The Efficiency of Medical Extern's Logbook from the Viewpoints of Externs and Faculties of Mashhad University of Medical Sciences: An Integration of Qualitative and Quantitative Methods

Introduction: As an instrument for supervising and directing teaching-learning procedure of learners, logbooks were developed and put into practice according to national educational objectives. This study was performed to determine the efficiency of externs’ educational logbooks. Methods: This descriptive evaluation study was performed in year 2012 in Mashhad Faculty of Medicine. Three study instruments included a 4-point Likert scale questionnaire, 3 multiple-choice questions, and 3 open-ended queries designed in Educational Development Office of faculty of medicine. Instruments’ validity and reliability was approved using content analysis and internal consistency methods (α= 0.91). Sample size was calculated by pilot study, 84 externs, and 51 faculties. Initially, 8 clinical groups were randomly selected, and then the questionnaire for completing sample size was given to faculties and externs. Ordinal and nominal data were reported using descriptive methods and analyzed by JMP4 software using chi square. Qualitative data were analyzed using summative content analysis method. Results: Seventy one externs (83%) and 40 faculties (81%), reported logbook’s information accuracy less than 60% averagely. Twenty five faculties (49%) believed that logbooks must have its own score as a document indicating student’s in-ward activity. This is while 43 students (51%) believed that this could lead to increasing registration of feigned information. Concerning achievement in 14 expected objectives, externs evaluated logbooks to be significantly less effective compared to the extent to which faculties did (p<0001). Systematically approaching this process, qualitative findings in areas of modality, structure, implementation, and outcome showed that students did not substantively object use of logbook. In fact they opposed the structure and the way in which logbook was used. Conclusion: Evaluation of procedures and outcomes of using logbooks for directing teaching-learning process showed that executive shortcomings have prevented the fulfillment of expected objectives. Further justification for teachers and learners as well as content and procedure revision is needed.