aeen mohammadi

Uncertainty is a natural and inevitable part of the medical field (1). In the clinical setting, doctors frequently deal with issues that have several possible interpretations (2). Lately, there has been a focus on the necessity of acknowledging ambiguity and uncertainty in educational programs by medical schools, educators, and students (2). After graduation, medical students must possess the professional competency of being able to accept and manage uncertainty, according to the UK's General Medical Council (GMC) (3). In a similar vein, one of the most crucial skills for physician candidates is the capacity to tolerate uncertainty, according to the Accreditation Council of Graduate Medical Education (ACGME) in the USA (4). As medical students progress in their training, they will encounter numerous clinical uncertainties in all aspects of medical practice (5). Therefore, assessments should authentically address uncertainty to help students prepare for real-world clinical challenges (6). But there is a question that deserves attention: Are the current assessment tools appropriate enough to support uncertainty tolerance among medical students, particularly the written assessment tools? In undergraduate medical education, medical schools still widely use multiple-choice questions (MCQs) with a best-answer approach (A-type MCQs) (7). Despite their popularity, this examination format may inadvertently suggest to students that there is always a single correct answer, which may not align with real clinical experiences (7). Sam et al. recently created the Clinical Prioritization Questions (CPQs), an innovative assessment instrument (8). Students must rank potential diagnoses in CPQs from most likely to least likely, based on likelihood (8). The outcomes show how well this Question format works to support students' growth in clinical reasoning abilities. CPQs also significantly contribute to cultivating students' competence in managing clinical uncertainty (8). One of the existing challenges that educators face is the different marking system of CPQs, which, unlike A-type MCQs, learners can get a range of marks. Therefore, faculty development in terms of the nature and marking system of CPQs can play an important role in dealing with this challenge. Also, students' lack of familiarity with the CPQs is another challenge. So, it is suggested that before using CPQs, educational sessions should be held with the students concerning the format of CPQs. Given the significance of managing uncertainty and ambiguity in their future medical careers, it is imperative to incorporate specific strategies into the curriculum to equip medical students to deal with clinical uncertainty. It is recommended that CPQs be used as a valuable formative assessment tool, due to their capability to meet this demand. Iranian medical schools may find implementing CPQs more practical and useful than other clinical reasoning assessment tools. However, before any embedment in the curriculum, pilot studies for revealing utility aspects of CPQs (e.g., validity, reliability, educational impact, acceptability, and feasibility) in Iranian settings are needed.

The COVID-19 pandemic has impacted medical education worldwide with several opportunities and challenges. This study aims to provide an overview of medical education's opportunities and challenges according to the experience of the COVID-19 pandemic in order to guide future endeavors in conducting the teaching-learning process in post-COVID era support.

In this systematized review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, databases of PubMed, Cochrane, Scopus, Web of Science, and Eric, in addition to Google Scholar as a search engine, were searched to retrieve relevant original peer-reviewed, review, editorial, and commentary articles published from Dec 2019 to the end of Sep 2022.

As per the qualitative synthesis, a total of 29 articles were included from the 1534 records that were identified. Reviewing the included articles showed that most of the relevant studies were considered Medical and healthcare students (51.8%) at undergraduate level (72.5%) in University settings (62.1%). As per the qualitative synthesis, a total of 29 articles were included from the 1534 records that were identified. Reviewing the included articles showed that most of the relevant studies were considered Medical and healthcare students (51.8%) at undergraduate level (72.5%) in University settings (62.1%). On the other hand, post-COVID medical education opportunities have been grouped into four main categories, which are teaching and learning processes, psychological impact, accessibility and education equity, and management and administrative affairs. Post-COVID medical education opportunities also consist of four main categories: teaching-learning process, psychological impact, accessibility and education equity, and management and administrative affairs. 

Changes in teaching and learning processes in medical education caused by the COVID-19 pandemic created opportunities and caused important challenges that should be considered in the post-COVID era. In this regard, blended learning with the integration of technology using a flexible approach could be an effective recommendation.

