فصلنامه آموزش و اخلاق در پرستاری
سال یازدهم شماره 3 (پاییز و زمستان 1401)

By conducting a proper evaluation, it is possible to identify the strengths and weaknesses of clinical education, and by strengthening the positive points and eliminating the shortcomings, steps can be taken in the direction of reforming the educational system. This study was conducted with the aim of investigating the three-circle model of Dundee University in determining the essential duties of clinical students of Jahrom University of Medical Sciences.

This research was carried out using a cross-sectional descriptive method. The subjects of studied were interns of Jahrom University of Medical Sciences (Intern) who were working in internal, surgery, pediatrics, women and events departments. Sampling was done in an easy and accessible way (from different sections by age and sex). Data collection was done using a researcher-made questionnaire. The questionnaire was distributed among 50 interns in Jahrom Faculty of Medical Sciences in Peymaniyeh and Motahari hospitals who were present in different departments. Data analysis was done using spss software version 21 as well as descriptive statistical tests (mean, percentage and standard deviation) and inferential tests (regression and Spearman).

The highest level of satisfaction with the quality of clinical experiences gained in clinical internship was in the surgery department (63.2%) and the lowest in the family medicine department (63.2%). The highest satisfaction score of students in social medicine, internal medicine, psychiatry and surgery department was from observing at least one professor during physical examination, and the highest satisfaction score of students in pediatric department was a good opportunity to follow the progress of patients' treatment. The majority of the students considered the training in patient interviewing skills (65.8%), taking care of hospitalized patients (65.8%) and doctor-patient communication skills (65.8%) as sufficient (suitable and good). Also, the majority of the students considered the educational training in the field of doctor-patient communication skills using an interpreter if needed (63.2%) and caring for elderly patients (65.8%) insufficient. The majority of the students found the educational training in the field of medical data recording (65.8%) and confidentiality and privacy of the patient (81.6%) to be sufficient (suitable and good). Also, the majority of students considered education in the field of medical economics (35.1%) and population-based medicine (31.6%) to be insufficient.

Based on the results of the present study, it was determined that using the three-circle model of Dundee University is an effective method in identifying the strengths and weaknesses of medical students in relation to clinical training.

Throughout the history of science, tools have had a special use in the field of medicine, so that modern medical advances in the context of tools should be evaluated. These advances in the field of tools have led to new issues in the field of medical ethics. Now the question is, "Can these tools be used to solve the challenges of medical ethics?" Therefore, this issue should be discussed and evaluated.

This study is a narrative review study. First, the issue of "technology neutrality or technology orientation" was discussed. Then, the possibility of using tools to solve ethical problems and challenges briefly was discussed. Finally, based on the “medical ethics” model, we redefined, the definition of medical ethics tools.

Medical tools are used to facilitate or solve medical challenges. According to the “medical ethics” model, each moral axis, has a medical equivalent. Therefore, in this framework, similar to medical situations, it is possible to use tools, to facilitate or resolve ethical challenges. Also, following the definition of medical tools (as a model), a definition of a device with ethical use (in medical environments) is obtained: "Medical ethics tools” means a device its purpose is to help implement bioethics (not for medical uses), and its purpose is determined by its creator. "

It seems that tools can be used to bridge the gap between ethics and medicine in the field of tools (hardware).Based on this, it is possible to design and produce device with direct ethical uses.

In their daily clinical performance, nurses are faced with many ethical issues every day and every hour, which they have to solve. Ethical knowledge guides the activities of nurses to consider what is important. Where to do their duties. Sometimes the Importance of ethical knowledge have superiority to the technical skills of nursing work. This study was conducted with the aim of investigating the role of ethical knowledge in the development of nursing.

The present study is a review- narrative type and the data is from library sources and databases (Medline, Google scholar, Magiran and SID), using the keywords ethics in nursing, development of ethical knowledge in nursing, ethical knowledge, nursing ethics. Or their combination and other related keywords along with their English equivalent were obtained between 2010 and 2020.

