مجله پژوهش در آموزش علوم پزشکی
سال پانزدهم شماره 3 (پاییز 1402)

Learning and teaching through personal computers have come a long way (1). Over the past two decades, Friedman has described the concept of the "amazing medical education machine" and how medical education can grow incrementally in space, time, and content through the appropriate use of this technology. With the advent of the Metaverse, this amazing medical learning machine has now become a reality. The Metaverse is a combination of "meta" and "universe" that describes a virtual environment connected to the physical world (2). In educational concepts, Metaverse is a term used to describe a variety of pervasive technologies, including virtual reality, augmented reality, or mixed reality, which are used to advance education and learning practices (3). The use of Metaverse in medical education offers new technological and educational capabilities in improving the abilities of health care professionals in patient care, medical knowledge, teamwork, diagnostic reasoning and critical thinking (4, 3). For trainees, with the help of Metaverse, a headset device was used to place them in the space and conditions similar to their working environments, similar to inside the room and next to the patient's bed. This new format allows teams of learners to interact with patients, peers, and educators while simultaneously visualizing the patient's clinical findings, imaging, and laboratory studies at the bedside (2). In another study, the research team developed a multitasking virtual reality application for cardiac arrest resuscitation. This program allows four interns to be in a "virtual room" and collaborate to care for a cardiac arrest patient. In short, medical education has also grown and developed according to new technologies. We need to know how to best use these unique features of the Metaverse in learning design and the overall future of medical education and therapy (1, 5). Metaverse can be used to simulate real-world scenarios, provide interactive feedback and personalized learning based on the needs and preferences of individual learners. This tool can be used to simulate real environments such as hospitals, operating rooms or natural environments, which can help medical students develop their skills and knowledge in a safe and controlled environment To develop (3,4). Research results show that learning based on clinical scenarios simulate real life and continuously improve learning results. Metaverse can improve experiential learning through the integration of effective educational approaches, such as problem-based learning, game-based learning, and scenario-based learning (6). The development of virtual reality simulation technologies in health care systems can be used not only in surgeries, but also in diagnosis, rehabilitation and education. The experiences of using Metaverse should be expanded so that health care providers and professors can understand the necessity of using it (5, 7). He pointed out the limitations of the Metaverse, weaker social connections and the possibility of violating one's privacy. In addition, committing various crimes in cyber space may happen due to the anonymity of people. The following suggestions can be used for educational use of Metaverse: professors should carefully analyze how students understand Metavers. also, educational Metaverse platforms should be created to prevent misuse of students' data (8).

Paying attention to the cultural background of universities as one of the influential factors in hidden curriculum leads to the academic and social success of students. It is necessary to be aware of the diverse and numerous cultural needs of students in order to making decisions and cultural planning in the university. This study was conducted with the aim of determining the cultural needs of students of Shahid Beheshti school of nursing and midwifery in Rasht.

This is a descriptive analytical cross- sectional study that was conducted on 237 students of the Shahid Beheshti school nursing and midwifery in Rasht in 2022. The research tool was a researcher-made questionnaire with a 5-point Likert scale with 47 items and seven subscales. Data were analyzed using descriptive statistics methods including frequency, mean and standard deviation and Spiroman, Shapiro-Wilk, Mann-Whitney U, Friedman and Bonferroni correction tests through SPSS.

The results showed that 137 students (57.8%) were female, 211 students (89%) not working,  152 students (63.7%) native and 226 students (%95.4) single and average age of students was 21.3±3.6 years. The students’ culturally related needs in order of priority; development of sports activities, artistic skills, the need related to social customs and traditions, the development of social skills, spiritual matters, the need related to political thinking and religious matters. The results showed that there is no statistically significant difference between students' cultural needs and gender (p<0.005).

According to the results of this study, Students have diverse cultural needs. From the viewpoints` of students, the need to develop sports and artistic activities is in priority. Therefore, it is recommended that the seven needs identified in this study should be taken into consideration by the university officials and to make appropriate planning should be done to meet these needs.

Universities are the most important place for producing science So, organizing academic research is one of the most important effective strategies for social development. The purpose of this study was to identify intra -academic barriers to research from the perspective of faculty members and students of the Islamic Azad University of Najaf Abad Branch.

