فهرست مطالب

  • سال پانزدهم شماره 1 (پیاپی 42، Dec 2018)
  • تاریخ انتشار: 1397/09/06
  • تعداد عناوین: 29
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  • Masoumeh Rahimi , Majid Shirani , * Page 1
    Background
    The operating room is considered a learning platform for technical and non-technical skill training. Training in operating rooms helps learners from different groups, especially surgery residents, acquire the necessary clinical competence. Nevertheless, operating room training is only effective if it is accompanied by efficient and applicable teaching methods.
    Objectives
    The current study aimed at reviewing the strategies and methods to enhance teaching and learning of residents in operating room settings.
    Methods
    The current review study was conducted based on library studies and review of the literature. PubMed, SID, and MagIran databases, as well as Google Scholar search engine, were searched using relevant phrases and keywords. A total of 60 articles were retrieved, out of which 22 articles were identified as consistent with the study objectives.
    Results
    The data obtained from the literature review were categorized into three sections: “General structure of training in the operating room”, “strategies and methods to strengthen teaching and learning in the operating room”, and “structured training models in the operating room”. Finally, application of these strategies in clinical teaching was summarized in three stages: Before operation, during operation, and after operation.
    Conclusions
    The operating room is a clinical facility with specific characteristics, which can challenge teaching in this setting. However, application of effective strategies and methods, as well as efficiently structured training based on the proposed models can facilitate teaching and learning enhancement in operating rooms
    Keywords: Medical, Education, Learning, Teaching Methods, Operating Room, Residency
  • Eileen Hoskin , Karl Woodmansey , * , Lynn Beck , Tobias Rodriguez Page 2
    Background and Objectives
    Healthcare providers must endeavor to treat patients with empathy if they expect to practice successfully. Empathy is especially relevant to dentists who provide treatment that is usually associated with pain and invasion of personal space boundaries. A 2011 study by Konrath and O’Brien showed that undergraduate college students have less empathy than the past generations. Anecdotal reports and the author's personal experiences also suggest a reduction in empathy among current dental students. This study was designed to assess empathy in a dental student cohort at a dental school in the United States.
    Methods
    This study examined empathy levels in third- and fourth-year dental students at a dental school in the United States using existing validated medical education psychometric assessments modified for dental education. Specifically, the Jefferson scale of physician empathy-health professional (JSPE-HP) and patient-practitioner orientation scale (PPOS) questionnaires were modified for use in the dental education domain by substituting the word “dentist” for “physician” and replacing “medical procedures” with “dental procedures.” E-mails were sent to all 240 third- and fourth-year dental students at the Rutgers school of dental medicine (RSDM) inviting them to participate in a brief online survey about their perceptions of dentist-patient interactions.
    Results
    Of the 240 invited students, 84 participated in the survey (27%). All questions were answered with a high empathy rating except for two questions - “It is difficult for me to view things from my patient’s perspective” and “I can treat and relate best to patients who look like me and have similar beliefs.” The calculated Cronbach’s coefficient alpha was 0.71 indicating acceptable internal consistency reliability.
    Conclusions
    This study did not confirm the hypothesis that students lacked empathy. Only two statements were answered in ways that suggested a decrease in empathic cognition. The responses to the open-ended questions provided an insight into the students’ self-interested thought processes
    Keywords: Empathy, Dental, Dental Education, Dental Student
  • Malihe Dadgar Moghadam , Majid Khadem, Rezaiyan , * Page 3
     
    Background
    It is claimed that role-playing is a teaching strategy that has several advantages for both the teacher and student. This study aimed to compare two educational methods (oral presentation, a traditional method that is known to be teacher-centered, versus role-playing which is a student-centered method).
    Methods
    This quasi-experimental study was performed between September 2013 and October 2014 in 95 medical students in Mashhad University of Medical Sciences. Role-playing and oral (plus Microsoft PowerPoint) presentation were done by one assistant professor. There were no changes in the educational content nor the classroom. Using random numbers, half of each group received one of the methods as the first class and vice versa. At the end of each session, the standard satisfaction evaluating questionnaire was filled by the students.
    Results
    During the one-year duration of this study, 95 students were evaluated, and 46 (60%) of them were female. The mean age was 22.5 ± 1 years, and 28 (87.5%) were single. Role-playing had a mean rank of 54.64, and oral presentation had 21.45 (P < 0.001). This difference was present based on gender as well (P < 0.001). The satisfaction score was significantly higher for role-playing (P < 0.001).
    Conclusions
    Role-playing can be much more helpful in education and needs to be incorporated into the lesson plans
    Keywords: Role-Playing, Education, Medicine, Non-Randomized Controlled Trials, Student, Oral Presentation
  • Farzaneh Rashidi Fakari , Mahin Tafazoli , *, Salmeh Dadgar Page 4
    Background
    Students’ personal characteristics are among the factors influencing the development of their critical thinking. Self-esteem is a normal influencing personality trait. Self-esteem affects all the aspects of individuals’ lives including the way of their thinking and performance.