The findings were presented in 4 sections describing ethics, types of ethics, different ethical perspectives and ethics in nursing literature.

Based on a review of the literature, it can be said that ethical knowledge is an inseparable part of the nursing profession, and as one of the four dimensions of knowledge development in nursing, it plays an important role, and it is impossible to develop nursing knowledge without considering ethical knowledge. In order to achieve this goal, it is necessary to investigate and identify the care environment, its opportunities and threats, and finally to develop regular and continuous training programs in the field of the importance and compliance with the principles of nursing ethics in hospitals.

To succeed in patients’ treatment and care and improving the health of them, a direct relationship with the level of confidence and satisfaction of patients between clients and health workers based on ethical principles is necessary. Therefore, these principles should be carefully followed among medical and paramedical students, especially clinical-students and the related courses of professional ethics and attention in the curriculums should be compiled. This study aims to investigation the courses related to professional Ethics in Medical Sciences Curriculum in Iran.

This was a Quantitative Content Analysis study by documentary (library) method in order to investigate the number of units related to the topic of professional ethics in variouse fields of medical and paramedical sciences. Which currently active in the Ministry of Health, Treatment and Medical Education were reviewed and reported to identify the degree of adaptation of existing units and courses to the topic of professional ethics.

Among the total of 11821 taken units from 205 disciplines, 675.5 (5.7%) units were identified to be relatively associated and 216.9 (1.8%) units were complete associated with the topic of professional ethics.

The allocation of few units related to the topic of professional ethics in the curriculums of medical and paramedical sciences in Iran, it requires a general revision and promote in education programs of students in these disciplines in order to strengthen moral and professional foundations.

Cardiovascular disease is the most common cause of death, today. Tachycardia is usually a medical emergency that indicates cardiac dysrhythmia. The aim of this study was to compare the knowledge of emergency medicine interns in the management of common rapid heartbeats before and after training by model-based and lecture methods.

In this semi-experimental study, before and after the intervention, 122 emergency medicine interns were included in the study (2019). Students were randomly divided into two groups: model-based workshop (60 people) and lecture (62 people). The data collection tool in this study was a researcher-made questionnaire whose validity and reliability (Cronbach's alpha = 85%) were confirmed. The questionnaire was completed by both groups of students before the intervention and after the intervention. Data analysis was done using SPSS version 20 software and descriptive statistics (percentage, mean and standard deviation) and inferential tests (Mann-Whitney and Wilcoxon). In all calculations, the value of 0.05 was considered as a significant level.

The mean score of the tachycardia management test after training in the lecture group was 8.6± 9.1 points (out of 13 points). And the mean score of the management test of tachycardia, after training in the model-based workshop group, is equal to 5. It was 6.9±1.00 points (out of 13 marks). According to Mann-Whitney non-parametric test, there was a statistically significant difference in terms of the mean score of the pulse management test after training between the two groups of model-based workshop and lecture group (P = 0.001). Also, the mean score of the rapid-fire management test after training was higher in the model-oriented workshop group.

It seems that the use of model-based method (practical workshop with modeling and clinical scenario) can be more effective on the knowledge of emergency medicine practitioners in the management of common tachycardia before and after training than the lecture method. Therefore, using the model-based method can increase the knowledge of emergency medicine students.

Advances in technology in recent decades have affected health care and led to moral distress. Moral distress is a concept that remains ambiguous in neonatal intensive care nursing. Therefore, the current research was conducted with the aim of analyzing moral distress in the neonatal intensive care unit, using Rogers' evolutionary approach.

This review study was done with the evolutionary approach of Rogers concept analysis. In the literature review stage, ScienceDirect, Google Scholar, PubMed, ProQuest, Magiran, medex Iran, SID, Scopus databases were searched using the keywords of the concept of moral distress, neonatal special care, without a time limit until August 2022. After removing the articles that did not meet the inclusion criteria, the full text of all the articles that met the inclusion criteria was prepared and analyzed.

