Masumeh Saeidi Medical Education Bulletin 2783-1809 7 2 2026 12 01 From Household Environmental Pollutants to Clinical Education: The Need to Incorporate Exposure History-Taking into Medical Education Curricula 1331 1335 251662 10.22034/meb.2026.599165.1140 EN Zahra Rezaei Borojerdi Medical Oncologist, Hematologist, and Stem Cell Transplantation Specialist, Department of Hematology and Oncology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-8027-0646 Zahra Khashi Department of Environmental Health Engineering, Fir.C., Islamic Azad University, Firoozabad, Iran. 0000-0002-6646-4575 Journal Article 2026 08 25 Household exposures to radon, secondhand tobacco smoke, combustion-related pollutants, and selected indoor chemicals may contribute to cancer and other chronic diseases. However, environmental exposure history-taking remains insufficiently integrated into medical education. This letter highlights the need to teach medical students and residents how to identify household exposures, distinguish hazards from risks, and provide appropriate preventive counselling. Structured checklists, problem-based learning, clinical simulation, and objective assessments may support the integration of environmental exposure history-taking into routine clinical practice.

https://www.medicaleducation-bulletin.ir/article_251662_cbbf6085746fe3acbbf7ec648905b6fd.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 7 2 2026 12 01 Challenges and Strategies in Teaching Growth Monitoring and Interpretation of Child Growth Charts to Medical Students: A Narrative Review 1337 1363 252447 10.22034/meb.2026.601171.1144 EN Hossein Ali Kharazmi Department of Pediatrics, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 0009-0007-6237-201X Samaneh Parviz Department of Pediatrics, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 0000-0003-3532-9837 Journal Article 2026 09 06 Background: Growth monitoring and the interpretation of child growth charts are essential components of preventive pediatric care. This review aimed to examine educational challenges and effective strategies for teaching growth monitoring and child growth-chart interpretation to medical students. Materials and Methods: We conducted a structured narrative review guided by the SANRA framework. We searched PubMed/MEDLINE, Scopus, Web of Science, Embase, ERIC, SID, Magian, CIVILICA, ISC, and Google Scholar from inception to April 2026, supplemented by citation tracking, reference-list screening, and grey-literature searches. Two researchers independently screened, extracted, quality-appraised, and thematically synthesized eligible English- and Persian-language quantitative, qualitative, interventional, and review studies. Results: Thematic synthesis identified three interrelated domains. First, fragmented curricular delivery; predominantly hospital-based training; limited exposure to well-child and primary care settings; inadequate opportunities for repeated practice; and insufficient structured feedback hindered the translation of theoretical knowledge into clinical competence. Second, learners required proficiency in accurate anthropometric measurement; selection and plotting of appropriate growth charts; longitudinal, context-sensitive interpretation of growth trajectories; clinical reasoning; and family-centered communication. Third, structured modules; supervised skills workshops; case-based learning using serial growth data; simulation; outpatient placements; longitudinal portfolios; direct feedback; and multi-method, performance-based assessment were identified as potentially effective strategies. Although workshops and IMCI-based training improved short-term knowledge, evidence on skill retention, transfer to authentic clinical settings, and sustained effects on clinical performance remained limited. Conclusion: A longitudinal, competency-based, primary care–oriented approach may better prepare medical students to deliver evidence-based, family-centered child health care. Integrating structured teaching; supervised anthropometric practice; case-based learning; simulation; outpatient experience; feedback; and performance-based assessment can strengthen technical accuracy, growth-trajectory interpretation, clinical reasoning, and communication with parents.

https://www.medicaleducation-bulletin.ir/article_252447_eeb7d0a848cec6797ff2e1a061142f24.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 7 2 2026 12 01 Oncology Education in Undergraduate Medical Training: A Review of Educational Approaches, Curriculum Challenges, and Localization Requirements in Iran with a Comparative Perspective on International Experiences 1365 1387 251789 10.22034/meb.2026.599486.1141 EN Zahra Rezaei Borojerdi Medical Oncologist, Hematologist, and Stem Cell Transplantation Specialist, Department of Hematology and Oncology, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-8027-0646 Journal Article 2026 08 27 Background: The escalating cancer burden and the pivotal role of primary-care physicians in prevention, early diagnosis, and timely referral highlight the urgent need to reform undergraduate oncology education. This study evaluated undergraduate oncology training in Iran, compared it with international benchmarks, and proposed context-sensitive recommendations for curriculum reform. Materials and Methods: A structured critical narrative review was conducted per the SANRA guidelines. English- and Persian-language sources up to March 31, 2026, were searched across PubMed/MEDLINE, Scopus, Web of Science, ERIC, Google Scholar, SID, CIVILICA, and ISC, as well as relevant organizational websites. Two reviewers independently screened studies. Data were synthesized thematically across curricular structure, teaching and assessment strategies, international competency benchmarks (ASCO/ESMO, CanMEDS/EPAs), and sociocultural adaptation. Results: Undergraduate oncology education in Iran is fragmented, compartmentalized across inpatient and subspecialty disciplines, and lacks a longitudinal curriculum map. Major gaps were identified in core general-practice competencies: primary prevention, screening, early detection, oncologic emergencies, cancer survivorship, and structured palliative care. Teaching relies heavily on passive lectures with minimal ambulatory, primary-care, simulation-based, or interprofessional training, and culturally sensitive communication (e.g., breaking bad news using SPIKES amid protective family collusion) is inadequately taught. Assessment remains predominantly knowledge-based, with limited workplace-based tools (OSCE, Mini-CEX, DOPS). International comparisons supported longitudinal cancer education, community-based ambulatory rotations, and competency-driven EPAs. Conclusion: Reforming undergraduate oncology education in Iran requires a longitudinal, competency-based, integrated curriculum aligned with primary healthcare needs. Strategic priorities include formulating national core oncology EPAs, expanding ambulatory and community-based exposure, embedding palliative and supportive care, integrating simulation for complex communication, and deploying programmatic, workplace-based assessments.

