located in southeastern Iran.

Methods: This cross-sectional study was conducted in 2011 on 303 medical students at different levels of medical education at Kerman’s teaching hospitals. A modified SERVQUAL instrument was used to collect the data after its validity and reliability were checked. The data were analyzed by SPSS 18.0 using the paired t-test, Kruskal-Wallis, and post hoc tests, when appropriate. 

Results: In all five dimensions of quality, gaps were observed between students’ perceptions and expectations as follows: Assurance (mean = -1.18), Responsiveness (-1.56), Empathy (-1.4), Reliability (-1.27), and Tangibles (-1.21). There was a significant difference between the quality perceptions and expectations of the medical students (p < 0.001). A significant difference was observed between three educational levels, including externships, internships, and assistantships regarding the dimensions of the quality gaps (p < 0.001). 

Conclusion: The clinical services provided by teaching hospitals in the study did not meet the students' expectations at any of the three educational levels. As we precisely assessed the dimensions and items that had the higher quality gaps, it was apparent that, for most part, clinical education officials could improve the quality by designing interventions, which would not be very difficult to do.

References

Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, et al. Human resources for health:

overcoming the crisis. Lancet 2004; 364 (9449): 1984-90. doi: 10.1016/S0140-6736(04)17482-5

Margolis PA, Lannon CM, Stuart JM, Fried BJ, Keyes-Elstein L, Moore DE. Practice based education to

improve delivery systems for prevention in primary care: randomised trial. BMJ 2004; 328 (7436): 388.

doi: 10.1136/bmj.38009.706319.47. PMID: 14766718, PMCID: PMC341391

Biggs J. The reflective institution: Assuring and enhancing the quality of teaching and learning. High Educ

; 41: 221-38. doi: 10.1023/A:1004181331049.

Measuring Quality and Performance in Higher Education. Qual High Educ 2001; 7 (1): 47-54. doi:

1080/13538320120045076

Tan KC, Kek SW. Service quality in higher education using an enhanced SERVQUAL approach. Qual

High Educ 2004; 10 (1): 18-24. doi: 10.1080/1353832242000195032

Mehrdad R. Health system in Iran. JMAJ 2009; 52 (1): 69-73.

Azizi F. The reform of medical education in Iran. Med Educ 1997; 34 (3): 159-62. doi: 10.1111/j.1365- 2923.1997.tb02559.x

Clewes D. A Student-centred Conceptual Model of Service Quality in Higher Education. Qual High Educ

; 9 (1): 69-85. doi: 10.1080/13538320308163

Tam M. Measuring Quality and Performance in Higher Education. Qual High Educ 2001; 7 (1): 47-54. doi:

1080/13538320120045076

Hill Y, Lomas L, Macgregor J. Students' perceptions of quality in higher education. Quality Assurance

Educ 2003; 11 (1): 15-20. doi: 10.1108/09684880310462047

Elliott KM, Shin D. Student Satisfaction: An alternative approach to assessing this important concept. J

High Educ Pol Manag 2002; 24 (2): 197-209. doi: 10.1080/1360080022000013518

Distler JW. Critical thinking and clinical competence: Result of the implementation of student-centered

teaching strategies in an advanced practice nurse curriculum. Nurs Educ Prac 2007; 7 (1): 53-9. doi:

1016/j.nepr.2006.08.003. PMID: 17689424

Worrell JA, Profetto-McGrath J. Critical thinking as an outcome of context-based learning among post RN

students: A literature review. Nurs Educ Today 2007; 27 (5): 420-6. doi: 10.1016/j.nedt.2006.07.004.

PMID: 16945453

Ozturk C, Muslu GK, Dicle A. A comparison of problem-based and traditional education on nursing

students’ critical thinking disposition. Nurs Educ Today 2008; 28 (5): 627-32. doi:

1016/j.nedt.2007.10.001. PMID: 18054412

De Oliviera OJ, Ferreira EC. Adaptation and application of the SERVQUAL scale in higher education.