    Objectives
    Therefore, the current study aimed to determine the relationship between critical thinking disposition and self-esteem in the midwifery students of Mashhad University of Medical Sciences in 2014.
    Methods
    This cross sectional study was carried out on all bachelor students (N = 53) of the Mashhad Nursing and Midwifery Faculty. Data were collected through a personal information form, the Rosenberg’s self-esteem questionnaire, and the California critical thinking disposition questionnaire. The collected data were analyzed in SPSS through descriptive statistical methods and a Pearson correlation coefficient test.
    Results
    The vast majority of students (62.26%) had an unsteady critical thinking disposition. However, 84.90% of them had a moderate level of self-esteem. Pearson correlation test showed no significant relationship between critical thinking disposition and self-esteem (P > 0.05).
    Conclusions
    According to the study results, the vast majority of the study cases had a moderate level of self-esteem with an unsteady critical thinking disposition. There was no significant relationship between critical thinking disposition and self-esteem in the studied midwifery students
    Keywords: Self Esteem, Critical Thinking, Midwife
  • Abdolhussein Shakurnia , *, Maryam Baniasad Page 5
    Background
    Since medical students play an important role in public health system as well as the treatment of patients, the need for critical thinking in them is extensively felt. The current study aimed at evaluating the level of critical thinking disposition in the first- and last-year medical students and its association with goal orientation in Ahvaz Jundishapur University of Medical Sciences in 2016.
    Methods
    The current cross sectional study used critical thinking disposition inventory (CTDI) developed by Rudd and Ricketts, and achievement goal questionnaire-revised (AGQ-R) developed by McGregor and Elliot to collect data. The questionnaires were distributed among 255 students of which 204 (80%) students completed them. Data were analyzed using t-test and Pearson correlation coefficient.
    Results
    Of the 255 studied subjects, 104 were the first-year and 100 the last-year medical students. The mean age of the students in the first and last year of medical students was 18.93 ± 0.86 and 24.60 ± 1.31 years, respectively. Moreover, 47 first-year and 66 last-year subjects were female. The mean score of CTDI for the first- and last-year students were 69.82 ± 10.60 and 71.48 ± 11.86, respectively, lower than the average range. Based on the t-test results, there was no significant difference between this group students (P = 0.310). The mean score of CTDI and AGQ for all the study participants was 70.75 ± 11.12 and 28.22 ± 7.76, respectively; a significant correlation was observed between critical thinking disposition and achievement goal orientation (P = 0.001, r = 0.294).
    Conclusions
    The results of the current study indicated that the CTDI score was lower than average range in the first- and last-year students; besides, lack of difference between first and last year students emphasized that educational processes should be propelled toward employment of approaches to promote and strengthen critical thinking disposition.
    Keywords: Critical Thinking Disposition, Achievement Goal Orientation, Medical Students, Medical Education
  • Mostafa Rad , Kazem Hassanpour , Nematullah Shomoossi , * Page 6
  • Soleiman Ahmady , Hamed Khani*, Zohrehsadat Mirmoghtadaie Page 7
    Background
    A universal challenge in the development of medical training methods is the description and characteristics of a good physician. It is essential to collect the information of hospitalized patients and their families in order to revise the curricula of medical departments.
    Objectives
    The present study aimed to explain the viewpoints of patients and their families about the key characteristics of a good physician.
    Methods
    The present study was carried out using inductive content analysis in 2017. The study sample consisted of patients admitted to different wards of Imam Khomeini Hospital (Tehran, Iran), as well as family members accompanying the patients. Data were collected via purposeful sampling (maximum variation sampling) by conducting semi-structured interviews until reaching data saturation. After the recorded interviews were transcribed, they were reviewed several times and analyzed using Elo and Kyngas coding system.
    Results
    A total of 19 participants, including 13 patients and six accompanying family members, were recruited in the present study (11 males and 8 females). The analysis of interviews with the participants indicated seven major categories: “Positive personality traits”; “academic and clinical proficiency”; “professionalism”; “effective communication skills”; “fairness and altruism”; “spirituality”; and “continuous professional development”.
    Conclusions
    The definition of a good physician by patients and their families has different implications in educational programs, as future physicians not only can benefit from education about the medical needs of their patients, but also should be familiar with the needs, fears, and concerns of their patients.
    Keywords: Patient’s Viewpoint, Good Physician, Physician-Patient, Qualitative Content Analysis
  • Majid Sadoughi*, Amene Markoubi Page 8
    Background
    Academic burnout has several negative consequences such as decreased motivation, academic eagerness, and achievement among students.
    Objectives
    The current study aimed to investigate the relationship between basic psychological needs and academic burnout.
    Methods
    The current descriptive-correlational study was conducted among 233 students of Kashan University of Medical Sciences (140 females and 93 males) selected through stratified multistage sampling in the second semester of the 2016 - 2017 academic year. The participants responded to Breso Academic Burnout and Gagné Basic Psychological Needs questionnaires and provided their demographic information. Data were analyzed using SPSS (Version 22) using canonical correlation analysis.
