JOURNAL OF CLINICAL EXCELLENCE
Year:2024 | Volume:14 | Issue:1|Papers Count:10

2Health organizations have many challenges all over the world due to providing and maintaining the health of the society, and their proper performance depends on the proper management of them. Also, the examination of the state of the country's healthcare system shows that there is no competent clinical leadership in the country and it is necessary to make reforms in it. The purpose of this study was to identify the obstacles and solutions to improve the clinical leadership competence among managers of Gilan University of Medical Sciences. This research is a type of qualitative research that was conducted using the content analysis approach. The statistical community of managers of Gilan University of Medical Sciences was in 1402, and 15 senior managers were selected as participants in the research with a targeted sampling approach. In order to obtain the reliability and validity of the data, two methods of reviewing the participants and reviewing the experts who did not participate in the research were used.After analyzing and combining the data, the data were categorized into 139 primary concepts and 2 main categories and 12 sub-themes. The main categories included: barriers and solutions. Considering the importance of leadership competence and the complexity of specialized work, the role of the Ministry of Health in determining the management perspective, its implementation and monitoring in the whole country, in order to determine the comprehensive health road map, is very key and important. Also, at the individual level, training people and equipping the country's health managers with management tools is very key and vital, in addition to training a generation of specialists.

2Risk management in the field of education necessitates accurate identification and treatment. Lack of prediction regarding risk management can create irreparable educational difficulties in the teaching-learning process. Consequently, risk management in the application of educational technologies was selected as the primary goal of the present study. This descriptive review was conducted from 2019 to 2024  and focused on the keywords of risk management, information technology, and educational management. The search was performed using the method of library study and database search, including ISI, ISC, Google Scholar, and PubMed. In total, 120 articles were obtained, 45 of which were selected and thoroughly reviewed. Following the final screening, 20 articles were extracted and utilized based on the objectives of the study and its criteria, and the results were analyzed. The findings indicated that in order to leverage the educational capabilities of educators and learners, risk management in the field of education is essential. This can be managed effectively and measurably through the prediction of educational management challenges and the estimation of risk management indicators. It can be concluded that in order to transfer educational data in educational fields, it is crucial to make micro and macro educational decisions in line with accepting risk management and planning to implement favorable and facilitating educational conditions by utilizing educational technologies in a timely and effective manner.

2Background and Objectives: Mentoring has been introduced in medical professions; nonetheless, formal mentoring for medical students did not develop until the late 1990s. The present study sought to assess the impact of mentoring alone and along with a portfolio on the improvement of students' academic performance. Materials and Methods: In this case-control research, the case group consisted of first-semester students of general medicine in the course of skeletal-muscular anatomy. They received the mentoring program and electronic portfolio. The control group in this study encompassed 2021 incoming general medicine students who were not administered the mentoring program. Mentors in this research were third-semester students. The program was implemented for students during one semester, and the results were analyzed using SPSS software (version 20). Results: The results demonstrated that mentoring was effective in end-of-semester scores; therefore, there was a significant difference between the end-of-semester grades of the two control groups and the case group (P=0.013). There was no significant difference in midterm scores (P=0.157). In addition, the results indicated no significant difference among the six groups of mentee students. Three groups benefited from the mentor alone, and three groups benefited from the mentor plus the electronic portfolio (P=0.323). Conclusion: The findings of the present research confirmed that the use of mentoring increased scores in the case group. Using the mentorship method improves students' knowledge. This method is based on student-centered education.

