Iranian Journal of Medical Education
Year:2018 | Volume:18 | Issue:81|Papers Count:60

Introduction: Lecture and computer-based teaching are two important methods for the teaching of medical students. However, comparison of the effectiveness and efficacy of both of these methods shows substantial deficiencies. The aim of this study was to compare the effects of lecture and computer-based teaching methods on the learning of medical students taking introduction to clinical medicine (ICM) courses at Isfahan University of Medical Sciences. Methods: This study was a quasi-experimental research which was conducted in Isfahan University of Medical Sciences. Research population included students taking ICM courses in two consecutive semesters. The first group of students were assigned to the control group (n=67) and were taught rheumatology through in-class lecture method while the second group of students (the intervention group) received computer-based teaching. For evaluation and comparison of the effects of the intervention on learning, two multiple-choice question tests were administered at the end of the training course and 8 weeks after the intervention. Results: No significant difference was found between the mean scores of the two groups in the first test (p=0. 77), but the difference in the second test was significant (p<0. 001). The computer-based teaching group performed better in recalling of the learning materials. Conclusion: Although short-term results were similar in both groups, long-term learning and recalling were greater with computer-based teaching than with lecture.

Introduction: Self-directed learning is a process in which learners are responsible for planning, implementing and evaluating their own learning. The aim of this study was to examine the exploratory relationship between epistemological beliefs and self-directed learning among nursing students. Methods: This descriptive, correlational study was conducted on nursing students of Isfahan University of Medical Sciences and Isfahan Azad University (Khorasgan Branch). Research population included 436 and 387 students from the two universities respectively. Using stratified randomized sampling, 159 and 141 students were selected respectively. Research instruments were self-directed and epistemological questionnaires whose validity and reliability had already been confirmed in the literature. Data were analyzed using a statistical package in Social Sciences version 22. Results: The correlation coefficients were calculated among the components of self-directed learning (selfmanagement, willingness to learn and self-control) and the components “ the truth is clear and obvious” at 0. 251, 0. 361, 0. 430, “ thinking about oneself is waste of time” at 0. 170, 0. 298, 0. 405, “ learning requires effort” at 0. 128, 0. 250, 0. 310, “ knowledge should be obtained quickly” at-0. 074,-0. 0510, 0. 018 and “ intelligence is not dynamic” at-0. 099,-0. 078, 0. 055. Results of the regression analysis showed that the components “ the truth is clear and obvious” and “ thinking about oneself is waste of time” explained 11. 6 and 18 percent and 3. 9 and 16 percent of the components of self-directed learning respectively. Also, “ learning requires effort” explained 6 and 9 percent of “ willingness to learn” and “ self-control” respectively. Conclusion: Results suggest that epistemological beliefs can be influential in students’ tendency towards self-directed learning.

Introduction: One of the most influential factors in student rehabilitation is the measures put to work by faculty members for education and application of curriculums. Given the direct effect of such measures on academic and social performance of medical sciences students, the purpose of this study was to examine the relationship between classroom management styles and academic rehabilitation with the mediating role of psychological capitals among students of Bushehr University of Medical Sciences. Methods: In this descriptive, correlational study, 340 students of Bushehr University of Medical Sciences were selected by means of partial stratified sampling method in 2015-16 academic year. Subjects responded to academic rehabilitation, classroom management styles, and psychological capitals questionnaires. The reliability of these questionnaires had already been confirmed in previous studies. Data were analyzed in Lisrel software using descriptive and inferential statistics. Results: The indirect effect of interactive management style on academic rehabilitation (0. 19) was significant (p<0. 01, t=5. 95). The indirect effect of non-intervening management style on academic rehabilitation (0. 12) was significant (p<0. 01, t=4. 12). The indirect effect of intervening management style on academic rehabilitation (0. 18) was significant (P<0. 01, t=-5. 29). Based on the results, RMSEA, AGFI, GFI, and X2/df were 0. 06, 0. 94, 0. 98, and 2. 36 respectively, all indicated good fit of the model. Conclusion: According to the results, it seems that students’ academic rehabilitation will increase by giving them more opportunities to exercise their own personal interests in academic affairs and classroom management and to interact more with their faculty members and classmates and also by boosting their academic abilities.

Introduction: Critical thinking is an ongoing debate in medical education, and application of modern educational methods such as flipped classroom have been suggested for developing this concept. The purpose of this study was to investigate the effect of flipped classroom on nursing students’ critical thinking disposition. Methods: This quasi-experimental one-group pre-and post-test study was conducted in 2016 on 43 nursing students of Azad University, Rasht Branch who had musculoskeletal disorders course. Subjects were selected by census method. Before each session, students observed the electronic contents, including recorded lectures and studied some parts of the textbook while the class time was used for cooperation in small groups to discuss the questions and clinical scenarios. Critical thinking disposition was assessed before and after the implementation of flipped classroom method using Ricketts’ Critical Thinking Disposition Questionnaire. The data were analyzed by means of one-sample t-test, paired t-test, Pearson correlation coefficient, and ANOVA. Results: The mean and the standard deviation of the critical thinking disposition scores before and after the intervention were 103. 63± 13. 26 and 122. 53± 10. 57 (total score=165) respectively. Total critical thinking disposition and the domain of intellectual engagement showed a significant increase after the intervention (p=0. 0001). Conclusion: The results showed that the flipped classroom method had a positive effect on critical thinking disposition of the nursing students. Investigation of students’ satisfaction with learning with this method as a factor in fostering critical thinking is suggested for future research.

Introduction: In the 21st century, higher education institutions seek to set up research activities and improve the quality of these research studies. One of the factors affecting the quality of research is student research self-efficacy which is expected to lead to career decision-making self-efficacy. Methods: Statistical population of this descriptive, correlational study included all the students of Shiraz University of Medical Sciences in 2015-16. A sample of 300 was formed by multi-stage cluster sampling. Research instruments were Betz and Luzzo’ s career decision-making self-efficacy scale and Holden’ s research self-efficacy scale. After calculating the validity and reliability, the questionnaires were distributed and the data were analyzed in LISREL using correlation coefficient test. Results: In research self-efficacy, reporting skill (47. 13± 1. 29) and collection skill (42. 20± 2. 67) had the highest and lowest scores respectively. In career decision-making, goal commitment (3. 10± 0. 89) and problem-solving skill (3. 00± 0. 78) had the highest and lowest scores respectively. There was a positive significant relationship between the dimensions of research self-efficacy and decision-making self-efficacy such that with students’ increased research self-efficacy, their career decision-making enhanced. Conclusion: The more the curriculum emphasizes the development of students’ research skills, the more their sense of self-efficacy increases in career decision-making and on the path to professional development.