    Results
    There was a significant negative correlation between academic burnout and autonomy (r = -0.296, P < 0.01), competence (r = -0.548, P < 0.01), and relatedness (r = -0.290, P < 0.01) needs. Canonical correlation coefficient was 0.61. The results of canonical analysis showed only one significant set of basic psychological needs and components of burnout. In addition, as psychological needs, especially the competence need, were satisfied more, the probability of academic burnout, especially in the academic inefficacy dimension, as the main component of academic burnout, was reduced.
    Conclusions
    The fulfillment of basic psychological needs, especially competence need, plays an important role in preventing academic inefficacy among students. Fulfilment of basic psychological needs in educational programs could be a protective factor against students' academic burnout and improve their academic performance.
    Keywords: Basic Psychological Needs, Academic Burnout, Medical Students
  • Ali Khalooei*, Akram Karbakhsh Page 9
    Background
    Community medicine departments play a major role in the education of medical students in order to provide primary health care services. The appropriate quality of education in such departments plays an important role in providing effective services for health promotion of communities.
    Objectives
    The current study was aimed to evaluate the quality of educational services at the Community Medicine Department of Kerman University of Medical Sciences from the viewpoint of interns and apprentices.
    Methods
    The current cross sectional, descriptive-analytical study was conducted on all medical students that completed their internship or apprenticeship course at the Community Medicine Department of Kerman University of Medical Sciences in 2016 as the study population. Data were collected by the service quality measurement questionnaire (SERVQUAL), and analyzed by Independent t test, paired t test, and one sample t test, as well as Pearson correlation coefficient.
    Results
    Of 244 participants in the study, 58.2% (n = 142) were female and 41.8% (n = 102) male, 57% (n = 139) were in the internship and 43% (105) in the apprenticeship courses. From the students' point of view, the mean score of perception in all five dimensions of educational quality was significantly lower than the expectations score, which indicated a negative gap in the quality of educational services in all dimensions (P < 0.001). The greatest quality gap was observed in the responsiveness dimension (- 0.86) and the lowest in the assurance dimension (- 0.59). The utility level of the quality of educational services in the Department of Community Medicine was 84% from the viewpoint of the students. The highest level of utility in the quality of medical services was respectively observed in the dimensions of assurance (86.4%) and empathy (86.1%) and the lowest in responsiveness dimension (79.6%) (P < 0.001). The lowest and highest correlations were respectively observed between tangibles and assurance (r = 0.486) and between empathy and assurance (r = 0.708) dimensions.
    Conclusions
    In all five dimensions of the quality of educational services, there were negative gap that required planning for quality improvement. Issues such as modifying educational contents and tailoring training to future jobs, modifying educational methods, increasing the contribution of students to educational planning, and updating educational facilities should be considered more urgently in the education quality promotion programs.
    Keywords: Quality, Quality of Educational Services, Quality Measurement, Community Medicine, Medical Students
  • Adel Soleimani Nejad*, Elaheh Amirmahani Page 10
    Background
    Data visualization refers to the methods of data presentation in visual formats using specific technologies, which can present data through a visual process with better understanding and recognition. The current study aimed at evaluating the rate of data transfer, learning, and ease of access to data through data visualization in virtual learning systems.
    Methods
    The current survey was conducted on 131 students and teachers of virtual medical courses at Shahid Beheshti University of Medical Sciences as the statistical population in the academic year 2015 - 2016. Of the study population, 79 subjects were selected using the simple random sampling method. Data collection tool was a 28-item researcher-made questionnaire, which its reliability was confirmed by the Cronbach’s alpha 0.82.
    Results
    Based on the results of the current study, data visualization could significantly affect virtual learning in the students. In addition, data visualization improved productivity indices as well as rate of data transfer, learning, and ease of access to data among students and teachers.
    Conclusions
    Based on the results of the current study, it is recommended that data visualization be used in educational programs at all grades and courses in order to benefit from its advantages in improving productivity, rate of data transfer, learning, and ease of access to data among students and teachers of universities and institutes.
    Keywords: Data Visualization, Learning Rate, Data Accessibility, Data Transfer Rate
  • Azim Mirzazadeh , Maryam Alizadeh*, Mohammad Shariati , Leyla Sadighpour Page 11
    Background
    Whereas much has been written about the strategies, barriers and facilitator factors of effective and interactive lecturing in medical education little has been written about the effective and interactive lecturing skills educational programs for medical teachers based on peer observation of teaching.
    Objectives
    The current study aimed at designing and implementing an interactive and effective lecturing workshop using peer observation and feedback, and finally evaluating its results.
    Methods
    The current descriptive study was conducted in Tehran University of Medical Sciences from 2015 to 2016. The study population consisted of faculty members participating in the effective and interactive lecturing workshop and the study subjects were selected by convenience sampling method. The Kirkpatrick method was used to assess the workshop; for this purpose, the level of reaction, learning, and performance were evaluated using a valid and reliable questionnaire, as well as the one minute note technique, and a form addressing the extent of using interactive techniques in the classroom six months after participation in the workshop. Data were analyzed by using the SPSS 22. Data are presented as frequency and mean where appropriated. The notes were analyzed using manual content analyses.