The use of virtual reality in medical education to create diverse and new learning opportunities while maintaining patient safety is rapidly expanding. A review of the current status of virtual reality use in medical education shows that the adoption of this simulation method in Iran's universities of medical sciences has not grown alongside developed countries. Due to the lack of a unified authority, the absence of facilities and technical infrastructure, and the lack of interdepartmental coordination, the responsible structures and institutions cannot meet students' educational needs. Given the importance of modern technologies in medical education, this policy brief provides the necessary strategies and policies to address this issue. This policy brief is one of the results of future study research on applying virtual reality in medical education conducted at the country's medical universities. It assists administrators and stakeholders in medical education in planning to use virtual reality to transform education from passive to active learning, reduce educational costs, and improve patient safety.

The quantity and quality of interaction are critical elements of perceived interactions. This study aimed to summarize findings on the quality of interpersonal interactions in E-Learning at higher education and suggestions that inform future measurement efforts.

The scoping review proposed by Arksey and O'Malley (2005) was used. This approach consists of 5 steps: 1) identifying the research question,2) identifying relevant studies,3) study selection, 4) charting the data, and 5) reporting the results. PubMed, Scopus, and Web of Science have searched three databases, including manuscripts in English. The search was conducted from 2000 to July 2021. A PCC (population, concept, and context) was used as eligibility criteria and included the most relevant. The present PCC was defined as a population: university students, context: higher education, and Concept: E-learning and Interpersonal Interactions.

This review includes twenty-five articles chosen for inclusion. With the thematic analysis, the results of this scoping review are presented in the form of four themes: interaction in the online environment affects learning outcomes, numerous factors affect the interaction of learners in online settings, online interaction and hidden curriculum, and the importance of forming an online learning community.

Findings showed that the quality of interpersonal interactions in e-learning seems to be a neglected link in e-learning. Further studies are needed focusing on the quality of interpersonal interactions in e-learning. It is necessary to develop appropriate tools to measure the quality of interpersonal interactions and further evaluate these interactions at the international level.

Conflict management skills include the ability of team members to actively use appropriate methods and strategies in different conflict situations. Considering the necessity of effective training in conflict management skills for medical students as a member of healthcare teams, this scoping review study aimed at reviewing the appropriate methods for teaching conflict management to medical students.  

In this scoping review, PubMed, Eric, ProQuest, Web of Science (WoS), and Scopus databases were systematically searched until May 21, 2023. Titles, abstracts, and full texts were screened separately by 2 researchers. The quality of the articles was assessed using the Best Evidence Medical Education (BEME) tool. Then, a descriptive synthesis was performed, and the results were reported. The Kirkpatrick model was used to evaluate the educational outcomes assessment.  

Out of 2888 retrieved studies, 19 studies were included. Although active and interactive teaching methods such as roleplay, group discussion, and interactive workshops were the most frequently used methods, the results did not pronounce the superiority of one method over others.   

Based on the results of this scoping review, further research should evaluate the effectiveness of conflict management training methods by focusing on the randomized controlled trial design and using standard and valid tools to assess educational outcomes.

Social accountability is defined as identifying social problems and needs, planning for resolving them and evaluating the effect of the plans. Considering the vital role in providing public health, the universities of medical sciences are the most important ones for fulfilling this mission and directing their education, research and service activities toward addressing health concerns of the community. Despite of these attempts, social accountability has not realized completely and satisfying yet. The aim of this study was exploring factors affecting social accountability and community-based medical education in universities of medical sciences from Iran’s educational development authorities’ view point.

This was a qualitative study performed by Education Development Center of the Ministry of Health and Medical Education in November 2022. Participants were 68 managers of Education Development Centers and 323 managers of Education Development Offices of schools and hospitals of universities of medical sciences in Iran. Participants were assigned to 8 focus groups. Conventional content analysis was used to extract the categories and subcategories.

At the first step 541 codes were extracted which were integrated in to 86 ones after defining similarities. These codes then were categorized into 18 sub-categories and 6 categories, namely “Curriculum” including: curriculum revision, approaches, credits and longitudinal themes and new disciplines, “Community-based education” including: educational fields and creating the foundation, “Students” including: students as teacher, educating students and graduates, “Faculty members” including: faculty members’ services, motivation and compensation and administration, “Evaluation” including: student assessment and program evaluation, and “Management” including: management and leadership, organizations, Interdepartmental communication and research.