This descriptive, cross-sectional study was conducted  on 51 faculty members and 311 students of Islamic Azad university of  Najaf Abad Branch in 2021. For gathering data a researcher-made questionnaire includes 26 questions in five areas; The student's ability to implement the research plans, the systematic barriers, the access to facilities, the cooperation of research centers, and the access to research and statistical consultants was used. The validity of the questionnaire was evaluated through the opinions of experts and confirmed by officials, and its reliability was calculated by Cronbach's alpha test of 90%. Data were analyzed by independent T-tests, analysis of variance, and Pearson correlation using SPSS.

The results showed that research obstacles from the perspective of students and faculty members were: The student's  inability to implement the research plans, the systematic barriers, lack of access to facilities, Non cooperation of centers, and lack of access to research and statistical consultants. There is no significant difference between the views of students and faculty members in any of the five areas. Girls had a significantly higher score in the field of student's inability to implement the research plans than boys (P=0.008, t=4.506). Students who had a history of publishing articles had a higher score in the area of lack of access to facilities (P=0.045, t=5.740).

According to the results of this study, research activities are affected by numerous obstacles from the perspective of the faculty members and students. The empowerment of human resources, providing facilities, as well as designing appropriate information and communication systems can be effective in resolving barriers to research.

Family medicine expertise as one of the most important policies have been proposed in the field of education and health system in the last decade.The aim of this study is the accreditation of the family physician residency in  medical sciences universities in Iran.

This is an accreditation and evaluation study that was implemented by the General Medical Council Secretariat of the Ministry of Health and Medical Education (MOHME) in collaboration with the Medical Education Research Center of Guilan University of Medical Sciences and the World Health Organization. The implementation process of this project was in two stages of internal evaluation and external evaluation in 12 universities of medical sciences of the country that were training the specialized course of family medicine and the sampling method was based on the entire research community. The family medicine specialty standards questionnaire designed by WONCA (2013 and 2016 editions) was used for internal evaluation. The translation and localization of the said questionnaire was done using the Backward- Forward method. After translation, the questionnaire was provided to the universities through the correspondence of the secretariat of the General Medical Council with 12 universities of the country. At the beginning of the internal evaluation, the self- evaluation forms were sent to universities.After the internal evaluation by the universities, an external evaluation was conducted. Then the members of the scientific committee determined the external evaluators to monitor the activities of the twelve universities. Data were analyzed in two quantitative and qualitative methods through SPSS. The information obtained from documents and interviews was analyzed qualitatively. In order to match the results of internal and external evaluation as well as the compatibility of documents with reports, a comparative evaluation was done by external evaluators and the research team.

According to the results of the internal and external evaluations and the opinions of the evaluators, the final decision regarding the accreditation of the specialized family medicine residency by universities was issued by the research team. Based on this decision, 2 universities of medical sciences partially approved the program (3 years); 3 University of Medical Sciences partial approval of the program (2 years); 2 University of Medical Sciences partial approval of the program (1 year); And 1 University of Medical Sciences received conditional approval of the program (6 months) and 4 Universities of Medical Sciences received non- approval.

The results of this study are a guide to promote the strengths and eliminate the weaknesses in the implementation of the existing program for universities of medical sciences and a source for decision-making at the macro level and the Ministry of Health, Treatment and Medical Education to grant permission to continue the work, and the activity of the universities is to train the specialized course of family medicine.

According to the policy of entrepreneurship of universities and students, creativity and innovative behavior in students  not only can be effective in the development of the university environment, but also, making students become entrepreneurs and creating employment. In fact, it can be said that in the current changing and knowledge- oriented environment, only innovative students can respond to the needs of the labor market in a given time. Therefore, the aim of this research was to predict students' innovative academic behavior based on thinking skills, teamwork skills and problem solving abilities.

This is a cross- sectional and correlation study. Statistical population consisted of all students in university of Kashan in academic year 2022-2023 (N=7873) that by using Morgan table and stratified random sampling 380 ones, selected as sample. The research tools were four questionnaires of innovative behavior, thinking skills, teamwork and problem solving strategy. Data were analyzed using descriptive and inferential statistics level through SPSS & Smart PLS.