    Results
    The participants believed that the workshop could successfully encourage them to use lecturing principles and interactive lecturing techniques, and provide them with the opportunity to practice and rethink the teaching process. The interactive techniques mostly used six months after participation in the workshop belonged to the question and answer (Q& A) techniques, active evaluation, and use of scenario.
    Conclusions
    It seems that the provision of training opportunities, observation of performance, and giving feedback were effective to improve the quality of empowerment programs. It was suggested that other empowerment programs should also address this point.
    Keywords: Faculty, Medical, Feedback, Education, Teaching
  • Reza Sepahvand , Ali Hozni * Page 12
  • Ahad Amiri Gharghani , Majid Amiri Gharghani , Ali Asghar Hayat * Page 13
    Background
    Success and academic achievement are among the most important goals of both students and educational systems. Researchers have examined the impact of different factors such as intelligence, personality, attitude, study habits, thinking skills and academic motivation on students’ academic performance.
    Objectives
    The purpose of this study was to investigate the relationship of motivational beliefs and cognitive and metacognitive strategies with students’ academic achievement.
    Methods
    In this descriptive - analytic cross-sectional study, the statistical population included all medical and health students of Shiraz University of Medical Sciences (1405 students), 250 of whom were selected according to the Levy and Lemeshow’s formula. After estimating the sample size, the stratified random sampling method was used. To collect data, Pintrich and de Groot’s motivated strategies for learning questionnaire (MSLQ) was employed. Data were analyzed using descriptive statistics, Pearson’s correlation and independent t-test.
    Results
    Among the components of cognitive learning strategies, comprehension (r = 0.1266, P < 0.10), and among the components of metacognitive learning strategies, the regulation component (r = 0.049, P < 0.05) had a significant positive correlation with academic performance. Among the components of motivational beliefs, the self-efficacy component (r = 0.173, P < 0.10) showed a significant positive correlation with academic performance. Based on the results of multiple regression analysis, only metacognitive learning strategies had the ability to predict the academic performance of the students. There was no significant difference between male and female students in any of the studied variables.
    Conclusions
    Based on the results, students who use more diverse cognitive strategies show better performance than others. Performance is more desirable among those who evaluate their understanding of the content of the course and make more efforts and have more perseverance (regulation) in the learning process. Students who believe in their abilities (self-efficacy) and reinforce these beliefs will have a better academic performance.
    Keywords: Learning Strategies, Cognitive, Metacognitive, Academic Achievement, Students
  • Mohammad Reza Amiresmaili , Moghaddameh Mirzaee , Mohsen Aminizadeh , Rohaneh Rahimisadegh * Page 14
    Background
    Training of human resources, especially nurses, is a profitable investment for hospitals with major economic return if properly planned and implemented.
    Objectives
    The present study aimed to evaluate the effectiveness of a cardiopulmonary resuscitation (CPR) course as an in-service training program, based on the Kirkpatrik model.
    Methods
    This interventional study was conducted at Afzalipour Hospital of Kerman, Iran from October 2014 to May 2015. The study sample consisted of 45 nurses, including 20 nurses in the case group and 25 nurses in the control group. The case group participated in a four-hour CPR training workshop. The Kirkpatrick model was used to determine the effectiveness of the CPR course. Data were collected using three questionnaires and hospital records.
    Results
    The participants were satisfied with the training course, and a significant difference was observed in the mean score of three intervals of learning levels evaluation (P < 0.0001). Based on the findings, CPR training affected the learning level of nurses from the case group; however, the average learning score was not significantly different between the two groups (P = 0.26). In addition, the difference in the mean score of behavior level was not significant before and after training (P = 0.91). The results of Chi-square test also showed that CPR training did not affect the forth level (P = 0.54). Finally, the overall effectiveness of the CPR training course was estimated at 32.51%.
    Conclusions
    This study indicated that effectiveness of in-service training is not at a desirable level. Since organizations allocate a lot of their resources to such training courses every year, it is essential to reconsider planning and implementation processes.
    Keywords: Evaluation, Education Effectiveness, Cardiopulmonary Resuscitation, Kirkpatrick Mode
  • Jamileh Salar , Fatemeh Keshmiri * Page 15
    Objectives
    The present study was conducted with the aim of psychometric evaluation of a tool measuring behavioral intention in relation to interprofessional shared decision-making based on the theory of planned behavior and its assessment among medical and nursing students.
    Methods
    This descriptive study was carried out in two stages. In the first stage, the psychometric properties of the interprofessional shared decision-making (IP-SDM) tool were evaluated based on experts’ opinions. In the second stage, the participants’ behavioral intention was evaluated using the mentioned questionnaire. The questionnaire consisted of five domains of cognitive attitude (2 items), emotional attitude (2 items), subjective norms (3 items), perceived behavioral control (3 items), and intention to use interprofessional shared decision-making (3 items). Content validity of the questionnaire was evaluated qualitatively and quantitatively (using the content validity ratio (CVR) and content validity index (CVI)). Cronbach’s alpha coefficient and interclass correlation coefficient (ICC) were used to determine the reliability of the questionnaire. In the second stage, the data were analyzed using descriptive statistics (mean and standard deviation) and Pearson’s correlation test in SPSS software.
