rita mojtahedzadeh

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.

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.

Changing the type of care in the family health internship curriculum towards continuing care programs can lead to the development of the professional identity of learners. This study was conducted with the aim of designing, implementing and evaluating a tele-continuous care program after delivery for midwifery students.

In this educational process, each student under the direction of the support team was responsible for the continuing care of his client for 6 weeks after delivery. The program was designed based on Taylor's curriculum development model and the evaluation of learners was done by qualitative interviews and completion of portfolios during the course at two levels of reaction and learning Kirkpatrick's model.

Data in the three main categories was categorized as  "learning", "continuous care" and "health provider" with sub-categories include new concept of postpartum period, knowing more about the profession of midwifery, improving communication skills with the client, strengthening the student's self-confidence, eagerness to learn, new experience of taking history, not being judged by others, daring to ask questions, synergy of knowledge, walking in mother's shoes, increasing intimacy, anticipating upcoming issues, availability, ability of follow-up, sense of pleasantness, sense of support,  earlier familiarization of the client with the conditions ahead, trust of the client and more motivation to provide service.

It appears that placing midwifery students in a continuing care model will provide them the opportunity to experience a rich holistic learning.

Objectiv (s):

 The aim of this study was to determine the effect of pre-service e-learning on health care providers’, knowledge in terms of family health cares.

This was a pre- and post-test design study. The framework for developing the course was based on the stages of the General Educational Design Model (ADDIE). First, the content was designed and uploaded in Learning Management System (LMS). Then, using the census sampling method, all female health care providers who had started working as health care provider in the health care facilities affiliated to Iran University of Medical Sciences in a period of 6 months in 2021-2022 were included in the study. First, their knowledge of the course contents was measured. They received training upon entering the service electronically. Finally, their knowledge and skills were assessed by an exam. The level of their satisfaction and skills after participating in the course was also assessed. The data were analyzed by SPSS statistical software.

In all 73 trainee included in the study. The results of the study showed that the mean total score of health care providers' knowledge, after participating in the designed e-learning course significantly increased compared to before participating in the course (p = 0.01). The findings showed that the highest satisfaction score of the participants was related to the suitability of the evaluation with the content presented in the course (86% of the participants reported good to very good level). The lowest satisfaction was related to support in technical issues (47% of the participants was reported good to very good level). The most acquired skill was related to the ability to assess a child health status (100% of the participants reported good to very good level) and the least acquired skill was related to the ability to identify the health status of pregnant mother (45% of the participants reported good to very good level).

This study showed that participating in pre-service e-learning training may increase the knowledge of female health care providers in various components of family health care.

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. 

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.

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.

Telemedicine can improve access to healthcare services; however, it has raised ethical concerns demanding special considerations. This study aimed at developing the codes of ethics for telemedicine, and hence several approved national and international ethical guidelines related to telemedicine practice were reviewed, and 48 semi-structured interviews were conducted with medical ethics and medical informatics experts as well as with physicians and patients who had telemedicine experiences. Content analysis was then performed on the interviews’ transcripts and a draft on code of ethics was prepared, which was further reviewed by the experts in the focus group meetings to reach a consensus on the final document. The final document consisted of a preface, five considerations, and 25 ethical statements. Considering the growing trend of adopting telemedicine worldwide, this document provides an ethical framework for those who use telemedicine in their medical practice.

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.

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.

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.