Introduction: Academic achievement has always been one of the most important constituents due to its individual and social effects and consequences. The purpose of this study was to assess the structural model of the correlation of family functioning and parental abuse with students` academic achievement with the mediating role of social adequacy and academic self-efficacy in 2015-16 academic year in Isfahan. Methods: This descriptive-correlational study was performed on 540 high school students in Isfahan during 2015-16 academic year. Data collection tools were Family Assessment Device (FAD), Demare’ s Parental Abuse Measurement Inventory, Morgan-Jinks Student Self-Efficacy Scale, and Fellner’ s Social Adequacy Scale. Data was analyzed in Lisrel software using path analysis. Results: Results showed that the coefficients of the effect of family functioning on the academic achievement and self-efficacy were significant. Pearson correlation analysis showed that social adequacy had a significant correlation with family functioning and parental abuse, but in the model of prediction coefficients through path analysis, these coefficients and effects were not significant. In addition, the coefficients of the effects of family functioning on academic achievement mediated by self-efficacy, the parental abuse on academic achievement, parental abuse on self-efficacy, parental abuse on academic achievement mediated by self-efficacy, and self-efficacy on academic achievement were significant. Conclusion: Results showed that family functioning was influential in academic achievement and selfefficacy and that planning for improving these variables was a necessity for the educational system. Focus on variables that are influential in the academic achievement of adolescents could pave the way for their academic achievement in higher education as well.

Introduction: Objective Structured Clinical Examination (OSCE) is one of the evaluation methods which has been widely used in medical and paramedical majors in the recent years. Since various studies have provided varying results about the effects of this method, there is still a question that how does the evaluation of nursing students using the OSCE method would influence their learning, satisfaction and test anxiety? Therefore, the current study aimed to review the literature and examine the effects of the OSCE method on the learning, satisfaction and test anxiety of nursing students. Methods: This systematic review was conducted by searching through Google scholar, SID, Iranmedex, PubMed, and ERIC databases. Articles published from 2008 to 2017 were searched using the key terms “ nursing students, assessment, evaluation, OSCE test, OSCE evaluation, learning, test stress, test anxiety and test satisfaction” . Based on the inclusion criteria, 15 articles were finally selected out of 110 publications found. Results: The results were categorized in three categories namely “ the effect of OSCE on the students’ satisfaction with the exam” , “ the OSCE as an anxiety-inducing method compared to traditional methods” , and “ the effect of OSCE on the nursing students’ learning” . The results indicated that due to the procedure of implementation, OSCE satisfies the students and thereby, will enhance their learning. However, results about the anxiety-inducing nature of the OSCE are conflicting. Conclusion: It is possible to perform accurate OSCE evaluations by meticulously designing the stations, appropriately preparing the students and faculty members during the academic semesters, providing an appropriate environment and all the necessary facilities and human resources, and allocating adequate time to the exams.

Introduction: Independence is one of the structural and functional requirements of university. The purpose of this study was to prioritize the dimensions of university independence from the perspective of academic experts at Babol University of Medical Sciences and Noshirvani University of Technology. Methods: This descriptive survey was conducted in 2017. Thirty faculty members of Noshirvani University of Technology and Babol University of Medical Sciences were selected by purposive sampling method to participate as academic experts in higher education, teaching and learning. Data collection tool was a researcher-made questionnaire based on paired comparison matrix whose validity was confirmed by the academic experts. Also, the incompatibility rate of the questionnaire was obtained at 0. 085 and 0. 074 at University of Medical Sciences and Noshirvani University of Technology, respectively. Data were analyzed using the AHP method in expert choice-11 software. Results: The dimensions of university independence from the viewpoints of experts at Noshirvani University of Technology, in priority order, was academic freedom (weight=1. 37), actual independence (weight=1. 23), financial independence (weight=1. 21), organizational independence and staff independence (weight=0. 86). The dimensions of university independence from the viewpoints of experts at Babol University of Medical Sciences, in priority order, was financial independence (weight=2. 33), actual independence (weight=1. 25), organizational independence (weight=0. 9), academic freedom (weight=0. 61), and staff independence (weight=0. 44). Conclusion: Achieving a desired university independence is one of the most important strengths of higher education systems. Assessment of the university independence priorities of the two universities showed that the importance of each dimension is influenced by the mission, goals and functions of the university. It is therefore suggested that in order to achieve independence, a plan should be developed for sensitization towards university independence and promotion of all of the dimensions.

Introduction: Despite various laws, regulations and therapeutic guidelines, it is difficult for doctors to make diagnostic and therapeutic decisions while trying to respect patients’ beliefs and cultural norms. This may affect the treatment of patients and their satisfaction. This study aimed to explore medical specialists’ experiences of decision-making in moral dilemmas at Isfahan University of Medical Sciences in 2012. Methods: This qualitative study was conducted at Isfahan University of Medical Sciences. Research population included medical specialists and participants were selected by purposive and maximum variation sampling. Data were gathered through semi-structured individual interviews. Interview transcriptions were analyzed using content analysis method. Review of the transcriptions yielded the main categories and subcategories. Results: Eight medical teachers and specialists participated in this study. Three main categories and 13 subcategories emerged. The main categories included “ gradually informing the patient” , “ building doctorpatient trust” , and “ doctor-patient joint decision-making” . Conclusion: In moral dilemmas, doctors tend to make joint decisions with patients and believe that after informing the patients and building trust, they must do their best for their improvement.