    Results
    Qualitative and quantitative content validity of the questionnaire was confirmed based on experts’ opinions. The internal consistency of the tool, based on the Cronbach’s alpha coefficient, was 0.92, and the tool’s repeatability was calculated at 0.84 using ICC. Participants in the study intended to participate in interprofessional shared decision-making.
    Conclusions
    The behavioral intention measurement tool in relation to interprofessional shared decision-making based on the theory of planned behavior has good validity and reliability in Iran. Regarding the participants’ behavioral intention to participate in shared decision-making, it is suggested that a suitable platform for shared decision-making and teamwork between health team members be provided in educational systems.
    Keywords: Shared Decision Making, Decision Making, Shared Interprofessional, Theory Planned Behavior, Behavioral Intention
  • Fatemeh Cheraghi , Maryam Dehghani , Sara Ehsani , Arash Khalili , Neda Alimohammadi , Saeideh Almasi * Page 16
    Background
    Documentation of nursing care is one of the most important professional responsibilities of nurses and one of the major components of medical care and patient record documentation.
    Objectives
    The present study was performed to determine the effect of problem, intervention, evaluation (PIE) training on the quality of nursing students' documentation.
    Methods
    In this semi-experimental single-group study with a pretest-posttest design, a total of 28 nursing students were selected by simple random sampling. The data collection tools included a demographic questionnaire, PIE documentation form, and documentation quality checklist. First, the students were asked to write two reports using the traditional or narrative method. Then, a training workshop was organized about PIE documentation, and the students were asked to use this method and write two more reports about the same patient on two consecutive days; overall, each student presented four reports. A total of 112 reports were analyzed using descriptive statistics and paired t test in SPSS.
    Results
    Based on the results of paired t test, there was a significant difference in the mean score of documentation quality between the pretest and posttest (P < 0.001). Also, there was a significant difference in the mean score of documentation quality between the pretest and posttest in terms of both report structure and content (P < 0.001).
    Conclusions
    Use of PIE reporting system improves the quality of nursing documentation. Therefore, it can be a suitable alternative for the current narrative or traditional method.
    Keywords: Nursing Documentation, Problem-Based Reporting, Nursing Students
  • Jonas Nordquist * Page 17
  • Sakineh Sabzevari , Hakime Hosainrezaee , Esmat Nouhi * Page 18
    Background
    One of the main goals of action research is to improve the quality of education at both individual and organizational levels. Management enables organizations to improve their performance in areas, which have the greatest impact on students’ learning and empowerment, without compromising the quality of education.
    Objectives
    In this study, we aimed to improve the quality of basic clinical skills training for nursing students in an action research, using the available resources.
    Methods
    In this action research, a sequential mixed method was applied. The participants in the qualitative phase included experts in the field of education, students, and stakeholders responsible for training at the nursing skills, midwifery, and medical-surgical nursing units of Razi Faculty of Nursing and Midwifery in Kerman, Iran. Assessment of facilities and resources in the quantitative phase was also carried out using a data collection form, a student survey form, and a checklist of basic clinical skills. The stages of action research included action planning for problem-solving, implementation, evaluation, and reflection. The students’ problems with the basic clinical skills and their possible causes were also identified. The most effective and practical solutions for quality improvement included improvement of the educational environment of skill laboratories, followed by the enhancement of skills assessment process using an objective structured clinical examination (OSCE).
    Results
    The conventional method failed in the assessment of students’ competence and lacked adequate objectivity and reliability. A significant difference was observed in the mean scores of basic clinical skills (e.g., injection, measurement of vital signs, and dressing) between the conventional method and OSCE (P < 0.05). From the viewpoint of students, OSCE is more reliable and accurate than the conventional method and uses more suitable educational materials and facilities.
    Conclusions
    Based on the findings, by improving the educational environment of clinical skills laboratories and implementation of OSCE, nursing students can translate their knowledge of basic clinical skills into practice. We can also improve the quality of health services and clinical care for patients and reduce the incidence of practical errors made by nursing students.
    Keywords: Education, Clinical Skills, Nursing, Midwifery, Students, Action Research
  • Shoaib Dehghani , Kaveh Bahmanpour , Bijan Nouri , Sina Valiee * Page 19
    Background
    Organ donation requires management to promote awareness and create the proper culture in all societies. Awareness and attitude of students and nursing staff can affect the process of donating organs.
    Objectives
    The aim of this study was to determine the effect of blended education on the awareness and attitude of nursing students towards organ donation.