The findings showed that the mean of innovative behavior (3.34±0.73), thinking skills (3.6±0.53) and teamwork (3.55±0.61) were higher than average. Also, the mean component of confidence in solving problems (47.49±6.16) is higher than the criterion score and the average components of avoidance tendency  (52.98±10.64) and personal control (13.92±4.54) are lower than criterion score. The path coefficients showed that thinking skills (Beta=0.195, P=0.003) and teamwork (Beta=0.377, P=0.001) have a positive & significant effect on students' innovative behavior but problem solving ability (Beta=0.061, P=0.08) has no significant effect on students' innovative behavior.

The results of this research showed that students' innovative behavior is affected by thinking and teamwork skills. Confirming the relationship between thinking skills and teamwork with students' innovative behavior and identifying the dimension or dimensions of thinking skills and teamwork that has the most relationship with students' innovative behavior will help the officials and practitioners of the educational system to consider the development of thinking skills and teamwork provide the grounds for the development of creativity and innovative behavior in students.

In modern educational approaches, game and gamification are one of the main approaches in creating attractive learning spaces. Game-based learning is also an active and appropriate method for behavioral and performance changes in students. This study reviews the design and implementation of a scenario- based gamification workshop and evaluates its impact on learning and participant satisfaction.

This semi-experimental pretest-posttest study was conducted on participants in a scenario-based gamification workshop in early 2021. The study population consisted of 52 participants, including medical faculty members and students, who participated in a national gamification workshop. Due to the small sample size, all individuals were included in the study through a census method, and ultimately, 46 participants completed both pretest and posttest questionnaires. The workshop was held online simultaneously through a six- hour webinar using the ZOOM platform and was conducted by two instructors through short lectures, interactive questions, and presenting scenarios. The research tools were two questionnaires to assess pre- and post- knowledge and participants' satisfaction with the quality of the workshop. The satisfaction cut- off point was considered to be 75%, equivalent to 4 out of 5, and the knowledge score range was from 0 to 10, with a cut- off point of 5. The data were analyzed using one- sample t- test, paired t-test, and ANOVA  through SPSS.

The results showed that the instructional intervention was significantly effective in increasing participants' knowledge (P< 0.001, t=14.36). Independent t- test of the posttest score by demographic variables showed no significant difference in gender (P = 0.134, t=.56) and academic status (P= 0.645, t = 1.01). There was no significant relationship between participants' educational level and posttest score (P= 0.871, F= 1.60). The results of the satisfaction score showed that the satisfaction score for all dimensions was above the cut-off-point (4) (P< 0.001). Participants' free comments emphasized the necessity and usefulness of game-based learning and gamification in teaching and learning.

It seems that developing practical concepts of gamification and scenario- based gamification for teachers will be useful in creating more attractive classrooms. In this regard, it is necessary to provide empowerment courses and educational programs for faculty members and educational staff on gamification and its implementation in educational environments.

Team- based learning (TBL) is a student- based teaching method in which students participate in teamwork and application of learning concepts to problem- solving. It has been widely proposed in the education of medical and dental education. This study describes the experience of implementation and evaluation of TBL and lecture- based teaching findings on dental education.

This interventional study was conducted in 2022 including dentistry students at Yazd dental school. They were randomly divided into two separate groups, traditional and team- based learning (TBL). A questionnaire was administered to measure the knowledge of the students toward chronic orofacial pain, at the beginning of the study, immediately after the completion of the training, and 4 months after training. The average knowledge score were analyzed by Mann- Whitney and Wilcoxon tests through SPSS. The significance level in this study was considered 0.05.

Of 23 participants, 6 students were males (26%) and 17 were females (74%) students. There was no significant difference in the level of awareness according to gender, native status, and marital status. Results show that students` knowledg  score in traditional education group  pertaining to chronic orofacial pain., 4 months after education were significantly lower in comparison with the immediate after- education group (P=0.027). The scores of the TBL group were significantly higher in the long term than the traditional education group (p=0.027). Average satisfaction with the TBL group was 7.09±10.56.

Based on the results of the present study, it seems that TBL has a positive effect on long- term learning. The short- term knowledge score was significantly higher in the TBL group in comparison with the traditional education method.

Different factors affect the quality of virtual education. Identifying them and their relationships with each other can provide a suitable opportunity for educational planning based on the needs of learners and the characteristics of the educational environment. Therefore, the purpose of this study was to investigate the status and relationship of three factors of metacognitive state, learning styles and time management among virtual master's students in the field of medical education.