2Background: Rapid changes in science and technology have introduced several new computer-based educational approaches to the field of nursing education. One of these educational methods is blended learning using electronic content. The present study aimed to use blended learning utilizing a storyline to investigate nursing students' satisfaction, collaboration, and interest in vaccination. Methods: This study was conducted on third-semester geriatric nursing postgraduate students at Ilam University of Medical Sciences. A lesson from the structure and geriatric care system course was designed and implemented in a blended learning method for geriatric nursing master's students. This course was conducted based on the ADDIE educational design model, which includes five stages of analysis, design, preparation, implementation, and evaluation. Educational content was defined and uploaded in the form of storyline content on Navid and Sama Live platforms. In the final session, the degree of students' collaboration and interest in the course was measured by the Exit Survey questionnaire. The level of students' satisfaction with the teaching method presented in the final session was measured by a visual comparison tool. Finally, the level of satisfaction, collaboration, and interest of students in this teaching method was evaluated. Results: Based on the results, the mean scores of interest and collaboration were reported as 4.02 and 4.31, respectively. These results demonstrated students' high level of interest and collaboration in using this game method for education. The level of students' satisfaction was assessed using a visual scale, illustrating a mean score of 8.76 (SD=1.35). For further investigation, one sample t-test was conducted to compare the mean of each case with the mean value (2.5), demonstrating that the mean scores of all three variables of satisfaction, collaboration, and interest were significantly higher than average. Conclusion: The use of e-learning in teaching geriatric nursing structures and systems was associated with high satisfaction, more significant interaction, and students' interest in the classroom.

2Providing health services in medical sciences without utilizing human ethical principles and professional ethics is fruitless. Therefore, it is necessary to use an ethics-oriented curriculum at the beginning of practicing various levels of health and medical education. In this regard, different methods can be employed in implementing the professional ethics curriculum, one of which is mentoring. In this narrative review study, a query was conducted on ISI, Uptodate, Google Scholar, and PubMed databases from 2004-2014 (10 years) using the following keywords: mentoring, curriculum, professional ethics, medical sciences, and medical education. Initially, 141 articles were retrieved, which were reduced to 23 articles after screening, and this number was included in the present article. The findings demonstrated that the use of mentoring in the curriculum or educational goals, whether in educational institutions, universities, or other fields, provides conditions that will make the achievement of the set goals more effective. Educational experience based on mentoring education and changing curriculum developments using the mentoring method is considered an educational success in the educational system. Accordingly, the medical education system needs to utilize the mentoring strategy, which is a coherent and purposeful educational approach in line with advancements in health and medical sciences worldwide, and make changes with a focus on promoting professional ethics in the medical sciences curriculum reform document.

2Purpose: Increasing attention to the evidence-based medical process in the education of medical students is considered an effective method. Therefore, this research was conducted to compare the morning report sessions using the evidence-based method with the traditional method from the perspective of medical students of Mazandaran University of Medical Sciences. Method: This study was descriptive-analytical and cross-sectional. All trainees, interns, and assistants were included in the study by census. Meetings in the intenal medicine and surgery groups are managed in a traditional way , and in the gynecology and psychosomatics and emergency medicine groups they are managed in an evidence-based way. Before the start of the meeting, the researcher attended the meeting place and after explaining the purpose of the research, he distributed the questionnaires whose validity and reliability had been confirmed before among to the trainees, interns, and assistants who were planning to enter the meeting. The students registered their opinions regarding the structure and educational content of the morning report session and the improvement of their scientific and practical capabilities. After the session, the researcher collected the questionnaires. we hope that the results of this study will help managers and professors active in the field of medical education in choosing a strategy that fits the educational needs of the group. Results: The findings of the study showed that the mean score of abilities from the student's point of view was 18.51±5.66 in traditional morning reports and 23.97±5.71 in the evidence-based morning reports. Moreover, from the perspective of students of both traditional and evidence-based morning reports, there was no significant difference in terms of structure and educational content, with the exception of two variables: the number of patients introduced at the start of the session and the location of professors during the session. Conclusion: research indicated that the use of evidence-based medicine and the latest scientific achievements enhances the academic and practical competencies of students. Additionally, it is essential to emphasize and pay attention to factors related to the structure and content of sessions, such as providing feedback, physical conditions, and the atmosphere of the sessions, which create greater interest and interaction among students.

2Purpose: One of the most critical obstacles presented to clinical education is the problems related to the learning system of working with medical devices and equipment. The present study sought to assess the impact of multimedia-based teaching on the clinical skills of nursing students in the hemodialysis department. Method: This pre-experimental research was conducted on 48 students at Birjand School of Nursing and Midwifery in 2023. The participants were selected using the census method. The students were randomly assigned to test and control groups using a coin toss. The intervention group was subjected to hemodialysis video training intervention (viewing the training video recorded by their instructor), and the control group was subjected to routine (traditional) training. The evaluation was carried out by a researcher-made questionnaire. Descriptive and inferential statistics were employed for data analysis using SPSS software (version 16). Results: before the intervention, the mean test score in the intervention group was higher than that in the control group; nonetheless, there was no significant difference between the two groups (P=0.313). However, there was a significant difference between the mean test scores after the intervention in the two groups (P=0.03). Conclusion: As evidenced by the obtained results, the use of video and multimedia had a significant impact on learning, especially learning skills that require a device. The best time for these trainings is before the student enters the department for internship. Nursing educators can use the results of this study to teach clinical skills, especially in the departments where the patient deals with medical equipment.