POMS 20th Annual Conference; 2009 May 1-4; Orlando, USA; Florida; 2009.

Parasuraman A, Berry LL, Zeithaml VA. SERVQUAL: a multiple-item scale for measuring consumer

perceptions of service quality. J Retailing 1988; 64 (1): 12-40.

Rahim Khanli M, Daneshmandi H, Choobineh A. The students’ viewpoint on the quality gap in educational

services. J Adv Med Educ Prof. 2014; 2 (3): 114–9. PMID: 25512931, PMCID: PMC4235544

Kwan P, Ng P. Quality indicators in higher education–comparing Hong Kong and China’s students. Manag

Audit J 1999; 14 (1/2): 20-77. doi: 10.1108/02686909910245964

Oldfield B, Baron S. Student perceptions of service quality in a UK university Business and management

faculty. Qual Assur Educ 2000; 8 (2): 85-95. doi: 10.1108/09684880010325600

Ladhari R. A review of twenty years of SERVQUAL research. International Journal of Quality and Service

Sciences 2009; 1 (2): 172-98. doi: 10.1108/17566690910971445

Karydis A, Komboli-Kodovazeniti M, Hatzigeorgiou D, Panis V. Expectations and perceptions of Greek

patients regarding the quality of dental health care. Int J Qual Health Care 2001; 13 (5): 409-16. doi:

1093/intqhc/13.5.409. PMID: 11669569

Aghamolaei T, Zare Sh. Quality gap of educational services in viewpoints of students in Hormozgan

University of medical sciences. BMC Medical Education 2008; 8: 34. doi: 10.1186/1472-6920-8-34.

PMID: 18564413, PMCID:PMC2442591.

Kebriaei A, Roudbari M. Quality gap in educational services at Zahedan university of medical sciences:

students viewpoints about current and optimal condition. Iranian Journal of Medical Education 2005; 5 (1):

-60. [In Persian]

Barnes BR. Analysing Service Quality: The Case of Post-Graduate Chinese Students. Total Quality

Management & Business Excellence. 2007; 18 (3): 313-31. doi: 10.1080/14783360601152558

Garakyaraghi M, Sabouri M, Avizhegan M, Ebrahimi A , Zolfaghari M. Interns’ viewpoints on assistants

teaching status in Esfahan University of Medical Sciences. Iranian Journal of Medical Education 2007;

(2): 361-9. [In Persian]

Tavakol M, Murphy R, Torabi S. Medical Education in Iran: An Exploration of Some Curriculum Issues.

Med Educ Online 2006; 11 (5): 1-8. doi: 10.3402/meo.v11i.4585

Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002; 287: 226-35. doi:

1001/jama.287.2.226.

Volpp K, Grande D. Residents’ Suggestions for Reducing Errors in Teaching Hospitals. NEJM 2003; 348

(9): 851-5. doi: 10.1056/nejmsb021667. PMID: 12606742

Nip IL, Haruno MM. A systematic approach to teaching insertion of a central venous line. Acad Med 2000;

: 552. doi: 10.1097/00001888-200005000-00083. PMID: 10824835

Nadel FM, Lavelle JM, Fein JA, Giardino AP, Decker JM, Durbin DR. Teaching resuscitation to pediatric

residents: the effects of an intervention. Arch Pediatr Adolesc Med 2000; 154 (10): 1049-54. doi:

1001/archpedi.154.10.1049. PMID: 11030858

Nekoei-Moghadam M, Amiresmaili M. Hospitals of Kerman University of Medical Sciences, as a tangible

example of a developing country. Int J Health Care Qual Assur 2011; 24 (1): 57-66. doi:

1108/09526861111098247. PMID: 21456498

Tabarraei M, Mohebi S. Assessing the Quality of Educational Services from the Viewpoint of Medical

Students of Islamic Azad University of Qom based on SERVQUAL Model- 2013. Arch Hyg Sci 2014; 3

(2): 50-8.

Published

2022-03-08