https://www.medicaleducation-bulletin.ir/article_251789_8fd228d5bf2bc21e9542d6c2db645a68.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 7 2 2026 12 01 Integrating Palliative Care into Pediatric Oncology Education: A Critical Curriculum Gap and a Priority for Iran 1389 1392 253617 10.22034/meb.2026.603935.1148 EN Amir Hesabi Pediatric Hematology and Oncology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Journal Article 2026 09 22 Advances in diagnostic and therapeutic strategies have substantially improved survival among children with cancer. Nevertheless, children with advanced, relapsed, refractory, or life-limiting disease, along with their families, continue to experience a substantial burden of physical, psychological, social, and spiritual suffering. Pediatric palliative care should begin at the time of diagnosis of a life-threatening illness and be delivered concurrently with disease-directed therapy, rather than being confined to end-of-life care. However, palliative-care education remains limited, unstructured, and inadequately assessed in many pediatric oncology training programs. Drawing on international evidence and the Iranian context, this letter proposes incorporating competency-based education, guided clinical exposure, communication simulation, interprofessional learning, and structured assessment into pediatric oncology curricula.

https://www.medicaleducation-bulletin.ir/article_253617_0b6cb9ea448011bc5e8c079232c5ae47.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 7 2 2026 12 01 Teaching Clinical Assessment of Puberty in Iranian Pediatric Practice: Educational Barriers, Cultural-Ethical Considerations, and Strategies to Enhance Clinical Competence 1393 1412 252942 10.22034/meb.2026.602357.1145 EN Samaneh Parviz Department of Pediatrics, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 0000-0003-3532-9837 Hossein Ali Kharazmi Department of Pediatrics, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 0009-0007-6237-201X Journal Article 2026 09 13 Background: Accurate pubertal assessment and Tanner staging are essential for diagnosing precocious or delayed puberty, monitoring growth, and preventing psychosocial harm. However, limited trainee competence may result in misclassification and inappropriate referrals. This study examined educational, structural, and cultural barriers to pubertal-assessment training and identified feasible, evidence-informed strategies for Iran. Materials and Methods: In this structured critical narrative review, guided by SANRA and the Thomas and Harden thematic synthesis framework, we searched international (PubMed/MEDLINE, Scopus, Web of Science, and ERIC) and Iranian (SID, Magiran, and CIVILICA) databases, plus grey literature, from inception to March 15, 2026. English- and Persian-language studies addressing pubertal-assessment education, Tanner-staging accuracy, examination barriers, or educational interventions were included. Data were synthesized thematically across skill-related, structural, ethical/cultural, and educational domains. Results: Three themes emerged: (1) Clinical and technical deficits, including overreliance on visual inspection, difficulty distinguishing glandular thelarche from lipomastia in girls with overweight or obesity, and high error rates and poor reliability in Prader orchidometer use; (2) Structural constraints, including high patient volume, limited consultation time, scarce private examination space, and inadequate opportunities for direct observation and feedback; and (3) Ethical and cultural complexities, including adolescent embarrassment, modesty norms, preferences for gender-concordant clinicians, ambiguity regarding adolescent assent and parental consent, and limited use of professional chaperones. Tactile and three-dimensional breast and scrotal simulators, standardized patients, case-based learning, and workplace-based assessments (DOPS, Mini-CEX, and OSCE) improved diagnostic accuracy, tactile discrimination, communication, and clinical decision-making. Conclusion: Improving pubertal-assessment training in Iran requires staged, simulation-based practice before real-patient contact, culturally congruent chaperone policies, institutionalized adolescent-assent protocols, and structured workplace-based assessments to develop comprehensive, patient-centered clinical competence among pediatric residents.

https://www.medicaleducation-bulletin.ir/article_252942_e549885e495444dd242cdc162c1eed84.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 7 2 2026 12 01 Longitudinal Training in Empathy and Breaking Bad News in Pediatric Oncology: An Educational and Ethical Priority in Iran 1413 1416 253487 10.22034/meb.2026.603760.1147 EN Amir Hesabi Pediatric Hematology and Oncology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Journal Article 2026 09 21 Breaking bad news in pediatric oncology is a complex clinical and ethical competency involving children, parents, and healthcare professionals. In Iran, parents have emphasized the importance of compassionate communication, privacy, clear information, and psychological and spiritual support. However, communication training is often brief and reliant on informal role modeling. This article proposes a longitudinal, culturally responsive, and competency-based curriculum across undergraduate medical education, pediatric residency, and pediatric hematology-oncology fellowship. Training should include simulation, role-play, standardized patients, direct observation, structured feedback, and reflective practice. Assessment should focus on observed communication performance, empathy, developmentally appropriate language, and family understanding rather than self-reported confidence alone. Adapting such training to Iran’s cultural, linguistic, ethical, and family context could support more compassionate, ethical, and family-centered pediatric oncology care.

https://www.medicaleducation-bulletin.ir/article_253487_b66e5a5e6e906cd5c56aede851b016ec.pdf