2Background and purpose: Despite the importance of acquiring clinical skills and competencies in medical students, the studies demonstrated that students do not develop the necessary clinical skills. Therefore, the present study aimed to assess the clinical-practical skills training status of medical interns at Qazvin University of Medical Sciences. Materials and Methods: This cross-sectional study was conducted on all incoming 2015 and 2016 interns in 2022. The participants were divided into two groups. The first group of interns who were at their first of 3-4 months of internship. The second group of interns who were at their end of 2-3 months of the internship period. The training status of their clinical-practical skills was collected in the form of self-assessment using a standardized questionnaire with a reliability coefficient of 0.87 and analyzed using SPSS 20 software. Results: In the self-assessment, The skills of measuring pulse rate, respiratory rate, bladder catheter, blood pressure, and gastric catheter from the first skill category and suturing skills from the second category had the highest mean scores. The difference in the mean skill scores of the second category was significant between the two groups (P<0.05); nonetheless, this difference was not significant in the other two categories (P>0.05). Conclusion: Considering the low self-assessment score of some clinical skills and the crucial role of clinical skills as the most critical source of skill acquisition, improving the quality of education in this center and expanding its activities can be a suitable solution to solve this problem.

2Learning procedures change along with the speed of educational developments. In order to achieve educational goals, sustainable and effective learning should be created for learners. Therefore, the current study aims to teach cognitive and metacognitive learning strategies as a progressive necessity from basic education levels to higher education levels. The current study is a descriptive review based on library search and Persian and English language information search engines with the keywords "cognitive learning", "metacognitive learning", "learning strategy" and "training" in the last five years. The findings showed that education based on cognitive and metacognitive learning is effective on both target groups (teachers and learners) and will lead to academic ability, progress and academic hope. Cognitive and metacognitive learning at lower levels will provide a platform for individual and social empowerment at higher levels (higher education and labor market). Metacognition and cognitive and metacognitive strategies play an important role in the teaching and learning process, and the teaching of these strategies may lead to the improvement of academic performance and individual abilities of students; As a result, teaching cognitive and metacognitive strategies to learners and promoting the use of these strategies in the educational environment by educators can lead to the improvement of educational capability in all educational systems.

2Background and purpose: Chronic, progressive, and acute diseases gradually lead to disability in daily activities. Telemedicine technology enables remote diagnosis and care through diagnostic equipment and devices. This technology allows patients with chronic and severe conditions to receive necessary consultations and care using information technology tools. The present study aimed to identify and analyze the factors affecting the adoption of telemedicine technology for patients with specific conditions in Iran. Materials and Methods: Following a review of previous studies, in-depth semi-structured interviews were conducted with 10 experts in health and health information technology to identify the factors affecting the adoption of telemedicine in Iran. After qualitative analysis of the experts' opinions and categorization of the factors, the Dematel method was employed to determine the influence, impact, and direction of the factors on each other. Subsequently, the Interpretive Structural Modeling (ISM) method was employed to classify the factors and identify the relationships between the criteria. Results: The structural model of this study comprises five levels, with organizational culture, appropriate resource allocation, and the reconfiguration of processes and services identified as the most influential and fundamental factors. Changes in these factors can have widespread effects on other factors and the overall system. In addition, patient acceptance and willingness to use telemedicine, the attitudes and beliefs of healthcare professionals toward telemedicine, and trust in this technology are the outcomes of higher-level factors. Conclusion: Given the medical needs of patients with chronic conditions who require regular visits to physicians and healthcare centers, strategies should be devised to facilitate access to services and support for these patients. The results of this study indicated that organizational culture, management support, the allocation of necessary resources, and process reengineering could significantly contribute to the expansion of telemedicine technology in Iran and benefit patients with chronic conditions.