    Methods
    In this clinical trial study, which used a Solomon four-group design, 94 undergraduate nursing students from Azad University of Sanandaj in 2016 were selected by the census method and randomly assigned to four groups. The data collection tool included demographic data and the Organ Donation Awareness and Attitude Questionnaire blended education was provided to students through a one-day interactive workshop and social networks for 2 weeks. Before and after the intervention, students’ awareness and attitude were evaluated. The collected data were analyzed by SPSS 16 using Fisher, Wilcoxon, Mann-Whitney, and Kruskal-Wallis tests.
    Results
    The comparison of the awareness level after the intervention in the four groups showed statistically significant differences (P = 0.0001). Moreover, there was a significant difference in the attitude level after the intervention between the four groups (P = 0.02).
    Conclusions
    Blended education increases the awareness and attitude of nursing students. Thus, trainers and educators are suggested using blended education to train students regarding donation. Moreover, it is recommended to include the topic of donation in the nurse’s curriculum.
    Keywords: Organ Donation, Nurse, Student, Education
  • Shadi Dehghanzadeh Page 20
    Background
    Active learning approaches, including the flipped classroom, can enhance meaningful learning among students of medical sciences.
    Objectives
    The purpose of this study was to investigate the effect of the flipped classroom teaching method on nursing students' learning approaches.
    Methods
    This one-group quasi-experimental study with a pretest-posttest design was carried out among 46 undergraduate nursing students who had passed the orthopedic nursing course in the academic year of 2017-2018. The participants were selected by the census method. To teach through the flipped classroom method, the instructor provided electronic content for the course using the Articulate Storyline software. Students studied electronic contents and the reference book prior to each session and participated in predetermined collaborative activities. Data were collected using the Revised Two-Factor Study Process Questionnaire (R-SPQ-2F) before and after the completion of the classes. Data were analyzed using descriptive statistics, independent t test, paired t test and Pearson correlation coefficient by SPSS software.
    Results
    The flipped classroom method significantly increased the deep learning approach (P <0.001) and its subscales including deep motive (P <0.001) and deep strategy (P = 0.001). Also, there was a significant negative correlation between deep learning and superficial learning before (r = -0.29, P = 0.047) and after (r = -0.34, P = 0.015) the implementation of the flipped classroom method.
    Conclusions
    By implementing the flipped classroom method, deep learning among nursing students is strengthened. Also, by assessing learners’ study approaches, it is possible to identify the various educational methods that affect deep learning.
    Keywords: Deep Learning, Active Learning, Nursing Education
  • Mehdi Mohamaddi , Mahboubeh Mehrvarz , Kamal Hashemi , Ghasem Salimi * Page 21
    Background
    Today knowledge and information sharing by means of new technologies among university students and faculty members is important. Therefore, it is necessary to identify factors which influence knowledge sharing among university students.
    Objectives
    The main purpose of the present study was to examine the role of technology acceptance in improving knowledge sharing among students of Shiraz University of Medical Sciences, Shiraz, Iran.
    Methods
    In this applied research, a descriptive-analytic cross-sectional study was used. The study sample consisted of 228 medical students from Shiraz University of Medical Sciences. The data collection tools included two questionnaires, i.e., technology acceptance (Toe, 2011) and knowledge sharing (Van den Hoof & Van Weenen, 2004) questionnaires. The validity of these scales in terms of form and content was examined by experts in the field, and their reliability was confirmed by measuring Cronbach’s alpha coefficients. The reliability of technology acceptance and knowledge sharing questionnaires was 0.83 and 0.72, respectively. After confirming the validity and reliability of the questionnaires, they were distributed among the participants. Finally, the collected data were analyzed using one-sample t-test and Pearson’s correlation coefficient test in SPSS and structural equation modeling (SEM) in Lisrel 8.8.
    Results
    The results of one-sample t-test showed that the levels of technology acceptance and knowledge sharing were higher than the acceptable level among medical students. In addition, the results of Pearson’s correlation test indicated a significant positive relationship between technology acceptance (and its components) and knowledge sharing. In addition, SEM showed that technology acceptance is a significant positive predictor of knowledge sharing among students. Among different components of technology acceptance, only perceived usefulness (PU) and facilitating conditions (FC) were significant predictors of knowledge collecting (P = 0.37 and 0.28, respectively). Nevertheless, other components of technology acceptance could not predict different types of knowledge sharing.
    Conclusions
    The present results showed that PU and FC could predict the knowledge sharing of students more than other components. To improve knowledge sharing in the context of higher medical education, different aspects of technology acceptance need to be evaluated and expanded; accordingly, establishment of new educational policies is necessary.
    Keywords: Knowledge Sharing, Knowledge Donation, Knowledge Collecting, Technology Acceptance, Medical Students
  • Aziz Shamsi , Safoura Dorri * Page 22
    Context: Effective clinical skills training of medical students can guarantee a higher quality of care, diagnosis, and treatment for patients. Therefore, selection of appropriate methods of clinical education is of great significance. Mastery learning is one of the learning models in which educational progress is not dependent on time, but rather performance. In this model, the learner is constantly assessed until achieving mastery. All students can achieve the same level of learning, although the amount of time required for mastery is variable.
    Objectives
    The purpose of the present study was to review the literature on the effects of mastery learning on the clinical education of medical students.
