مجله ایرانی آموزش در علوم پزشکی
سال چهاردهم شماره 10 (پیاپی 72، دی 1393)

Caring as a multidimensional concept in nursing can be realized through teaching main values. Thus، this study was performed to assess the impact of caring behavior educational program on nursing students with the aim of developing their potentials to become a healthcare professional staff. This quasi-experimental (educational-interventional) study was performed in the winter semester of academic year 2014 in Abadan School of Medical Sciences. Nursing students of 6th and 8th semester were randomly assigned to experimental and control groups (n=29، each group). The educational program designed on the basis of Watson’s theory was implemented for the experimental group during their internship in medical-surgical nursing while the control group received routine instructions. The students’ perception level was assessed by CDI-35 tool before and after the intervention for both groups. Data were analyzed using chi-square، independent T-test، and paired T-test. No significant difference was found between the two groups regarding demographic variables. A significant difference was found between the groups in the pre-test in terms of improper care (p=0. 0001). In the post-test، the mean score increase in each of the five dimensions of caring behavior was significant in the experimental group (p= 0. 0001) while in the control group، there was a significant increase only in the technical-professional dimension (p=0. 001). Given the importance of nursing care in every health system، and the fact that the goal of nursing clinical education programs is to train nurses who may promote the art and science of nursing، designing programs to strengthen and empower nurses is inevitable and the results of this study might be helpful in this regard.

In many countries in order to harmonize higher education systems and university programs along with global changes, improving the quality of learning and teaching is the priority. This study aimed to investigate the relationship between faculty members` demographic features and learning and education quality from the view point of faculty members of Fars Payame Noor University and Shiraz University of Medical Sciences. In this correlational study, all the faculty members of Fars PNU and Shiraz University of Medical Sciences were selected through Krejcie and Morgan (1970) formula and Simple Random Sampling. The data was collected via a 40-item questionnaire with a five-point Likert Scale. The collected data were analyzed using an independent samples t-test and one-way ANOVA. There was no significant difference between the faculty members’ gender and learning and education quality (T=0.556). There was a significant difference between academic rank (F=3.533), managerial position (t=2.461) and teaching experience (F=3.163) with learning and education quality. Faculty members with no managerial position had a more positive attitude toward learning and education quality compared with the ones with managerial positions. In terms of academic rank, the results indicated that faculty members who were associate and assistant professors had more emphasis on learning and teaching quality compared with faculty members who were instructors and professors. Also, the results showed that faculty members with 8-14 years of teaching experience had the highest mean scores in learning and education quality. As convincing results have not been attained regarding the relationship between demographic features and learning and education quality, it is recommended that more studies be conducted on this area.

Resilience has been defined as the capacity to sustain relatively stable psychological well-being and the ability to develop positive experiences and emotions under stressful and overwhelming situations. The present study aimed at assessing the internal consistency and confirmatory factor analysis of the Connor-Davidson Resilience Scale (CD-RISC) among female students of nursing. In this descriptive psychometric study, 500 undergraduate female nursing students of Kermanshah and Hamadan Universities of Medical Sciences in 2014 were randomly selected. The participants completed Conner-Davidson Resilience Scale(CD-RISC), Buss and Perry aggression questionnaire, Schwarzer & Jerusalem’s General Self-Efficacy scale(GSE-10), and Diener et al.`s Satisfaction With Life Scale(SWLS). The reliability was assessed through internal consistency methods (Chronbach’s alpha coefficient and Spearman-Brown Split-Half), and in order to assess concurrent validity, the correlation between self-efficacy scores, aggression and satisfaction with life scores and resilience was assessed. The construct validity was determined using confirmatory factor analysis method. The data were analyzed using LISREL8.5 and SPSS-16 with a 95% confidence level. The results of correlation coefficients of concurrent validity showed a negative significant correlation between resilience and aggression and a positive significant correlation with self-efficacy and satisfaction with life. Cronbach's alpha coefficient and split-half Spearman–Brown were 0.669 and 0.665, respectively. Confirmatory factor analysis showed that among 10 items of Conner-Davidson resilience Scale, items 5 and 8 had low loadings; therefore, they were excluded. After this modification, model parameters for one-dimensional factor analysis were fitted. It can be concluded that due to the moderating role of resilience in stressful and difficult occupations such as nursing, and the lack of appropriate tools to measure this factor among nurses, this scale can be used for research purposes and admitting students in the target population.

The Mini-Clinical Evaluation Exercise (Mini-CEX) is widely used to assess clinical performance because of its practicality. Although initial studies have supported its reliability and validity, the utility of Mini-CEX is under serious debate due to inconsistencies in rater judgments. This study aimed to review the relevant literature on the utility of Mini-CEX in order to find out the influencing factors on Mini-CEX scores. In this narrative review study,the MEDLINE, EMBASE, SCOPUS, SID & Magiran were searched to retrieve the relevant articles published from 1995 to 2014, using the key words such as Mini-CEX, ‘utility’, ‘validity’, ‘reliability’,‘score variability’. Subsequently, nineteen relevant studies out of 51 articles were selected to be reviewed. Factors influencing Mini-CEX scores were related to the raters, rating forms and clinical exposures, in order of importance. Variability in raters’ stringency and leniency and high intercorrelation between items were the most influencing factors affecting test scores. The results of the studies regarding factors such as rater trainingon Mini-CEX scores were not conclusive. Considering the inconsistencies in Mini-CEX exam scores and uncertainty about the influencing circumstances on scoring, it is recommended that Mini-CEX scores should not be used for summative assessment purposes, especially in order to rank the performance of the students.