In this study, the characteristics of this concept were determined under the title of emotional and psychological pain and discomfort, real or mental limitations, moral mistakes or failure to make moral decisions. Antecedents of this concept in dimensions; There are individual factors, social-environmental factors, cultural factors, organizational factors and institutional policies, and its consequences were identified in two physical and psychological dimensions.

The findings of this study, by clarifying the concept of moral distress in the neonatal intensive care unit, can help in the development of theories and even the construction of needed tools..

Theory-practice gap is one of the basic and oldest problems of nursing, which has shown itself well in the bedside and training of nurses. The use of philosophical approaches such as pragmatism is a solution to help reduce this gap and recognize the existing challenges in order to solve this gap. Therefore, the present study was conducted with the aim of investigating the pragmatism approach on the nursing theory-practice gap.

The present study is a scoping review type and Persian and English articles extracted from internal databases SID, MAGIRAN and IRANDOC and external databases PubMed, EMBASE, ScienceDirect, Google Scholar, ProQuest, SCOPUS and CINHEAL in the period from 2012 to 2022 using keywords theory-clinic gap, theory-to-practice gap, theory-bedside gap, theory-practice challenges, practicality challenges of nursing theories, philosophy of nursing education, philosophical schools in education, critical thinking at the clinical, Evidence-based nursing, process nursing and clinical improvement, pragmatism and education, nursing and pragmatism separately, combined and its English equivalent using Boolean operators.

A review of the selected articles showed that the gap between theory and practice based on the approach of pragmatism in nursing is divided into two main categories: a) individual factors including three subgroups: 1) motivation to study and continuous education, 2) strong communication skills, and 3) improving critical thinking, and b) Organizational factors include five main factors: 1) clinical-based training, 2) revision of the curriculum, 3) use of new training methods, 4) empowerment of nurses in different job positions, and 5) provision of new training facilities and equipment.

Paying attention to factors that increase the motivation and information of personnel along with strengthening critical thinking skills along with paying attention to organizational factors such as the use of new educational methods and empowering nurses in different branches can be a factor to reduce the gap in the theory of practice based on the pragmatism approach.

Cardiopulmonary resuscitation (CPR) is a life-saving method used in emergencies such as cardiac arrest. Knowledge of CPR among medical students is essential for its effective implementation. In Iran, there is limited information about the level of knowledge and awareness of CPR among students.

This narrative review was conducted with the aim of providing an overview of the studies conducted in Iran regarding the knowledge and awareness of CPR among students. The databases searched included PubMed, Scopus, Web of Science, SID, Elmnet, Iranmedex and Google Scholar search engine, and the search terms used were "Iran", "student", "medicine", "nursing", "intern", "Resident", "awareness" and "cardiopulmonary resuscitation" are the English equivalents of them.

Twelve studies were included in this narrative review, all of which were conducted in different regions of Iran. The results showed that the general level of knowledge and awareness of CPR among Iranian students was very low. For medical and paramedical students, participation in CPR courses is essential. It is necessary to emphasize on providing quality courses and workshops for all medical students and to re-evaluate their skills. Also, poor quality practical and theoretical training can lead to insufficient CPR knowledge and practical skills. However, attention to CPR training is necessary for all members of the community

The findings of this study indicate a lack of knowledge and awareness of CPR among Iranian students. Therefore, it is necessary to include CPR training as a mandatory part of the curriculum for all students in Iran. In addition, efforts should be made to raise public awareness of the importance of CPR and provide educational opportunities to the general public, including students.

The treatment of patients in the last days of life has always been a challenge for the treatment staff, both doctors and nurses, and deciding on the continuation of treatment in these patients is one of the most basic needs of health professionals. This study was conducted with the aim of investigating the attitude of the medical staff regarding the do not resuscitate order in the studies conducted in Iran.

