Open Access

Designing a psycho-educational cohort system in Shiraz Medical School

Arash Mani[1], Mitra Amini[2], Mohammad Mahdi Sagheb[2], Javad Kojuri[2], Hamidreza Mirzajani[2], Kamran Bagheri Lankarani[3]

Institution: 1. Cognitive Neuroscience Research Center for Psychiatry and Behavioral Science, Shiraz University of Medical Sciences, Shiraz, Iran, 2. Clinical Education Research Center,Shiraz University of Medical Sciences,Shiraz,Iran, 3. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Corresponding Author: Dr Mitra Amini ([email protected])
Categories: Students/Trainees
Published Date: 24/10/2018
Keywords: cohort; education; psychology; medical students


Dear Sir,

We read with great concern the article written by Harden et al (Harden 2018), describing the improvement in medical education over the past 4 decades. An analysis of papers published in the medical teacher journal has identified four trends in medical education: better collaboration, more international education, student involvement in the educational process and a change to evidence-based view in medical education. These changes over the years have been dramatic; however, Professor Harden declared that changes over the last decades in how students learn are few when matched to the changes that have occurred in the practice of medicine. (Harden 2018).We believed that one of the reasons for this slow change may be due to less emphasis on the relation of psychologic factors and learning in the medical education field. It seems essential to have an emphasis on psychology and learning theories as reported by Young et al. (Young 2014). There are several other possibilities; including a change in attitudes of the medical school entrees as well change in their driver for entering the field of medicine, the more technology-based medicine which has eroded the patient and physician relationship and increasing cost of the care.  In the last four years, we designed a psycho-educational cohort system in Shiraz Medical School because we think that considering the student development might be a valuable variable in predicting any success during the lifespan. All new medical students of the mentioned years were included, and their educational background was compared to their progress in the field and study would be continued until their specialty training and their final career. We also focused on the Early Maladaptive Schema (EMS) and it’s relation to academic achievement. In one part of the cohort system, 210 medical students in Shiraz Medical School from the year 2013 participated in our study (53% male & 47% female). They completed a valid and reliable Young Schema Questionnaire-short form- YSQ-SF at the beginning of the medical school and without any intervention during the course of basic science they were observed and their academic score in each semester registered as academic achievement. Finally, stepwise regression used to predict academic achievement and failure via EMS domains. (Yousefi 2010). The results showed that among five schema domain which is presented by  Younge as Disconnection and Rejection; Impaired Autonomy and performance; Impaired Limits; Other directedness and Over vigilance, only   Impaired Autonomy and performance and Other directedness entered the regression model and predicted academic achievement significantly in reverse ( negative). It means that the participant who got the higher score in these domains were vulnerable to poor self-esteem and prefer others demands to him/herself. Nowadays in the field of medical education, it is important to focus on individualizing the learning to the individual needs of the students, so it seems necessary to consider psychosocial issues and other important factors that are related to learning.

Take Home Messages

  • Designing psychoeducational cohorts in all medical schools help educators to understand how different factors affect students' learning.

Notes On Contributors

Dr. Arash Mani is an Associate Professor of Psychology and Cognitive Neuroscience Research Center for Psychiatry and Behavioral Science in Shiraz University of Medical Sciences. His interest is in the field of psychology and medical education.(ORCHID ID:https://orcid.org/0000-0002-6682-8957).

Dr. Mitra Amini is a full Professor of Community Medicine and Clinical Education Research Center in Shiraz University of Medical Sciences. Her interest is in the field of medical education and medical education research.(ORCHID ID:https://orcid.org/0000-0002-7332-5151).

Dr. Mohammad Mahdi Sagheb is a full Professor of Internal Medicine and Clinical Education Research Center in Shiraz University of Medical Sciences. His interest is in the field of internal medicine, nephrology, and medical education. (ORCHID ID:https://orcid.org/0000-0002-4493-5735).

Dr. Javad Kojuri is a full Professor of Cardiology and Clinical Education Research Center. His interest is in the field of cardiology and medical education. (ORCHID ID:https://orcid.org/0000-0001-8909-897X).

Dr. Hamidreza Mirzajani is MD, working at Education office. His interest is in the field of medical education.

Dr. Kamran Bagheri Lankarani is a full tenured Professor of Internal Medicine and Health Policy Research Center in Shiraz University of Medical Sciences. His interest is in the field of internal medicine and health policy research. He also interested in medical education research. (ORCHI ID:https://orcid.org/0000-0002-7524-9017).


The authors thank all Shiraz Medical School Students for their valuable contribution.


Harden RM, Lilley P, McLaughlin J. (2018), 'Forty years of medical education through the eyes of Medical Teacher: From chrysalis to butterfly'. Med Teach, 40:4, 328-330. https://doi.org/10.1080/0142159X.2018.1438593

Young JQ, Van Merrienboer J, Durning S, Ten Cate O. (2014), Cognitive load theory: Implications for medical education: AMEE Guide No. 86. Med Teach 36:371–384. https://doi.org/10.3109/0142159X.2014.889290

Yousefi N, Shirbagi N. (2010), 'Validating the Young Early Maladaptive Schema Questionnaire (YEMSQ) among Students'. Iranian Journal of Psychiatry and Behavioral Sciences (IJPBS),4(1): 38-46.




There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (https://creativecommons.org/licenses/by-sa/4.0/)

Ethics Statement

The ethical approval was done by ethics' committee of Shiraz University of Medical Sciences with ethical code number: IR.SUMS.REC.1391.6057.

External Funding

This paper has not had any External Funding


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Ken Masters - (04/06/2019) Panel Member Icon
The letter refers to changes in medical education, and the design and implementation of a psycho-educational cohort system at Shiraz university.

Although it appears that the authors have established something worthy of being described, it is a pity that the authors have confined themselves to writing a brief letter on the topic. Doing this restricts the authors from explaining properly what is meant by a psycho-educational cohort system, and also from giving the required amount detail about their project. It is, therefore, not possible to give a fair appraisal of their work, not of the letter’s contribution.

I would strongly urge the authors write a proper, full-blown research paper on the topic, so that the readers can have the benefit of reading of the project’s details. I would look forward to reading such an article.
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Richard Hays - (05/11/2018) Panel Member Icon
It may be risky yo enter a space between two opinions, but the authors raise some interesting issues that merit comment. I found this article confusing, because I am not sure that I understand what 'psycho-educational support' is. Perhaps the authors could clarify this? I would agree that the behavioural sciences can make two substantial contributions to medical education. The first is as part of the foundation for medical practice, as doctors need to understand and work with individuals, organisations and society as a whole. The second is in understanding how students develop into experienced professionals, dealing along the way with what life throws at them. I am not familiar with the survey instrument, but the results are interesting, although from only one medical university and with no comparison with the general population (matched for age). Also, what does this mean for medical education? I am not sure that personalised learning is the only answer. Further elaboration of these issues may have merited an additional star.
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I am the editor of MedEdPublish