Introduction: Competency-based education has been highly regarded by the experts in the field of medical education and many of the curriculums have changed accordingly. Despite the importance of the subject and much use of the term in educational texts, there is no consensus on its practical and theoretical definitions. Therefore, since the concept is ambiguous and there is no definite distinction between this concept and similar and adjacent concepts and, this study was conducted with the aim of providing an analytical definition of "competency” through the McKenna approach. Methods: This concept analysis was performed by implementing McKenna’ s nine-step approach. After extensive search in scientific databases with pre-defined strategies, 52 documents were studied, defining attributes of the concept were extracted, and then the analytical definition was provided. Results: Literature review yielded four conceptual domains including “ competency goals, competency components, competency characteristics, and competency development” . Model, contrary, borderline and invented cases were presented. Antecedents and consequences of the concept and empirical criteria were also determined. Conclusion: Based on the findings, “ competency” is defined as the ability to perform an activity which is composed of knowledge (applied codified knowledge and tacit experience-based knowledge), skills (technical and cognitive) and perceptual capability. This ability is habitual, durable, task-dependent, observable, measurable, independent, knowledge-based, and context-dependent and is considered the main part of a job. Explaining competencies will lead to the establishment of excellent performance criteria, provide a framework for performance-based training for the future job, and become the basis for certifying competency and strengthening social accountability. Competencies are developed through supervised teaching and training as well as reflective authentic experience.

Introduction: Nowadays, the effective teaching performance of faculty members and the factors affecting its growth in higher education system is of increasing importance. The main purpose of this study was to determine the effect of teaching dialogical skills to faculty members on their effective teaching performance. Methods: This research was carried out in the first semester of the academic year 2016-17 using a quasiexperimental two-group, pretest-posttest study design. The sample consisted of 43 faculty members of Isfahan University who were divided into experimental and control groups. The experimental group received training on the use of dialogical skills in the teaching process while no intervention was implemented in the control group. A researcher-made self-assessment questionnaire was administered before and after the intervention to determine the extent of application of effective teaching components by the faculty members. Data were analyzed using descriptive (frequency, percentage, mean and standard deviation) and inferential (independent and paired t-tests) statistics. Results: In the pre-test stage, the difference between the total mean scores (total=120) of effective teaching performance in the control group (100. 10± 26. 51) and the experimental group (96. 84± 11. 78) were not statistically significant (p=0. 548). However, after the intervention, the improvement of the mean score of effective teaching was significant (p=0. 028) in the experimental group (107. 77± 14. 11) compared to that of the control group (95. 66± 14. 28). Conclusion: Application of dialogical skills in the teaching and learning process can help faculty members in favorable implementation of effective teaching and provide a basis for the efficiency of their teaching.

Introduction: The processes of teaching and learning have changed dramatically over the past decades. The present study aimed to evaluate the ESP curriculum of faculty of medicine at Isfahan University of Medical Sciences from the perspective of students and faculty members. Methods: In this cross-sectional descriptive study, a number of 600 third-and seventh-year students of medicine studying in the second semester of 2016-17 academic year and six ESP instructors were selected through census method. A researcher-made questionnaire, already checked for reliability and validity, was used to collect data. The collected data were analyzed through descriptive statistics, one-way and two-way ttests and median test. Results: A total of 380 questionnaires were analyzed. The participants were not satisfied with the ESP materials and believed that the number of credits offered was inadequate. They also indicated that the sequence of the semesters offering the ESP courses was not appropriate. Moreover, the participants believed that the ESP courses should be designed while considering their familiarity with the course Introduction to Clinical Medicine (ICM), and that the materials should be updated. They also maintained that it was necessary to include medical terminology together with case studies in each unit. According to the participants, final exam was not an adequate way of evaluating students’ abilities and they preferred intermittent quizzes. Moreover, they believed that language instructors were more skillful in teaching ESP courses than medical instructors. Conclusion: The content of ESP textbooks for medicine need to be changed, and it is suggested that language instructors should teach these courses.

Introduction: Identifying the effective factors in creating and increasing job motivation of faculty members to conduct educational and research activities is very useful. The purpose of this study was to assess the effect of Hackman & Oldham’ s job characteristics model on creating and developing job motivation in faculty members. Methods: The statistical population of this descriptive, correlational study consisted of faculty members of Shiraz University of Medical Sciences, of whom 140 were selected as the sample. Data collection tool was a compilation of two close-ended and standard questionnaires based on 5-point Likert scale. Data were analyzed using Lisrel 8. 5. Results: Results showed that task importance, task identity, task variety, job autonomy and job feedback had a direct significant effect on job motivation of the faculty members. Job autonomy (path coefficient=0. 51) and task identity (path coefficient=0. 19) had the most and the least effect on job motivation respectively. Conclusion: Considering the confirmation of all the hypotheses in this study, the present conceptual model is appropriate for creating and developing job motivation among faculty members. Drawing on these findings, managers of universities of medical sciences can make appropriate decisions in order to increase faculty members’ job motivation.

Introduction: Research self-efficacy is the main factor influencing successful administration and pursuing of research by postgraduate students. This study aimed to determine research self-efficacy among postgraduate students at Birjand University of Medical Sciences (BUMS) in 2015-16. Methods: This descriptive, cross-sectional study was conducted on 200 master and PhD students at BUMS in 2015-16 academic year who were selected by census method. Data were collected by means of Phillips and Russell’ s research self-efficacy questionnaire whose validity and reliability had already been confirmed. The collected data were analyzed using independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple linear regression. Results: A total of 154 questionnaires were analyzed. The average age of students was 30. 51± 6. 3 years. The mean score of research self-efficacy was 180. 43± 53. 1 (out of 297) and showed a significant difference in terms of education and marital status being significantly higher in PhD students (223. 24± 18. 84) and single students (189. 45± 33. 52). However, no significant difference was found in research self-efficacy scores in terms of gender, residential status, and faculty. There was a significant direct relationship between grade point average and research self-efficacy (r=0. 290, p=0. 0001). Conclusion: The results showed that the research self-efficacy of the postgraduate students at BUMS was at an average level and appropriate educational interventions are required to enhance research self-efficacy.