    Data Sources: This systematic review was conducted in English and Persian databases to evaluate articles on mastery learning in clinical education, published from 1990 to 2016. In the primary search, 503 articles were retrieved using Persian and English keywords, including “clinical teaching” and “mastery learning”. After reviewing the abstracts, 50 relevant articles were selected, and, finally, 26 articles were reviewed.
    Results
    Based on the findings, mastery learning can improve skill mastery among students, reduce the complications of medical interventions, increase the students’ self-confidence, reduce the required time for skill acquisition, increase the students’ knowledge, and improve their communication skills. Also, this method of learning has been effectively applied in medicine, nursing, and occupational therapy for students and hospital staff.
    Conclusions
    Mastery learning is a suitable method for teaching clinical skills to students. Considering the advantages of this method, it can be used effectively to train students from different medical disciplines.
    Keywords: Clinical Education, Mastery Learning, Medical Student, Systematic Review
  • Mahboobeh Eshaghi Page 23
  • Afshin Mousavi Chelak , Hasan Kaviani Page 24
    Objectives
    Considering the contradictory evidence on the effectiveness of educational technologies, this meta-analysis was conducted to evaluate the impact of these technologies on medical education.
    Data Sources: This meta-analysis was conducted based on secondary analysis methods. The analysis included experimental and semi-experimental studies on the effectiveness of educational technologies in the medical education of Iran. The census sampling method was applied in this study, and 54 studies were identified as relevant based on the inclusion and exclusion criteria. For data collection, a researcher-made checklist consisting of three sections, i.e., bibliographic information, methodological information, and findings, was completed. Finally, the Comprehensive Meta-Analysis (CMA) software was used for analysis of data.
    Results
    Among different educational technologies, multimedia education, E-learning, and computer-mediated learning using compact discs and software packages had significant effects on medical education; therefore, use of these technologies was effective in medical education. According to our findings, multimedia education (effect size, 1.793) was considered to be the most influential virtual technology in medical education. In general, all educational technologies were effective in the medical education of Iran; however, their effectiveness was insubstantial. Considering the area under the normal curve, the average effectiveness of educational technologies was 63% higher in the virtual education groups, compared to the controls without virtual education.
    Conclusions
    One of the most important issues in medical education and training is preparation of an engaging learning environment for students, which can be realized through a variety of educational technologies. However, for optimal effectiveness, complementary use of virtual technologies along with traditional methods or their integration in other educational approaches is suggested
    Keywords: Technology, Virtual Education, Medical Education
  • Soheyla Kalantary, Maryam Chehrehgosha, Nadia Shirazi, Mehri Behmadi, Fereshte Araghian Mojarad *, Leila Jouybari Page 25
    Background
    Medical students are in direct contact with patients due to their clinical situation, and one of the important goals of medical education is professional development of these students.
    Objectives
    The purpose of this study was to explain students’ experiences regarding professionalism training using hidden curriculum.
    Methods
    This study was carried out through content analysis, and data were collected through semi-structured interviews with 6th and 8th semester undergraduate students of surgical technology. The participants were entered into the study using the purposive sampling method and each individual interview lasted for about 35 - 45 minutes. Semi-structured questions were used to conduct the interviews and then follow-up and exploratory questions were used to clarify the concept and to deepen the interview process.
    Results
    Overall, 358 primary codes and the two main themes of observing patient rights and professional accountability were extracted. The theme of observing patient rights includes three sub-themes, including observing patient privacy, respect for patient’s dignity and patient safety, and the theme of professional accountability comprised the three sub-themes of compliance with professional standards, professional communication and instructor as ethics teacher.
    Conclusions
    Professors’ familiarity with the training and development of professionalism among medical students, and attention to the role of hidden curriculum in the formulation of values, norms and behaviors regarding professionalism is suggested.
    Keywords: Professionalism, Hidden Curriculum, Explanation, Student
  • Mahmoud Reza Dehghani , Mahla Salajegheh *, Majid Fasihi Harandi , Kambiz Bahaadinbeigy , Bahareh Bahman Bijari , Zeynab Shakiba , Zahra Fatahi Page 26
    Background
    Attempts to increase the development of faculty members can improve their ability to assume different roles.
    Objectives
    The purpose of this study was to design, implementation, and evaluation a medical education fellowship program for the faculty members of Kerman University of Medical Sciences and to propose practical recommendations for the future design of development programs.
    Methods
    In this semi-experimental study, a total of 53 faculty members of Kerman University of Medical Sciences participated in a one-year development program, which was designed by the Education Development Center and included the main disciplines of medical education. The program was evaluated in several steps, using the Kirkpatrick model.
    Results
    In the first level of Kirkpatrick model, the majority of the participants were satisfied with the general quality of the fellowship program. Based on the findings, the program led to an increase in the knowledge of faculty members and promoted a more positive attitude towards education and these programs. The findings related to the second level of Kirkpatrick model showed a significant difference between the pretest and posttest results (P < 0.05). In addition, analysis of the effects of the program on the participants’ behaviors and practical learning indicated positive changes.