In this study a comprehensive collection of factors affecting SA in universities of medical sciences were identified and categorized. These factors that are compatible with medical education context in Iran can be used by top managers and educational administrators as a framework for short and long-term planning.

The COVID-19 pandemic has created opportunities and challenges for education and research as the two main academic activities in medical sciences disciplines, which due to their mutual influence can be used to propose solutions for improving these two areas. The present study was conducted to compare two review articles, each of which dealt with one of these two areas.This comparative study with a qualitative explanatory design was conducted in three steps. First, two review articles were selected that investigated the opportunities and challenges caused by the coronavirus pandemic to propose strategies for the post-corona era. Then, both studies were carefully studied and described. Finally, two researchers separately extracted the similarities and differences mentioned in the two articles and compared them to remove the inconsistencies. A panel of experts confirmed the findings. The opportunities and challenges mentioned in the two articles were extracted and categorized into two areas based on similarities and differences. The similar proposed strategies for the post-corona era were continuing to use virtual space facilities, diversifying the communication methods with students and research participants, and providing and developing suitable electronic infrastructure. Comparing two review articles and determining the similarities and differences between the opportunities and challenges caused by the COVID-19 pandemic and the strategies for the post-COVID-19 era related to medical education and clinical research, led to proposing strategies that could promote these two related areas coherently.

Metacognitive skills have an important role in training efficient learners and competent clinicians in health professions education. The aim of this systematized review was to determine the factors enhancing metacognitive skills in nursing students.

For data collection, we searched the databases of PubMed, Ovid, Cochrane, Scopus, Web of Science, ProQuest, Springer, EMBASE, Science Direct, PsycInfo, Nursing and Allied Health, and ERIC up to the end of March 2019, using the study key words. We used PRISMA flowchart diagram for reporting the results of the study. Peer‑reviewed articles in English, addressing factors enhancing metacognition in nursing students, were included in our review. The Critical Appraisal Skills Program (CASP) checklist was used for assessing the quality of the included studies.

Out of 2355 studies, 16 were included for the review. Several factors, namely “specific curricular activities,” “self‑regulated e‑learning modules,” “e‑portfolio,” “cognitive apprenticeship,” “specific teaching techniques for classroom and experiential settings,” “metacognitive wrappers,” “problem‑based learning,” “blended learning,” “grit,” and “clinical log,” enhancing metacognition in nursing students, were extracted.

The findings of our study can contribute to planning for improvement of learners’ metacognitive skills. However, there is a need for future research on determining further factors influencing nursing students’ metacognitive skills. 

Professionalism means understanding a profession and introducing it to the society through professional behaviors. In particular in clinical settings, constructive feedback is provided in education to create professional behaviors.

This study aimed to investigate giving feedback on professionalism in clinical education.

A narrative review was conducted in PubMed and Google Scholar on the publications over the last 10 years. Eight hundred twenty-six articles were found in the first step, among which 30 were handed over to the expert panel. Fifteen of 30 articles were finally selected.

The data of the studies were in four categories: feedback techniques, feedback in. curriculum, the scope of feedback, and feedback outcome. Feedback on professionalism was mostly presented through online services, portfolio, video-based systems, by a preceptor or peers, longitudinally in internship courses, and Multi Source Feedback (360 degree). In a study, feedback on professionalism was considered formally in the curriculum. Educational experts give both formative and summative feedback (most of which were formative). Based on the literature, feedback can enhance learning professionalism, curriculum reforms, system support, student comfort, evaluations, and efficacy of professionalism.

Multi-Source feedback assessment was the most used tool for giving feedback in professionalism, and the most popular form was informal-formative feedback. Since professionalism is a multidimensional concept related to personal communication, multi-source tools have been the most commonly used in the literature.