Introduction: For any medical student, bedside training plays a pivotal role that could integrate his clinical skills and theoretical knowledge. Every efficient educational system requires regular evaluation and medical education is not an exception. The purpose of this study was to assess major clinical training fields from the perspective of medical students in Isfahan School of Medicine. Methods: This descriptive, cross-sectional study assessed the clinical training fields (training round and outpatient training) of the surgery, internal medicine, gynecology, and pediatrics departments of teaching hospitals affiliated with Isfahan University of Medical Sciences from the perspective of medical students in the first semester of the academic year 2015-16. The study was conducted in the first week of the program on 61 groups of medical students selected by means of census method including 21 groups of internal medicine, 20 groups of surgery, 7 groups of gynecology, and 13 groups of pediatrics medical students. Data were collected by the notebook of clinical training monitoring to record the number of medical students attended, hours attended, hours of training by teachers, and the number of visited patients per day for a week categorized by the training fields. The data were analyzed in Excel using mean and standard deviation. Results: Daily training hours of the medical students (training rounds and outpatient training) were 2. 5± 0. 53 (internal medicine), 2. 75± 0. 32 (surgery), 2. 04± 0. 3 (gynecology), and 2. 17± 0. 24 (pediatrics) hours in the wards and 2. 75± 0. 25 in the clinics. The medical students visited an average number of 5. 54± 1. 55 inpatients and outpatients (internal medicine), 8. 25± 1. 25 (surgery), 3± 0. 6 inpatients and 22. 2± 5. 02 outpatients (gynecology), and 5. 7± 1. 02 inpatients and 15. 9± 5. 14 outpatients (pediatrics) per day. Conclusion: The information obtained in relation to the average number of medical students, interns and residents, the number of visited patients per day, and the hours of medical students’ attendance and training by teachers in the wards can show a realistic picture of the conditions of training fields and help program planners.

Introduction: One of the main factors influencing students’ learning is learning style that tends to be flexible thus facilitating the learning process by adapting to a given teaching method. The aim of this study was to identify the learning styles of dental students at Shahid Beheshti University of Medical Sciences. Methods: The population of this descriptive, cross-sectional study included all junior and senior dental students at International Branch of Shahid Beheshti University of Medical Sciences during 2016-17. Subjects were selected by means of complete enumeration sampling and standard VARK questionnaire (version 7. 8) was used to collect data. Data were analyzed using descriptive and inferential statistics. Results: Of the 93 students, 72% were female and 28% were male. Their average age was 25. 09 years and their mean GPA of their previous semester was 15. 5. The results showed that 86% of the students used a single style with auditory style as the dominant style. Kinesthetic and auditory styles were the most frequent styles among the male and female students respectively. Double style technique was the most frequent multiple learning style. Moreover, no significant relationship was found between demographic variables (p≤ 0. 05). Conclusion: It is recommended to determine students’ learning styles in the freshman year and especially after finishing the basic sciences course. This will help teachers adapt their teaching styles to students’ learning styles which in turn will improve the effectiveness of training courses.

Introduction: Morning reports refer to case-based conferences attended by faculty members, residents and medical students to discuss patients admitted the night earlier. This study assessed the conduction of morning report sessions in teaching hospitals of Shahrekord based on the national standards. Methods: In this descriptive, cross-sectional study, a morning report assessment checklist was developed according to the national standards issued by the Ministry of Health. The researcher completed the checklist by attending 22 morning report sessions (selected by census method). Data were analyzed by means of descriptive statistics. Results: The mean session duration was 49. 36± 13. 6 minutes. In 20 sessions (90. 9%), faculty members led the discussions, while 16 sessions (77. 3%) were conducted as Q&A and the faculty members only asked questions. In 14 cases (63. 6%), one patient was introduced in each session, and in 12 cases (54. 5%) patients were introduced by the interns. The majority of patients introduced were complicated patients (n=11, 50%) followed by common patients (n=3, 13. 6%). Conclusion: The results suggest that despite existing deficiencies, the general structure of morning report sessions is acceptable and the department are committed to conducting such sessions. Therefore, identifying the weaknesses and strengths and encouraging the departments will lead to enhanced settings for report sessions and contribute to effective clinical training.

Introduction: Today, accountable education has received special attention while aiming at identifying and evaluating educational needs, and revising and developing educational programs in order to meet the needs of society. Therefore, the purpose of this study was to evaluate the curriculum of medical library and information sciences MSc program from the perspective of graduates according to accountable education. Methods: In this descriptive survey, all of the MSc graduates of medical library and information sciences who had been graduated from 2014-16 were selected through census method. The information data of 47 graduates were collected from the graduate database of the Ministry of health and medical education based on their names and contact numbers. Data were collected using a researcher-made (electronic) questionnaire that its validity and reliability were checked. Data were analyzed by means of descriptive statistics and t-tests. Results: From the graduates’ viewpoints, the adaptation of the curriculum of medical library and information sciences MSc program to the scientific, personal, social, occupational and informational needs of the medical community was significantly lower than the average (50%) (p<0. 05). The highest (23. 76) and the lowest (22. 63) mean scores were related to social (39. 66) and scientific (35. 99) needs respectively. Conclusion: Results suggest that the existing curriculum does not fully meet the needs of graduates and that it is necessary to revise the contents and syllabuses of the courses.

Introduction: Evaluation of the effectiveness of learning environments in promoting research morale is a step towards shifting the education system from a memorization-oriented approach to strengthening research thinking and creating incentives for research skills in students. One of the factors affecting research thinking and skill is teaching method. This study aimed to investigate the relationship between inquiry teaching and research morale among the nursing students of Tabriz University of Medical Sciences. Methods: This descriptive-correlational study was conducted on all nursing graduate students in 2016-17 academic year. The sample size was estimated at 181 and subjects were selected through random sampling. Data collection tools included a researcher-made 28-item inquiry teaching questionnaire and a researchermade 35-item research morale questionnaire. Both had been checked for validity and reliability. The data were analyzed using Pearson correlation coefficient and multiple regression analysis. Results: There was a positive and significant relationship between research morale and inquiry teaching components, namely reasoning (r=0. 293, p<0. 001), problem-solving (r=0. 234, p<0. 011), hypothesisbuilding (r=0. 229, p<0. 013), and curiosity (r=0. 462, p<0. 001). Results of correlation coefficient and multiple regression analysis showed that of these components, curiosity was a dependable predictor of research morale among the nursing students. Conclusion: Based on the results from the components of these components, curiosity was a dependable predictor of research morale among the nursing students. So paying attention to students' curiosity is an effective factor in encouraging them to research.