Communication skill (CS) has been regarded as one of the fundamental competencies for medical and other health care professionals. Student’s attitude toward learning CS is a key factor in designing educational interventions. The original CSAS, as positive and negative subscales, was developed in the UK; however, there is no scale to measure these attitudes in Iran. The aim of this study was to assess the psychometric characteristic of the Communication Skills Attitude Scale (CSAS), in an Iranian context and to understand if it is a valid tool to assess attitude toward learning communication skills among health care professionals.
Psychometric characteristics of the CSAS were assessed by using a cross-sectional design. In the current study, 410 medical students were selected using stratified sampling framework. The face validity of the scale was estimated through students and experts’ opinion. Content validity of CSAS was assessed qualitatively and quantitatively. Reliability was examined through two methods including Chronbach’s alpha coefficient and Intra class Correlation of Coefficient (ICC). Construct validity of CSAS was assessed using confirmatory factor analysis (CFA) and explanatory factor analysis (PCA) followed by varimax rotation. Convergent and discriminant validity of the scale was measured through Spearman correlation. Statistical analysis was performed using SPSS 19 and EQS, 6.1.
The internal consistency and reproducibility of the total CSAS score were 0.84 (Cronbach’s alpha) and 0.81, which demonstrates an acceptable reliability of the questionnaire. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI/ Ave) demonstrated appropriate 0.97 and 0.94, respectively. An exploratory factor analysis (EFA) on the 25 items of the CSAS revealed 4-factor structure that all together explained %55 of the variance. Results of the confirmatory factor analysis indicated an acceptable goodness-offit between the model and the observed data. [χ2/df=2.36, Comparative Fit Index (CFI)=0.95, the GFI=0.96, Root Mean Square Error of Approximation (RMSEA)=0.05].
The Persian version of CSAS is a multidimensional, valid and reliable tool for assessing attitudes towards communication skill among medical students.

There is a growing trend in online education courses in higher education institutes. Previous studies have shown that high levels of self-direction are essential for successful online learning. The present study aims to investigate challenges of and barriers to self-directed virtual-learning among postgraduate students of medical sciences.
23 postgraduate virtual students of medical sciences in Iran, collected through maximum variation purposive sampling and semi-structured interviews, served as the sample of this study. The collected data were analyzed using the inductive content analysis method.
Three themes and six sub-themes were identified as barriers to self-directed learning in virtual education, including cognitive barriers (information overload and lack of focus on learning or mind wondering), communication barriers (inadequate coping skills and inadequate writing skills) and educational environment barriers (heavy workload and role ambiguity).
By the importance of self-direction in online education, the present study results can be used by virtual education planners in the review and design of courses, so as to adequately equip students, obviate barriers to self-directed virtual education, and ultimately train highly self-directed learners in online medical education.

Background and In education of medical science courses, there has been a growing orientation towards replacing traditional teaching in with E-learning education. Since the modern system of education is based on self-directed learning, e-learning requires special powers to deal with new-emerging challenges and professionally encounter the learning environment. The purpose of the present research is to explain and provide a conceptual model for professional competency in this system.
In this review, different internet and library resources, indexed in Scirus, Pre Quest, Scopus, IEEE, SID, Magiran, Eric, Taylor and Francis, and Google Scholar from 1990 to 2015 were searched using the following keywords: function, manner, ethics, conduct disposition, netiquette, values, academic fraud, moral professionalism, and behavior ine-learning in combination and separately. The Critical Review methodology and Carnwell and Randolph structures were used. The most recent and richest resources that were more relevant to the issue were selected and their information was extracted.
Among review of 98 articles, documents of 34 relevant and valid articles were extracted. Based on the results, Digital Literacy, study skills, Cyber Ethics, and Netiquette were considered the main components of scientific and ethical competency in e-learning. 40 components were included in these dimensions.
Although there is general interest in e-learning, the target population (learners) are not prepared to use such an environment and require strong support. In this paper, we provided a summarized scheme and conceptual pattern fore-learners to move towards promotion of learning.