Accreditation is used to monitor, guide, examine, and assure the quality of higher education. There is no formal evaluation system to ensure the quality and quantity of scientific associations’ activities. So this study aimed to develop and implement a national accreditation system to be applied for biomedical scientific associations through a participatory process among stakeholders.   

Consensus development techniques, i.e., focus group and Delphi methods, were used to design the accreditation system. An expert committee, set up at the recognized accreditation body, devised the accreditation structure, procedure, and permit rules using the focus group technique. Then, we prepared the standards draft which was further modified in an expert panel in focus group sessions and finalized among the stakeholders through the Delphi technique. Finally, the procedure was performed for 66 associations.   

The accreditation structure, procedure, and standards were determined and legitimized. Standards included 20 ones in four domains of educational activities (3 standards), research affairs (2 standards), cross-sector collaborations (2 standards), and organization and equipment (13 standards). Among 66 associations, 16 and 12 were approved and conditionally approved respectively.   

In spite of associations’ influential academic and social activities, no study was found in regards to their accreditation. Standards devised in this research can be employed by scientific associations for developing their plans and enhancing their performance. This experience can be adopted for accrediting not only scientific associations but also any other academic institutions, especially non-student training ones.

Considering the importance and role of cyberspace facilities during the COVID-19 pandemic and prediction of the literature about the impossibility of returning to the previous traditional methods, it is necessary for the society of Iranian medical sciences education to have the essential plans and prepare for the transition from COVID to Post-COVID time. Optimal usage of cyberspace facilities and tools requires relevant knowledge and skills. As the main players in this path, faculty members and students of medical sciences, , need to gain expertise in essential relevant skills and competencies. Initial review of the literature indicates that there are some shortcomings in this regard. Therefore, this policy brief presents the practical recommendations to empower faculty members and students of medical sciences with regard to the skills essential for playing their professional role in the information technology-based world.

 Advanced cardiac resuscitation and treatment of cardiac arrest are important issues that emergency medical assistants should be fully acquainted with. The purpose of this project is to compare the two methods of face-to-face training and the use of messaging services (which have the ability to share audio and video, such as WhatsApp).

 In this study, emergency medicine assistants were randomly divided into two groups for cardiopulmonary resuscitation training. The control group did the in-person training as a scenario design and in the second group the resuscitation training was done as a scenario design in the WhatsApp messenger group in absentia. Pre-test and post-test were performed from both groups. Test scores were calculated and statistically analyzed.

 Comparison of sexual frequency, comparison of mean year of residency, comparison of frequency of CPR, and mean age of the two groups did not show a significant difference. Also, the mean percentage of CPR test scores did not show a significant difference between the two groups before and after training. But the mean percentage of CPR test scores in the intervention group before and after training showed a significant difference. The mean percentage of CPR test scores in the control group before and after training was significantly different. Also, if we enter the post-test as a dependent variable and the two groups as an independent variable and the pre-test as covariance in the ANCOVA formula, there is a significant difference between the two groups in the post-test. (P-value = 0.002)

 Scenario-based education on adult resuscitation through group discussion with messaging software is more effective on assistants. For future studies, a study with a larger sample size over a longer period of time is recommended.

Kane’s validity framework examines the validity of the interpretation of a test at the four levels of scoring, generalization, extrapolation, and implications. No model has been yet proposed to use this framework particularly for a system of assessment. This study provided a model for the validation of the internal medicine residents’ assessment system, based on the Kane’s framework.

Through a five stages study, first, by reviewing the literature, the methods used, and the study challenges, in using Kane’s framework, were extracted. Then, possible assumptions about the design and implementation of residents’ tests and the proposed methods for their validation at each of their four inferences of Kane’s validity were made in the form of two tables. Subsequently, in a focus group session, the assumptions and proposed validation methods were reviewed. In the fourth stage, the opinions of seven internal medicine professors were asked about the results of the focus group. Finally, the assumptions and the final validation model were prepared.

The proposed tables were modified in the focus group. The validation table was developed consisting of tests, used at each Miller’s pyramid level. The results were approved by five professors of the internal medicine. The final table has five rows, respectively, as the levels of Knows and Knows How, Shows How, Shows, Does, and the fifth one for the final scores of residents. The columns of the table demonstrate the necessary measures for validation at the four levels of inferences of Kane’s framework.