    Conclusions
    The medical education fellowship program led to positive changes in the participants’ attitudes towards education and faculty development programs and increased their knowledge about educational principles and strategies and achieving of training skills. It can be concluded that the medical education fellowship program could achieve many of its preset goals.
    Keywords: Faculty Development Programs, Medical Education, Faculty Members
  • Ali Arefi , Mohammadreza Zangiabadi *, Nima Soltaninejad , Rahimeh Khademipoor Page 27
    Background
    According to the status of ethics in medical education and owing to the students’ talent and rational spirit, it seems that the education system, despite the emphasis on courses such as medical ethics, should focus on the improvement of teaching quality of Islamic education and explanation of religious concepts, since emphasis on increasing the quality of Islamic education leads to the promotion of medical ethics.
    Objectives
    The current study aimed at evaluating the impact of courses on Islamic education and religious concepts on the promotion of medical ethics among the students of Kerman University of Medical Sciences, Kerman, Iran.
    Methods
    The current descriptive cross sectional study was conducted on 5831 students of Kerman University of Medical Sciences as the statistical population in the academic year of 2016 - 2017. Using the Morgan table, 360 subjects were selected as the study sample using stratified random sampling method. In order to collect data, a standard questionnaire, which its reliability was confirmed by Cronbach’s alpha coefficient, was used. Data were analyzed using structural equation modeling with AMOS software.
    Results
    Structural equation modeling was used to analyze the data and test the hypotheses. The models could explain the measurement indices, and based on the adopted method, the fitting indices of the measurement models showed the acceptability of the measurement models for Islamic education, religious concepts, and medical ethics.
    Conclusions
    In addition to the content-related relationship with medical ethics, the Islamic education promotes ethics in the target community and has a direct impact on the education of medical ethics. Also, the explanation of religious concepts has a major impact on the promotion of the quality of medical ethics, since religious concepts, as students' subjective presuppositions, help them to better understand the content of medical ethics. By the evaluation of the research hypotheses, a direct relationship was observed between the education of Islamic education and promotion of medical ethics. Accordingly, a relationship between the religious concepts and the promotion of medical ethics was also confirmed. The course of Islamic education has a lower impact on medical ethics compared with that of religious concepts. The attention paid by the medical education system to the results of data analysis leads to an increase in the quality of Islamic education course offered to the students.
    Keywords: Islamic Education Religious Concepts, Medical Ethics, Medical Students
  • Ali Reza Kalantari , Noora Rafiee , Saeed Hosseni , Somaye Noori Hekmat , Ali Akbar Haghdoost , Reza Dehnavieh * Page 28
    Background
    Medical education development (MED) centers are established in order to improve the quality of medical education. It seems that after more than two decades since the establishment, the centers still have difficulties to perform some tasks.
    Objectives
    According to the important role of MED centers, the current study aimed at adapting the performances of such centers with their assigned tasks.
    Methods
    The current qualitative applied study was conducted in 2013. The statistical population of the study included managers of MED centers in Iran. Data were collected through a questionnaire containing open questions. During a national meeting the questionnaire distributed among 40 managers of MED centers and then analyzed using content analysis.
    Results
    More than half of the major functions that the managers stated, were referred to the first, second, and fourth tasks of the centers, and only 18% of the major functions were related to other tasks (11 cases). About 28% of the functions performed in such centers had no direct correlation with any of the 14 tasks.
    Conclusions
    Despite the history of MED centers for several decades, they are not justified in respect to their duties. It is recommended that guidelines be developed to address all duties and adequately monitor their implementation.
    Keywords: Medical Education Development Centers, Performance, Indicator, Quality, Medical Education, Iran
  • Shahin Salarvand *, Zahra Bagheri , Mehdi Safari Ebrahim Saraie Page 29
    Background
    Due to the pivotal role of clinical education in the nursing profession, paying attention to effective approaches in improving the quality of education is of great importance.
    Objectives
    The current study aimed at determining the effect of mentorship with senior students or nurses on knowledge and clinical self-efficacy of nursing students.
    Methods
    The current trial was conducted on 72 nursing students in Lorestan University of medical sciences in academic year 2012 - 2013. The participants selected by convenience sampling method and assigned, using stratified random blocks, to one control group which supervised by a faculty member only and two intervention groups supervised by a faculty member and a senior student or nurse as mentor. Clinical self-efficacy scale and a researcher-made questionnaire were used to measure the participants’ knowledge and self-efficacy before and after the educational intervention. ANOVA and paired samples t test and chi square were used to analyze the data.
    Results
    The mean score of knowledge and clinical self-efficacy increased in all the three groups, but the increase was significantly higher in the third group (the group supervised by a faculty member and a qualified nurse as mentor) than the others.
    Conclusions
    Due to the positive effects of mentorship with a qualified nurse, it is suggested that mentorship programs be included in the curriculum of nursing students.
    Keywords: Mentorship, Undergraduate, Nursing Students, Knowledge, Self-Efficacy, Clinical Education