Resuscitation self-efficacy is defined as a judgment of perceived capability to organize and execute the process of care during cardiopulmonary resuscitation. It is believed to be an important factor in teaching vital nursing skills especially cardiopulmonary resuscitation. Therefore, this study aimed to investigate the impact of mannequin-based simulation and computer-based simulation on nursing students’ perception of self-efficacy in cardiopulmonary resuscitation. This quasi-experimental study was performed on 64 nursing students who were randomly assigned to computer-based simulation and mannequin-based simulation groups. Data collection tool was a two-part questionnaire including demographic information and the perceived self-efficacy of cardiopulmonary resuscitation. The data were collected before and after two methods of teaching. Data were analyzed using measures of central tendency and dispersion, Mann-Whitney, and Wilcoxon tests. There was a significant difference in mean score and standard deviation of students’ perception of self-efficacy between mannequin-based group (Z=-5.23,P<0.0001) and computer-based group (Z=-4.15,P<0.0001) before and after intervention. Trainings provided to both groups of students increased their perception of self-efficacy, however, no significant difference was observed between the two groups (P=0.41). Results indicated that both of the simulation methods increased the perception of self-efficacy in cardiopulmonary resuscitation; therefore educational centers, depending on their situations and facilities, can use any of these methods in teaching students so that they will be prepared better to serve patients.

Nursing theses are one of the most important sources to provide knowledge and evidence for nursing practice. Thus, this study aimed to investigate the status of research outcomes of nursing MSc theses and their levels of evidence. This study was a cross-sectional descriptive study. All MSc nursing theses conducted from 1381 to 1390 in Mashhad Nursing and Midwifery School were investigated. The articles extracted from these theses were studied as well. These articles were evaluated in terms of their levels of evidence and type of journal in which they were published. Out of 92 theses conducted in this period, 70 articles were published. 39 percent of these theses were in level 6 (descriptive, quantitative, and cross sectional), 38 percent were in level 4 (case-control and cohort studies) and 23 percent were in level 2 (randomized controlled trial). Comparisons between the first five years and the second five years regarding the study type showed that 38 percent and 77 percent of these theses were experimental and quasi-experimental studies in the first and second periods, respectively. Also 41 percent of the theses were published in journals in the first period whereas this number increased to 82 percent in second period. The results showed that the methodology of nursing MSc theses has moved toward clinical interventions and important nursing challenges and their resulting articles have been published in more scientific journals. Given the importance of evidence-based practice, it is necessary to develop individual and organizational mechanisms for promoting the levels of evidence in nursing research.

Training and information transfer are considered as one of the major functions of medical education. However, traditional lecture-based methods no longer satisfy the needs of medical education and require new approaches. One of these approaches which has presented new methods in medical education is constructivist trainingversus traditional training. The aim of this study was to explain the characteristics of constructivist curriculum in medical education. In this review study, library materials and documents related to constructivism approach in medical education and various online sources such as articles indexed from 2001 to 2014 in SID, Magiran, and Eric were used. Keywords used were constructivism, medical education, curriculum elements and faculty members, both alone and in combination. The initial search yielded a large number of articles then the researcher who was just eliminated summary available and browse articles that were more associated with the selected material was then extracted. Based on more recent literature, the main elements of the constructivist approach to curriculum in medical education were explained. Finally, Out of 120 investigated articles in total, documents of 37 relevent and credible articles were obtained. Four elements of curriculum namely goal, content, teaching methods, and evaluation were explained in the constructivist framework. In this approach the goal of education was to develop critical thinking, analytical skills, and insight in students. The content of the training program was based on real situations such as hospitals or at least training videos. Teaching methods were based on dynamic methods which engaged students in the learning process. The evaluation was process-based so that it was not a tool for scoring, but for learning. Given the main elements of curriculum in this approach, education in the medical field should be based on actual situations, practical and laboratory tools. Moreover, the active and participatory role of students and the role of teachers as facilitators should be underscored for preparing the learning environment.

Decisional procrastination is one of the negative factors which might hinder students’ progress and it is an ineffective defense strategy used by students to avoid failure, maintain self-esteem and personal values. It is essential in the learning process to provide the learning condition for achieving the best results. The aim of this study was to investigate the relationship between cognitive failure and alexithymia and decisional procrastination among university students. In this descriptive-correlational study, 400 students of Arak University of Medical Sciences were selected by convenient sampling based on Krejcie and Morgan’s formula in 2013-2014 academic years. The data was collected through Rieffe et al. `s Alexithymia Scale, Broadbent’s cognitive failure scale and Mann's decisional procrastination scale. Data were analyzed using correlation coefficient and linear regression tests. In this study 300 questionnaires were analyzed (75 percent response rate). Findings showed a significant positive relation between cognitive failure and alexithymia and decisional procrastination (P>0. 001). The results of multivariate regression analysis showed that cognitive failure and alexithymia predicted respectively 35 percent and 26 percent of the variance of decisional procrastination among students. The results of current research showed the importance of cognitive failure and alexithymia in decisional procrastination of students. These results suggest that the cognitive failure and alexithymia share an important role in exacerbating and incidence of decisional procrastination among students. Given the importance of decision making process for students, it seems necessary for authorities, planners and stakeholders of educational system to pay attention to the objectives and adopt strategies in order to change the orientation of objectives and reduce or improve decisional procrastinations.