Introduction: Virology is one of the most important courses in medical sciences programs, so that teaching it improperly would lead to reduced skills of viral disease diagnosis in clinics and labs. Nevertheless, virology is offered as a small part of microbiology course in most medical schools. Hence the purpose of this paper was to investigate medical and MLS students’ perspective on the necessity of revising the virology course at Hamedan and Kermanshah Universities of Medical Sciences. Methods: This descriptive, cross-sectional research was conducted on medical apprentices and interns and senior MLS students at Hamedan and Kermanshah Universities of Medical Sciences in 2016. A total of 275 students were selected by means of census method. Data were collected by a researcher-made questionnaire and analyzed by means of descriptive statistics, independent t-test and Mann-Whitney test. Results: Most of the medical (n=154, 80. 7%) and MLS (n=67, 79. 8%) students perceived virology as a very important course; moreover, 94 of the medical students (49. 3%) and 40 of the MLS students (47. 6%) agreed to more credits for this course. Findings showed a significant difference in gender between the scores of MLS students only in the educational environment area(p=0. 026). However, no significant difference was found in gender between the scores of medical students in any of the areas. Conclusion: Based on the findings, the students considered virology as one of the most important courses in their fields and agreed to the revision of syllabuses and credits. Given the clinical importance and application of the virology course, revision of the curriculum for this course seems necessary.

Introduction: One of the goals of educational systems is improvement of teaching quality and students’ satisfaction with the curricula. The current study was designed to assess the effect of early-semester student evaluation of faculty members teaching on results of end-of-semester evaluation of faculty members. Methods: In this interventional study with control group, 30 faculty members of the faculty of nursing and midwifery at Islamic Azad University, Tehran Medical Branch were divided randomly into experimental and control groups. Early-and end-of-semester evaluations were carried out for both groups and the experimental group faculty members were provided with the early-semester evaluation results. The difference between the early-and end-of-semester evaluation scores was compared in both groups. Data collection tools were a demographic information questionnaire and a teaching evaluation form. The data were analyzed by descriptive statistics, independent t-test, paired t-test, and non-parametric Wilcoxon and Mann-Whitney tests. Results: There was a statistically significant difference in the mean scores of early-and end-of-semester evaluations (t=4. 51, p<0. 001) between the control group (x =0. 05, SD=0. 06) and the experimental group (x =0. 49, SD=0. 35). Conclusion: The results pointed out the positive effect of early-semester students’ evaluation of faculty members. faculty members’ awareness of students’ viewpoints during the semester can improve their teaching quality as well as students’ satisfaction.

Introduction: One of the characteristics of quality in universities is to meet students’ expectations of educational services. The purpose of this study was to study the viewpoints of students on the quality of educational services at the faculty of pharmacy of Isfahan University of Medical Sciences based on SERVQUAL model. Methods: This descriptive, comparative study was conducted in 2015-16 academic year. Research population consisted of 400 students and through random stratified sampling, 80 doctoral students (40 males and 40 females) were selected based on five different entrance years. Data were collected by means of SERVQUAL questionnaire and analyzed using descriptive statistics, Wilcoxon test, paired t-test and ANOVA. Results: There were gaps in all of the dimensions of educational service quality (p<0. 001). The highest gap mean score was in the empathy dimension (-1. 62± 0. 74) and the lowest gap mean score was related to the assurance dimension (-1. 09± 0. 68). Conclusion: The students’ expectations were far higher than their perception of the current situation at the faculty, and none of the service dimensions met their expectations. To improve this situation, authorities should prioritize the service dimensions from empathy to other dimensions.

Introduction: One of the challenges of medical education is students’ absence from the classrooms. This study was conducted to determine the factors affecting class absenteeism from the viewpoint of faculty members and students, and to compare their views on the effect of class attendance on students’ achievement, faculty members’ motivation and class attendance as a criterion of professionalism. Methods: This mixed method study was conducted in 2015-2017 at the faculty of medicine of Tehran University of Medical Sciences. Participants were students and faculty members of basic sciences of the faculty of medicine at the time of the study. Purposive sampling and convenience sampling were used for developing the instrument and for analyzing the views respectively. Two valid and reliable researcher-made instruments were used. Data were analyzed using descriptive statistics and independent t-test. Results: From the viewpoint of faculty members and students, the most important factor affecting student attendance was faculty members’ scientific expertise, their mastery of the content and power of expression. There was a statistically significant difference between the views of students and faculty members (T =-2. 34, P = 0. 02) in the effect of class attendance on academic achievement. The faculty members believed that class attendance was a criterion of student professionalism, while students were less likely to agree with this criterion (T =-6. 21, P = 0. 001). Conclusion: The most important factor affecting student attendance was faculty members’ expertise, their mastery of the content and power of expression. It seems that in order to increase student attendance, further attention should be paid to how faculty members are recruited and to their empowerment in the field of education.

Introduction: Teaching as a main activates of instruction and successful doing of them is required attention to it creations’ . The purpose of this study was to determine the criteria of effective teaching and its application in the educational process of University of Tabriz from the viewpoints of Faculty members and students. Methods: This mixed method research (qualitative-quantitative) was conducted on a population including all of the undergraduate and graduate students and faculty members of Tabriz University. In quantitative part, sampling method was stright random. Using Morgan table, 375 students and 145 faculty members were selected as samples. In the qualitative part, sampling of faculty members and students in the interview continued until data saturation, and 14 faculty members and 30 students were selected through convenience sampling. Descriptive and inferential statistics (one-sample t-test) in the quantitative part, and Smith method in the qualitative part were used for data analysis. Results: In the qualitative part, the participants reported course design and development, implementation and presentation of course, human relations and personal characteristics, and evaluation as the criteria of effective teaching. In the quantitative part, from the viewpoints of faculty members and students respectively, the components: course design and development (3. 3± 66. 35, 4. 2± 51. 98), implementation and presentation of course (3. 5± 58. 14, 3. 7± 38. 38), human relations and personal characteristics (3. 3± 92. 48, 3. 4± 35. 58), and evaluation (3. 2± 15. 69, 2. 4± 25. 54) could be applied as the criteria of effective teaching in the educational process. Conclusion: Application of these criteria for effective teaching in University of Tabriz can contribute to the promotion of the educational process.

