Results: Overall satisfaction with clinical education was 38.8%; outpatient and bedside teaching 52% each and theoretical education 70.8%. Overall satisfaction had a significant association with approach to common and epidemic diseases, class size, and the course planning.
Conclusion: Based on the present study, we conclude that clinical education should be reevaluated in our university with the specific attention to the class size, variety of diseases and course planning considered for each session in clinical education.
Although job satisfaction has been amply studied, literature on satisfaction with clinical education is quite limited.
Some theories such as career theory have been used to explain how occupational and psychological variables can influence attitudes toward careers.
Since the students' satisfaction has been associated with their later professional attitudes, career commitment and retention, professional education faculties should be concerned with students' satisfaction as an outcome of the educational process.
Elements of job satisfaction can be categorized into three domains: i.e. personal, interpersonal, and organizational.
Personal domain is considered as an individual's character and it is defined as specific characteristics that are related to the students (e.g. life satisfaction, self-esteem).
Relationship between the student and the clinical instructor is categorized into interpersonal
domain.
The characteristics of clinical education that might influence satisfaction are categorized
as an organizational domain, which are included number of teachers, patients, educational methods, and the practical skills that the students learn.
There are few studies that evaluate the effect of different factors in these three domains clearly, but some of these factors were evaluated unclassifiable in several
different studies.
It has been shown that autonomy, variety, the availability of learning opportunities, being supervised by more than one supervision and use of institutionalized methods of orientation increased satisfaction.
Models that predict job satisfaction are not appropriate to evaluate student satisfaction.
Clinical experiences for medical students are not the same as jobs, and the role of a student in clinic is not the same as that of an employee. Unlike typical employees,
students are located at facilities temporarily.
Students typically are not paid and, therefore, do not have the same rights and privileges, or work expectations as employees. Student often complete their experiences
at clinical sites, which are not the places they usually choose for regular employment.
Although the above mentioned are between student's experiences and
employment, we can design a model for predicting satisfaction with clinical experiences from combining some of the variables that predict job or career satisfaction.
Although medical students and other students in the health care professions appear to be satisfied with their clinical practices and learning, the elements that contribute to this satisfaction aren't well known.
On the other hand, changes in health care system in Iran from 1994 have had an enormous impact on the medical education, students, instructors and health
care workers satisfaction.
For some years, evaluation of medical teaching has been demanded in our university. Thus, we designed a questionnaire study at Tehran University of Medical
Sciences to assess the medical student's satisfaction with clinical education during their medical internship.
We studied the separate effects of variables in the organizational domain, as well.
Methods
This was a cross sectional descriptive analytic study, which was conducted in 2000, at Tehran University of Medical sciences.
Subjects were medical students during their medical internship (the last two
years of sixth and seventh year medical students).
Assuming the previous available study that students' satisfaction with clinical education was 40%, the calculated sample size was 250.
After explaining the study design and objectives, we obtained students’
verbal consent.
This study was approved by the faculty of medicine (Tehran University of Medical Sciences).
We used a questionnaire based on job satisfaction (Appendix 1).
The clinical education was classified into three categories including: outpatient, bedside
and theoretical teaching.
In addition, the students' satisfaction of the way that they were tested for clinical
skills was also assessed.
The students' satisfaction with clinical education was classified into; completely,
partial and none.
Students who were satisfied completely or partially with clinical education were
considered satisfied and those who didn't express satisfaction with their education were defined as unsatisfied ones.
Furthermore, the elements of satisfaction were ranked according to scores given by students in this study (the most important factor scored 1, while the least important factor scored 7 for outpatient training and bedside teaching variables and
score 5 for theoretical education variables).
The students recorded their age, the living state (dormitory or no dormitory), their gender and maritalstatus.
We felt the questionnaire has face validity based on the use of similar questions in previous studies, and the elements that we considered as affective factors on clinical education in three different domains, were those which were considered as the
most important elements in clinical education by an expert committee in the Tehran University of Medical Sciences.
The statistical package for the social sciences (SPSS version 9) was used for statistical analysis.
The relation between satisfaction of outpatient training, bedside teaching, theoretical education and variables was analyzed by chi square.
Manthel Haenzel Chi square was computed whenever indicated.
P values equal to or less than 5% were considered significant.