Nowadays, there is an ongoing development in virtual social networks and their application for patients'' support, diagnosis, self-care, and education. On the other hand, applying short messages as the easiest, simplest, and cheapest way of presenting information would be helpful in this regard. Thus, in this study the effect of social network and sending short messages was assessed on negative thinking status of women.
This was an experimental study with pretest-posttest design performed in 2015. Out of 1165 women in Mohajeran city, 75 were randomly assigned into three groups of social network, short message, and control. The participants received a compact disc containing e-content about reducing negative thoughts. They filled out the Crandell cognition inventory (CCI) before and immediately after the intervention and also one month later for assessing their negative thoughts. A Telegram group was established for the social network group while follow-up short messages were sent for the other intervention group. SPSS V.21 was used for data analysis by paired t test, one way analysis of variance, analysis of covariance and repeated measures tests. Validity (in terms of content and structure) of the questionnaire was confirmed by comments from experts and professors and Bartlett test (KMO = 0.846, p and lt; 0.001); the reliability was confirmed by Cronbach’s alpha coefficient (0.69) and test-retest coefficient (0.928).
There were significant differences between pretest and posttest scores in social network, short message, and control groups (P value 0.45, 0.001 and lt; 0.001 and lt; respectively). There were also significant differences between pretest and follow-up scores in the abovementioned groups (P value 0.003, 0.012, 0.001 respectively). There was no significant difference in the follow-up scores between three groups (P = 0.917).
The results showed that multimedia e-content merely would reduce participants’negative thoughts. Therefore, providing multimedia e-content could be beneficial in improving the effectiveness of public health education.

The widespread use of internet has caused new psychological, social, and educational problems for the students. The aim of this study was to examine the quality of life in medical students who suffer from internet addiction. This cross-sectional survey was carried out in Tehran University of Medical Sciences, and a total of 174 fourth-to seventh-year undergraduate medical students were enrolled. The quality of life was assessed by WHOQOL-BREF questionnaire which covers four domains of physical health, psychological, social relationships, and the environment. For assessing internet addiction, we used Internet Addiction Test (IAT) of Young. The students with IAT score higher than 50 were considered as addicted. For evaluating academic performance, the students were requested to report their grade point average (GPA). The mean IA score (±SD) was 34.13±12.76. Twenty-eight students (16.90%) had IAT score above 50. The mean quality of life score in internet addicted group was 54.97±11.38 versus 61.65±11.21 in normal group (P=0.005). Furthermore, there was a negative correlation between IA score and physical domain (r=-0.18, P=0.02); psychological domain (r=-0.35, P=0.000); and social relation domain (r=-0.26, P=0.001). Mean GPA was significantly lower in the addicted group. It seems that quality of life is lower in the internet addicted medical students; moreover, such students academically perform poorer in comparison with non-addicts. Since internet addiction is increasing at a rapid pace which may provoke considerable academic, psychological and social implications; as a result, it may require screening programs to the immediate finding of such problem to give consultations to prevent unwanted complications.

Developing continuing medical education (CME) programs should be based on assessments of learners’ needs. On the other hand, one of the prevalent problems in Iran is the excessive use of blood products, and the highest demand for blood transfusion is related to surgical wards. Hence, the purpose of this study was to assess the educational needs of anesthesiologists and surgeons in transfusion medicine.
This survey was carried out on a convenience sample of 134 anesthesiologists and surgeons in Isfahan. The educational need assessment was administered using two valid and reliable researcher-made questionnaires: self-assessment and knowledge assessment. Cronbach’s alphas were calculated at 0.958 for information self-assessment questions, 0.981 for educational needs questions, and 0.72 for knowledge assessment questions. Data were imported to Excel Software. Distribution frequency indices and Pearson correlation coefficient test were used respectively to analyze the data and compare the findings.
The majority of participants were male (70.9%) with a mean work experience of 15.9±8.8 years. 65.8 percent of the participants evaluated their knowledge at an “average level”. The most important educational need was about cryoprecipitate and the least important was related to packed red blood cells. The mean score of knowledge assessment questions was 6.60±0.24 (out of 20). There was a significant correlation between self-assessment mean scores and the knowledge assessment mean scores and the frequency of encountering blood products (P≤0.0001). No significant correlation was found between the educational need assessment mean scores and the self-assessment mean scores and the frequency of encountering blood products (P=0.23).
Given the findings of the present need assessment and little knowledge of the physicians, it is suggested that an appropriate educational program should be developed for surgeons and anesthesiologists. Such program could be offered in the form of continuing education programs for graduates. Further research is needed to make decision about how transfusion medicine should be introduced into the anesthesiology and surgery residency programs.