The proposed model ensures the validity of the internal medicine specialty residency assessment system based on Kane’s framework, especially at the implication level.

Studies on the efficacy of adaptive e-learning in dentistry are limited. This study aimed to compare the efficacy of linear and adaptive electronic continuing medical education (CME) courses about dental bleaching.

This quasi-experimental study using a post-test control group design evaluated the efficacy of an electronic CME course on dental bleaching offered to 60 dentists who were non-randomly allocated in two linear and adaptive groups (n = 30). One training session was held for participants of both the intervention and the control groups. At the end of the course, the learners participated in a post-test and completed a satisfaction questionnaire. SPSS 23 was used to analyze the results. An independent t test was used to assess the effect of type of intervention on the outcome of education, and Pearson’s chi-square test was applied to assess the effect of the intervention on participants’ satisfaction.

The mean post-test scores of participants were 6.33 ± 1.47 for the linear group and 6.40 ± 2.31 for the adaptive group. The mean satisfaction scores of participants were 4.02 ± 0.53 for the linear group and 4.15 ± 0.42 for the adaptive group. According to an independent t-test, the two groups were not significantly different in terms of post-test score (P = 0.7) or level of satisfaction (P = 0.2).

The adaptive approach has considerable advantages and comparable efficacy to the linear method in terms of post-test score and self-reported knowledge and satisfaction of participants. Thus, this method of education may be as effective as the linear method for instruction in dental bleaching. The use of an adaptive approach is therefore recommended in educational curricula.

Storytelling is one of the earliest ways to share scientific advancements and discoveries. The advent of technology has updated this ancient art into a digitalized form. The boundaries between the digital storytelling (DST), and other types of videos are unclear. Therefore, in this review, the process, aim, producers, and uses of DST in health profession education have been reviewed.

This study is a systematized review, which is in nature like a systematic review with only a few differences in the comprehensive search and quality assessment procedure. All studies, whose duplicates were removed, were retrieved from Science Direct, PubMed, and Scopus databases or through google scholar search engine screened in 3 stages: title, abstract and full study. All journal articles including experimental, case study and case report, mixed method, and qualitative studies in English language in the field of health profession education were chosen for this review after being evaluated based on QUESTS dimensions.

In total, 35 articles were included in the review. The studies had been done in health promotion, nursing education, medical education, patient education, social work education, andcommunity health education. In some of these studies, the producers and users of digital stories were different, which is in contrast with center for digital storytelling that emphasizes the process of DST. The results of this review showed that all stakeholders of health system could be producers of digital stories with various aims; e.g. community health, empathy promotion, attitude and behaviorchange, clinical thinking, and skills improvement.

This systematized review indicated that DST has some applications in different subjects in different fields of health professions and with a potential to be used by different stakeholders of health system. According to the definition of DST, digital storytelling involves the process of writing a script to produce a digital story by one individual or a group. Consequently, there is a difference between DST and producing a digital story. Therefore, researchers should consider the correct use of this term in their studies. Although few interventional and high-quality studies have been conducted in this area, further quantitative and qualitative research is suggested.

Nowadays, several studies have been performed on the factors affecting the effectiveness of virtual education. One of the characteristics of learners is their different learning styles.

The purpose of this study was to investigate the relationship between learning style and the level of satisfaction and usage of e-learning facilities in medical students.

This cross-sectional and retrospective (ex post facto) study was performed among medical, public health, and operating room students of Shahrekord University of Medical Sciences in 2017. We redesigned their courses to be delivered in the blended method, so that teachers used a Learning Management System (LMS) in addition to traditional teaching. Information about learning styles was collected using Kolb’s questionnaire, satisfaction level evaluated with a researcher made questionnaire and use of e-learning was examined by checking system loggings. Data were analyzed using one-way ANOVA, Tukey’s post hoc, Welch’s ANOVA and X2 tests in SPSS software.