Introduction: Over the last two decades, members of the medical education community have devoted a great deal of time and effort trying to ensure that medical professionalism is being inculcated in medical students and residents. There is a set of educational principles that apply to professionalism teaching during undergraduate and postgraduate education. This study aimed to investigate whether and how teaching medical professionalism is possible in medical education. Methods: This review study was conducted by searching through the databases of Medlib, Magiran, SID, ERIC, Scopus, Medline, and Web of Science for publications from 1995-2015, using the keywords professionalism, medical professionalism, medical education, medical ethics, and medical ethics curriculum. Out of 60 articles and 4 e-booksfound, a number of 28 articles and two books were selected for review. Results: Review of the publications showed that professionalism in medical education is achieved in two explicit and implicit forms. The result will be a physicianas a “ professional” with all of the necessary qualities Conclusion: Moving towards the teachings of situated learning theory shows that there should be a balance between explicit teaching of the cognitive basis of professionalism and providing opportunities for making learning happen in real-life settings. In doing so, the curriculum of medical education needs to be reformed.

Introduction: Test anxiety is now one of the most common types of anxiety. The purpose of the present study was to examine the effect of cognitive behavioral and existential methods on reducing test anxiety in nursing students. Methods: This quasi-experimental study employed a pretest-posttest design with control group. Statistical population consisted of all nursing students of Ardabil University of Medical Sciences in 2016. Sarason’ s test anxiety questionnaire (pretest) was first administered to 500 nursing students. Of those found to have test anxiety, 45 students were selected by random sampling and randomly assigned to three groups (two experimental groups and one control group). The first group received cognitive behavioral therapy and the second group received existential psychotherapy for six 50-minute sessions. The control group received no intervention. Sarason’ s test anxiety questionnaire was administered once again (posttest) to all of the participants, and the collected data were analyzed by means of descriptive statistical tests and ANCOVA. Results: The mean and standard deviation of anxiety scores were 16. 20± 2. 30 (pretest) and 13. 33± 10. 3 (posttest) in the cognitive-behavioral therapy group, 17. 06± 2. 63 (pretest) and 14. 73± 34. 3 (posttest) in the existential psychotherapy group, and 16. 68+54. 7 (pretest) and 17. 33± 41. 3 (posttest) in the control group. Analysis of covariance showed that the posttest anxiety mean scores (F=10. 17, p=0. 001) were significantly different in the three groups. Conclusion: Results of the study suggest that proper planning and timely implementation of cognitivebehavioral and existential therapies can prevent the consequences of anxiety in students.

Introduction: Learning is an experience that causes stress in learners and on the other hand, procrastination in the educational situation is a very common phenomenon. The aim of this study was to examine the relationship between student-life stressors and procrastination in students living in dormitories of Tehran University of Medical Sciences in 2016. Methods: This cross-sectional study was conducted on 267 students living in dormitories of Tehran University of Medical Sciences who were selected by stratified sampling. Data were collected through Gadzella’ s 51-item student-life stress inventory and Schwarzer and Diehl’ s 10-item procrastination scale. Descriptive statistics and Pearson correlation coefficient were used to analyze the data at a 0. 05 significance level. Results: The mean age of the participants was 23. 39± 3. 56. As to gender, 39. 7 percent of students were male and the rest were female. According to the correlation coefficient test, there was a positive and weak correlation between student-life stressors and procrastination (p<0. 001, r=0. 30). There was also a negative and very weak correlation between GPA and procrastination (p=0. 028, r=-0. 13). Conclusion: Students who are exposed to a great number of stressors tend to procrastinate more. It is therefore possible to reduce procrastination by identifying and controlling student-life stressors.

Introduction: In the broad sense life-long learning thought to be a multi-dimensional process which in addition to the economic and social benefits, also give rise to personal development. This study was conducted to evaluate the attitudes of medical students towards life-long learning at Tabriz University of Medical Science in the academic year 2016-2017. Methods: The method of study was descriptive-research. A life-long learning questionnaire from Knapper and Cropleywas used to collect data. The research sample included 140 people who selected accidentally among medical students of Tabriz University of Medical Science. SPSS23 software and One-sample Test and Hotelling’ s T Test were used to analyze the data. Results: In the four components of Goal setting(0/55± 0/50), Application of knowledge and skills(1/02± 0/60), Self-direction and evaluation (0/66± 0/54) and Adaptable learning strategies the difference between the hypothesized mean (zero) and the obtained meanwere significant (p=0/0001). but in the Locating informationthere is no significant difference (p=0/702). Also the mean of male students in two component locating information and adaptable learning strategies were more than mean of female (p=0/0001). Conclusion: Medical students have a positive attitude toward lifelong learning components. The highest average is the application of knowledge and skills and the lowest component of information search. Given the nature of the practical nature of medical courses, the average of the application of knowledge and skill is greater than other components. It is worthwhile to note that students have the least amount of information searching component and that it is necessary to pay more attention to knowledge management skills and knowledge sharing in the curriculum.

question. The aim of this study was to investigate the viewpoints of medical students of Tehran University of Medical Sciences about the learning and motivational outcomes of using real patients in comparison with written scenarios in case-based learning sessions of basic sciences program. Methods: This descriptive, cross-sectional study was conducted on 85 medical students of Tehran University of Medical Sciences in 2017. Subjects were selected by convenience sampling method and 74 students completed a questionnaire. Case-based learning sessions were conducted using written scenarios in the first year of the basic sciences program. In the second year, case-based immunology discussion sessions were held by inviting real patients and the students’ opinions were assessed using a valid and reliable researcher-made questionnaire. Data were analyzed by means of descriptive statistics. Results: All of the students believed that the presence of a patient was more interesting and challenging than the written scenarios. Seventy-three students (98. 22%) preferred an actual patient to a written scenario. Sixtynine students (92. 86%) stated that the presence of a real patient had a greater impact on their learning than the written scenarios. Seventy-three students (98. 22%) believed that the use of real patients in basic sciences courses would increase their motivation to attend the classes. Conclusion: The medical students seem to prefer real patients to written scenarios in case-based learning sessions. They believe that real patients are more interesting and challenging, have greater impact on learning and retention, and are more effective in the understanding the link between basic sciences and clinical trainings, as well as studying basic sciences.