This study is a systematic review. For the preliminary review of the studies carried out from the articles of the Persian language databases: SID, Iranmedex, Magiran and the English language databases Science Direct, Web of Science and Scopus and the search engines PubMed and Google Scholar without time limit and logical search for Farsi keywords of non-revival cardiopulmonary, do-not-resuscitate policies, do-not-resuscitate order, Iran, etc. and the English keywords cardiopulmonary do-notresuscitate, do-not-resuscitate policy, iran, do-not-resuscitate order, DNR were used. The quality of the articles was evaluated using the STROBE standard checklist.

In the initial stage of searching for studies, 963 studies were reviewed. Then the researchers reviewed the searched articles and 952 studies were removed completely due to not being related to the topic under study and being repetitive and not having access to the article. Descriptive articles in Iran were selected in both Persian and English languages, and finally 11 studies were used to analyze and write the article. The articles were examined in three categories of evaluation of attitudes, tools and policies.

Considering the existence of positive attitude in the studies, it is suggested to develop, integrate and standardize the attitude measurement tools and examine the role of other mediating variables on the attitude of the treatment staff towards the do not resuscitate order; It is necessary to properly analyze the ethical, jurisprudential, and legal considerations of this matter, and according to that, clear executive instructions should be provided to the treatment staff.

Peer guidance has been welcomed in medical science education in recent years. One of the dimensions of the success of this process is the selection of a competent peer leader who can fulfill his role well. The present study was conducted with the aim of reviewing a narrative on the dos and don'ts of selecting peer mentors in medical science education

This study is a narrative review method that was conducted during three stages of literature search, data evaluation and analysis with the aim of providing an overview of the characteristics and dos and don'ts of selecting peer guides. Gathering information by searching for the keywords of Peer Mentors, Peer Mentoring, Peer Mentors, Peer Mentoring, with the help of logical operators from the articles of Persian language databases; SID, Iranmedex, Magiran and other databases. English language Science Direct, web of science and Scopus, Cochrane and PubMed and Google Scholar search engines have been used without time limit

9 characteristics and competences have been extracted for peer educators, which are included in the category of competences, and they are: similarity and common areas (principle of compatibility), having strong communication skills, ability in the field of leadership, passion and enthusiasm for education. and supporting others, paying attention to the training process in guiding with a mutual approach, having enough time for guiding, empathy, flexibility and criticism, trustworthiness; And four negative characteristics were also obtained in the opposite point, which are included in the category of not to choose a peer guide and include: not playing a role in the form of a private tutor, academic advisor and trainer editor, also the peer guide should not have a communication style in relation to the guided follow threatening or hierarchical

Accurate identification of the characteristics and competencies of peer mentors along with the effectiveness of the mentoring program and the competencies of the mentored person can lead to the desired result. The findings of this research can help educational planners to select peer leaders who have the necessary competencies and strive to achieve the goals of the process.

The use of positivist epistemology in patient care education requires perceptibility, experienceability, and testability of care dimensions. This is while the nursing student, in his work area, is in contact with a person who has intangible dimensions. Dimensions that may not have external perspectives for a person's experiences. The purpose of the present study is to criticize the role of positivist epistemology in the education of nursing students.

The present study is a narrative review that by searching the key words including positivism, Philosophy, Nursing, Education in PubMed, Google Scholar, Science Direct, Ovid, Wiley, Web of Science, Magiran and SIDs databases and in domestic and foreign journals was done from 2000 to 2023.

The positivism epistemology as a philosophical approach, is widely seen in the education of nursing students. This is while undergraduate and graduate students are not familiar with this philosophical approach; and it has no place in their educational curriculum. On the other hand, one of the main disadvantages of using this approach alone in the education of nursing students is that this philosophical approach deliberately pays attention to the physiological dimension of persons and does not pay special attention to other aspects of them; including the mental-psychological and spiritual dimension due to its abstractness and intangibility.

Considering the multiple use of this philosophical approach in examining and evaluating the physiological dimension in patients, although it seems necessary that nursing students in the bachelor's and master's degree should be familiar with the basics of this philosophical approach. But on the other hand, their familiarity with other Philosophical approach is a necessity to evaluate and manage the non-physiological aspects of patients.