Students’ satisfaction with e-content in diverging learning style was higher (P = 0.032), but there was no significant relationship between learning style and demographic characteristics and total average mark. Also, there was no significant difference in the amount of using e-learning facilities between different learning style groups (P = 0.256).

It seems that using virtual learning facilities and considering the type of learning style in students can increase their satisfaction.

One of the most important diseases among children is urinary tract infection which can lead to permanent damage to the renal parenchyma with the possibility of delayed complications such as hypertension or chronic renal failure. The aim of designing and evaluating the effectiveness of education by the "Child Care of Kidneys" tool on the level of knowledge, practice and satisfaction of parents of children with kidney disease.

In this quasi-experimental study, 70 parents referred to the Pediatric Nephrology Clinic in the Pediatric Nephrology Clinic were enrolled in the study in 1398 (35 received traditional training and 35 received face-to-face training by installing an application on the Android mobile phone, after 6 weeks the questionnaire was completed and the data were analyzed. The software used was version 23 of SPSS software. Significance level was considered 0.05.

The mean score of knowledge in both groups was equal to 6 ±1 (moderate). There was no statistically significant difference between the knowledge scores of the two groups (0.68). The performance score of the traditional training group was 12±2 (average) and the second group who were trained with the application was 13 ± 2 (moderate). There was a statistically significant difference between the performance scores of the two groups (0.02). The satisfaction score of the application was relatively good. Discussion and

Parent education through the installation of applications on mobile phones has a very good effect on the performance and satisfaction of parents of children with kidney disease.

Increasing the number of students in universities, simultaneously limiting allocation of funds to them, and maintaining the highest efficiency level in education and research are of paramount importance. There are several methods to assess the efficiency of universities, and one of the most widely used of which is data envelopment analysis (DEA). The aim of this study was to determine the input and output criteria to evaluate the efficiency of universities of medical sciences through review-related articles using the DEA method.

The time limit for retrieving articles was considered from the beginning of the publication of the first paper in this field until the end of 2017. The data were retrieved from Web of Science, Scopus, Ovid, ProQuest, Science Direct, and PubMed using advanced searches. Inclusion criteria were as follow: relevancy of the articles to the purpose of the research, availability of the articles’ full-text, articles published to the end of 2017, and articles published in English.

The most inputs used in the literature to determine university efficiency were number of academic staffs, budget and costs, number of students, number of nonacademic staffs, spaces, and equipment and studentchr('39')s entrance scores. Also, the most outputs used in the literature to determine university efficiency were number of graduates, publications, incomes, number of students, and studentchr('39')s scores.

This study showed that a large number of researchers have focused on measuring and comparing the efficiency of universities to improve efficiency, reduce costs, and manage the resources. Efficiency analysis by DEA allows the policymakers to define and develop policies and guidelines to improve their performances.

Promoting ethics is one of the goals of education, but the free flow of communication and divulging unethical behaviors in e-learning make the urgent need to clarify ethical values. Therefore, the aim of this study was to prepare ethical codes to develop and deliver e-contents 

A draft of e-content ethical codes was prepared based on the literature review. Then, it was further revised by e-learning, medical education, ethics, and e-content experts. Finally, the draft was finalized through a 2-round Delphi process among related experts all over the country.

The final document of e-content ethical codes, including introduction, definitions, and 7 ethical code statements, was devised.

Considering the difference between e-content and other kinds of publications, this set of ethical codes can be used straightforwardly to assess ethical aspects of e-contents.

Students' academic achievement is one of the important indicators in evaluating the educational system. Emotional intelligence is one of the success factors in educational environments that can predict success in different aspects of life.The purpose of this study was to determine the relationship between emotional intelligence and academic achievement in students of Anesthesiology and Operating Room of Tehran University of Medical Sciences.

This cross-sectional study was performed on 140 people of anesthesiology students and operating room of Tehran University of Medical Sciences in 2018. The samples were selected by available method. The instrument consisted of two demographic questionnaires and the Bradbury and Graves' standard questionnaire for emotional intelligence. In order to measure academic achievement, the average score of the whole course of the students was used. Data were analyzed by SPSS software and P<0.05 was considered as significant.