Introduction: Since neonatal nursing MSc program has not been evaluated systematically, it requires systematic and coherent evaluation for qualitative and quantitative improvement. Therefore, the purpose of this study was to evaluate the neonatal intensive care nursing MSc program based on CIPP model in Isfahan University of Medical Sciences. Methods: As a CIPP-based educational evaluation, this descriptive cross-sectional study was performed in 2014 on 40 participants including one head of department, 7 faculty members of pediatric nursing department, 25 students and 7 graduates of NICU nursing MSc program at Isfahan University of Medical Sciences. Participants were selected by means of census method. The program was evaluated using a researcher-made CIPP-based questionnaire that consisted of context, input, process, and product dimensions. Experts’ opinion was used to verify face and content validity and Cronbach’ s alpha coefficient was used to determine the questionnaire’ s reliability. Data were analyzed in SPSS software. Results: Findings showed that the mean scores of context (47/18± 7/77), process (120/23± 24/5) and product (59/85± 17/16) were significantly higher than the average while the mean score of input (84/18± 17/9) was lower (p=0. 003). Conclusion: Results indicate that the input aspect of the neonatal intensive care nursing MSc program at Isfahan University of Medical Sciences is at an undesirable level. Therefore, it seems that improvement of the educational quality and revision of the program require greater emphasis on enhancing factors that might affect the input, especially curriculum and faculty members.

Introduction: One of the most important challenges in outcome based education is to understand the necessity of acquiring competences by students. The purpose of this study was to investigate students’ views and attitudes towards the introduction of expected competences in the undergraduate medical education program. Methods: This quasi-experimental study used a one-group pretest-posttest design. A total of 442 medical freshmen were selected by census method and participated in the competence introduction program. After showing a footage, students would discuss and brainstorm about the scenes on the expected competences. Pretest and posttest were administered to compare the students’ attitudes toward the importance of obtaining the competences. A researcher-made evaluation questionnaire was completed by the participants at the end of the program. Descriptive statistics and dependent t-test were used to analyze the data. Results: Most of the students (83. 5%) stated by participating in the program they could develop a clear understanding of the expected competences. In addition, 69. 7% of the students said that the program increased their motivation for learning and reinforced their competences during their studies. There was also a significant difference between the students’ understanding of the importance of acquiring the competences before and after the program in some areas including effective communication with patients and their families (p=0. 03, t=2. 15), interaction with medical team members, nurses and colleagues ( p>0. 01, t=2. 90), work-life balance (p=0. 01, t=2. 40), stress and emotions management ability (p>0. 01, t=2. 72), ability to collect and critique valid information (p=0. 02, t=2. 37), and familiarity with the healthcare system (8p=0. 03, t=2. 25). Conclusion: Most of the students believed that the competences introduction program at the beginning of the undergraduate medical education program is necessary and that their attendance at this program has increased their motivation to acquire and reinforce the competences during their studies.

Introduction: Medical universities need more than ever competent and effective managers and leaders to face the threats and challenges of the modern world. The aim of this research was to review the studies on the components of professional development of medical education heads of departments. Methods: This systematic review examined the studies related to the components of professional development of medical education heads of departments published in Persian and English from 1990 to 2016. The keywords “ professional development, department chair, department head, program director, educational leadership, and leadership development” were used to search through the databases of Cochran Data Base of Systematic Review, Eric, Medline, PubMed, Science Direct, Sage, Wiley, Taylor & Francis, ProQuest, SID, Iran Medex, and Magiran. The initial search yielded 1065 articles. Having the articles screened and qualitatively evaluated, final synthesis was performed on 35 articles. The data analysis method was framework analysis. Results: Synthesis of the related articles in two categories of higher education and medical education identified the components of professional development of medical education heads of departments in six themes including managerial development, leadership development, personal development, educational development, research development, and clinical development. Conclusion: The six themes derived from this systematic review can be used as an effective model for designing professional development programs for medical education heads of departments and have useful results to improve the quality of medical education.

Introduction: Development of advanced learning along with students’ progress is one of the main goals of higher education and learning approaches act as a key concept. Therefore, it is very important to understand how students’ learning approaches change over time. The aim of this study was to investigate the learning approaches of undergraduate nursing and midwifery students during their studies at Bushehr University of Medical Sciences. Methods: This descriptive-longitudinal study was conducted from 2012-16. A total of 76 undergraduate nursing and midwifery students who entered Bushehr University of Medical Sciences were selected by means of census method. Learning approaches of the students were measured using the Persian version of Revised Two-Factor Study Process Questionnaire whose validity and reliability were confirmed. Data were analyzed using descriptive statistics, independent t-test and ANOVA. Results: Findings showed that the majority of students used the deep learning approach (29. 81± 7. 234, total=? ? ? ) throughout their studying years. However, ANOVA test did not show a statistically significant difference between surface and deep learning approaches scores of nursing (p=0. 109, p=0. 481) and midwifery (p=0. 232, p=0. 328) students in terms of the years of study. Although, independent t-test showed a statistically significant difference in employing the surface learning approach in terms of the field of study (p=0. 02) and gender (p=0. 001). Conclusion: Although deep learning was the dominant approach, there was no change in the students’ learning approaches in higher years of education. Therefore, given the focus of higher education on developing the deep learning approach in students and the importance of medical science fields for society, it is necessary for teachers, managers and educational planners to assess the deep learning approach.