This cross-sectional analytical study was conducted in Iran University of Medical Sciences in 2021-2022. Fifty-four medical education master's students were included in the study by census method. Data collection tools were O’neil and Abedi's metacognitive state questionnaires, WARk's learning style questionnaire and Truman's time management questionnaire. The data were analyzed and using Mann-Whitney, Chi-square, Kruskal-Wallis and Spearman's correlation coefficient through SPSS .

The results showed that the most used learning style in both sexes was listening. The mean of time management score was 41.77±6.74 and the mean of metacognitive strategies was 50.03±7.46. The results of the study showed that there was significant relationship between learning style and metacognitive score (P=0.005, H=14.745),  as well as,between learning style and time management (P=0.001, H=19.433). Also, the relationship between learning style and all metacognitive components was significant (P<0.05). According to Spearman's test, there was no significant relationship between metacognitive state and time management (P>0.05, r=0.109).

According to the results of the current study, the dominant learning style of virtual students was listening, and the mean of metacognitive score was average and time management was relatively favorable. Therefore, it is suggested, policy makers pay attention to these three factors in the revision of curriculum and educational planning for virtual students.

Letter to the Editor The family physician program in Iran was initially implemented in rural areas in 2005 and later expanded to cover urban communities up to 20,000 population(1). In this program, the family physician team serves as the first point of contact for patients within the healthcare system, and the family physician, as the central element of this team, requires competency in various medical and interpersonal areas. However, this program faced challenges that led to inconsistencies in the training of the required workforce. Efforts to strengthen the training of family physicians included introducing programs leading to certification and modular courses. Despite these efforts, challenges such as lengthy training schedules and uncertain outcomes, as well as limited acceptance, led to a lack of appeal for the general physicians(2). Despite the changes in the national general medical education program, in order to address this issue and to announce it in 2017, a national survey was conducted in 2021 to assess the extent of using the capacities of this national educational program to increase the presence of medical students in the healthcare fields. Severe weaknesses in the use of these capacities and the establishment of a family medicine internship program (optional or mandatory) were still observed. In such a way that only 37% of the educational programs of medical schools showed signs of a maximum one-month presence of interns in the field of family medicine (3). The General Medical Education Secretariat of the Ministry of Health began to address and diagnose this problem from the same year. After numerous expert meetings, using the six-element Carnegie model for educational change (4), it moved towards establishing family medicine internships as relatively long-term programs. In the first phase of these changes, it took action to implement a three-month internship in family medicine at 15 medical universities in the country. The elements of the Carnegie six-element model include: identifying problems with a user-centered approach, focusing on performance change, viewing the entire system as a factor in creating the current situation, determining success indicators and measurement methods, regular research for system improvement, and accelerating learning through the formation and enhancement of networked communities(4). Now, nine months after the announcement of these changes in leading universities, a rapid survey conducted at 15 universities shows that the situation of using family medicine educational field has visibly changed. Not only independent one-month family medicine internship programs have been launched in over 90% of these universities, but also more than 60% of these universities report the implementation of two to three-month independent family medicine internships and a range of changes in educational programs for medical students' participation in family medicine even before they start their internship. This rapid pace of change, in conditions where medical universities are facing financial and human resource shortages, indicates the suitability of the change model used to implement changes in the educational program. Certainly, this path has not been without its challenges, including issues such as a lack of physical space and human resources in the field of healthcare, a shortage of faculty members among family medicine, community medicine, and even trained family physicians for education, the high volume of traditional block-based internship programs, the need for an integrated and unified curriculum for a three-month family medicine internship, misinterpretation by some senior university officials regarding the training program in the healthcare system and its comparison to hospital-based training programs, the absence of a defined payment system for family physicians collaborating in education, and the lack of an efficient referral system in most universities involved, as reported by 15 participating universities in the intervention program. However, considering the serious determination of the Ministry of Health and Medical Education to launch an urban family health program and the urgent need for capable personnel to carry out this important task, it seems that, based on the recent rapid survey results, the implemented changes have been able to achieve acceptable results in the short term. According to the implemented planning, it appears that a unified family medicine internship program will be established in all medical universities of the country from the beginning of the 2024 April.