Pearson's correlation coefficient showed a significant positive correlation between academic achievement and total emotional intelligence(r=0.554) and all its dimensions(self-awareness, self-management, social awareness and relationship management)(P=0.000). The mean score of emotional intelligence in female students(114.11±11.40) was higher than that of male students(113.39±12.57)(P=0.887).

The mean score of students' emotional intelligence and its dimensions was in a desired level. There was a positive and significant relationship between emotional intelligence and all aspects of it with academic achievement. Therefore, it is essential for the authorities to plan for the improvement of the level of emotional intelligence for the students' academic achievement.

In the test-enhanced spaced learning, educationalcontents are presented in small packages of well-developedtest questions with a defined frequency to the learners. It is notclear that applying this educational style might have a positiveimpact on the summative assessment. Therefore, in this studywe assessed the effect of the test-enhanced spaced learning onthe otolaryngology board and annual examinations of residencytraining. In a quasi-experimental study with consecutivesampling, all forty-four residents of otolaryngology in four levelsof training in 2016 at Tehran University of Medical Sciences(TUMS) received daily-standardized multiple-choice questionswith a twice-repeated frequency of 10 days. Individual feedbackaccording to one’s response to each test was provided. The resultsof national board and annual exam were compared with the sameresults of all residents of other universities and previous yearTUMS’ residents for whom spaced learning were not applied andthey were considered as the control groups. The board exam hadtwo parts, multiple-choice questions, and computer-based clinicalexamination. The annual exam format was multiple-choicequestions. The total score for each one was 150. Student’s t-testand Mann-Whitney U test were used for comparative analyses. The mean of the board exam results showed statisticallysignificant improvement compared to other medical schools(113.6±10.7 vs. 102.9±13.4 in multiple-choice questions,p=0.048, 118.7±12.5 vs. 54.1±60.0 in the computer-based clinicalexamination, p<0.001), while similar comparison results in theprevious year did not show any significant difference. Spaced learning with testing effect may be useful inthe clinical education setting to improve the learning outcomes.

Since the beginning of the third millennium, the word e-learning has been used and is still expanding. Today, the term refers to the use of online technologies to strengthen the teaching-learning process and gain knowledge and skills. The aim of this study was to investigate the evolution of electronic learning in Iran's medical sciences universities and the introduction of Virtual University of Medical Sciences. The present study is a case study using a documentary analysis and review of texts including a series of articles published in the field of electronic learning in Iran, as well as a collection of approvals of the High Council for Medical Planning and the Council for the Development of Medical Sciences Universities and Virtual University of Medical Sciences. Virtual University of Medical Sciences has been established in 1394 to promote the education, research, production and promotion of science and the extension of knowledge boundaries in the field of cyberspace and in pursuit of the goals of the development plan and innovation in medical education. The university is also committed to helping the development of virtual education in medical science universities and the development of necessary infrastructures for all universities in the country. Virtual virtual medicine university has taken steps to develop electronic learning, realization of educational justice and creation of virtual educational opportunities. It seems that in case of the support and fulfillment of the missions of this university, we will see more development in the field of e-learning at the level of medical universities of the country.

The aim of this study was to develop and implement a national accreditation system for virtual centers and schools of Universities of Medical Sciences, according to Ministry of Health and Medical Education policies, which are documented in the package of Medical Education Innovation Plan. In this study the expertise oriented approach and accreditation model was chosen for evaluation. At the first step an extensive library study was performed and accreditation and quality assurance systems in developed countries were assessed extensively. Then an expert committee including medical educationists and e-learning specialists was organized. The draft of standards and consequent rules and regulation of accreditation body were designed. Afterward all standards were finalized through a national Delphi process among all eLearning stakeholders around the country. These documents were legislated in Ministry of Health and Medical Education. The standards consisted of four main domains: governance (5 standards), infrastructure (6 standards), educational affairs (5 standards) and consultation and support (3 standards). Currently this system is being used for evaluation of virtual centers of Universities of Medical Sciences in Iran.