Introduction: Any personal decision to invest in higher education requires evaluation of its economic return. This paper aimed to analyze the expected economic return of general medicine and medical specialty programs from the viewpoints of general medicine students. Methods: This study was a descriptive, cross-sectional, applied study. Using Gorjesy & Morgan table, a total of 208 general medicine students were selected from Isfahan University of Medical Sciences in 2016. The internal rate of return (IRR) method was applied to evaluate the investment in general medicine and medical specialty programs. Data collection tool was a questionnaire designed according to Hackman & Oldham’ s standard job motivation questionnaire with the items adjusted for general medicine and medical specialty programs. The content validity and repeatable reliability were confirmed by experts’ opinion and inter-cluster correlation coefficient (r=0. 82) respectively. Data were analyzed in Stata 12. Results: The students believed that the general medicine and medical specialty programs had higher expected return in comparison to competing fields with medical specialties having the greatest expected return among all of the assessed fields of study. The expected return of general medicine and medical specialty programs was higher for the male students. Conclusion: Medical students showed an economically oriented behavior in choosing their field of study. They considered their expected economic evaluations in deciding to continue their studies in general medicine and medical specialty programs. Thus, economic components of the future job were one of the factors of studying in medical fields.

Introduction: The operating room internship is associated with stress and anxiety and using simulations may reduce this anxiety. The aim of this study was to determine the effect of operating room simulation on students’ hidden anxiety during operating room internship. Methods: This study was a quasi-experimental research. All students of a class (n=17) were simple randomly assigned to a simulation and a control group. The students in the simulation group were trained by simulation method prior to the internship program. The control group received routine and traditional training. The students’ anxiety level was measured before the intervention, the first and the last day of the internship using Spielberger's hidden anxiety questionnaire. Data were analyzed by Mann-Whitney U and Friedman tests at a significance level of 0. 05. Results: Mean anxiety scores (total=80) before the intervention, the first and the last day of internship were 43. 7± 75. 64, 41. 5± 00. 12, and 37. 62± 2. 32 in the simulation group and 42. 11± 6. 23, 40. 88± 6. 8 and 42. 55± 5. 07 in the control group, respectively. There was no significant difference between the two groups (P=0. 321) in the anxiety scores before the intervention and the first day of internship, while a significant difference was found between the two groups in the anxiety scores on the last day of the internship program (P=0. 021, t=-2/078). Conclusion: Exposing the operating room students to a simulated environment before the internship cannot reduce their anxiety on the first day of internship, but it can lower their anxiety during the internship period and significantly reduce anxiety at the end of this period.

Introduction: One of the most important goals of general medical education is to achieve acceptable competencies in clinical skills. Medical schools have to take steps to meet International Standards for general Medical Education. The aim of this study was to determine the amount of medical students' clerkship exposures to expected clinical skills and compare with the Specified minimums at Isfahan University of Medical Sciences. Methods: This descriptive, cross-sectional study was conducted in 2015-16 academic year using census method (n=95). Educational Council of the clinical departments was provided with a checklist of the expected skills and the minimum number of exposures to those skills was determined. The number of exposures for each clinical skill during the clerkship period and the background information of the students were asked for in the checklist. Data were analyzed using one sample t-test, independent t-test, chi-square and Pearson and Spearman correlation coefficients. Results: None of the students could meet the minimum number of exposures established by the Educational Council in to the clinical skills venous cutdown, anterior nasal packing, arterial blood sampling, venipuncture and serum infusion, splinting, basic CPR, pediatric routine vaccination, wound dressing with debridement and specialized washing process, suprapubic sampling, simple casting and cast removing, and superficial skin abscess drainage. The rate of conformity was adequate in CPR (ACLS, BCLS) and nasogastric intubation, but low in other skills. Conclusion: The lack of conformity of the exposures to the minimums expected in the number of exposures to the essential clinical skills and the weaknesses in the clinical training of the students indicate the poor quality of clinical education. It seems that achieving the desired conformity for each clinical skill depends on peripheral training and the greater collaboration of clinical residents and clinical faculty members.

Introduction: Professional socialization is an essential process of learning skills, attitudes and behaviors necessary to fulfill professional roles. The consequences of professional socialization are widely varied and influenced by personal, situational and organizational factors. The aim of this study was to review the role of educational activities on professional socialization of nursing students. Methods: This narrative review study was carried out by searching library resources and the databases of CINAHL, Science Direct, Scopus, Google Scholar, Elsevier, SID, and Magiran for articles published during 2002-17. The keywords used for the search included socialization, professional, educational activity, and nursing students. Preliminary results yielded 106 articles of which 10 articles were selected for the review. Results: Contemporary studies show that professional socialization of nursing students is influenced by different factors among which the role of mentors, peers and effective role models is of great importance. Personal experiences and the role of clinical trainers are also important in facilitating students’ learning development and socialization. Conclusion: Improvement and organization of the educational system and focus on selection of effective and interested clinical trainers, as well as utilization of mentors, peers and effective role models are the proposed solutions to facilitate and promote the professional socialization of nursing students.

Introduction: Educational environment is part of the teaching-learning process. Clinical training, as a part of medical education, is now facing numerous challenges. Nowadays, there are clinical training environments different from hospital and clinic environments. Considering the establishment and operation of the instrumental lab in the department of psychiatry in Isfahan University of Medical Sciences, this study was conducted to explain the views of psychiatry residents on the instrumental interventions lab in the department of psychiatry, Isfahan University of Medical Sciences. Methods: This qualitative, exploratory study was conducted using purposive sampling. All the residents who had completed the course of instrumental interventions lab in psychiatry and were willing to participate were included in the study (n = 9). Data were collected through focus group discussions. Interview transcriptions were analyzed by means of thematic analysis. Results: Drawing on the inductive technique, two main themes emerged: “ instrumental interventions lab, a new field in education” and “ psychiatry residency, another narrative” . Each of these themes consisted of two subthemes “ components of instrumental interventions lab” and “ benefits of instrumental interventions lab” . Conclusion: The instrumental interventions lab encompasses the components of a clinical environment, and given its own nature, has led to positive experiences for the residents.

Introduction: The Ministry of Health Language Exam (MHLE) is one of the decisive English language exams which is held nationally and periodically in Iran. This study investigated the role of gender and field of study and their relation to participants’ MHLE scores. Methods: In this descriptive, cross-sectional study, the participants’ performance in one issue of the MHLE exams (held in 2013 and attended by 1777-799 males and 978 females-examinees) was assessed in terms of gender and field of study (medicine: 406 examinees-30%; paramedicine: 1371 examinees-70%) and their relation to the test scores. The data were analyzed by means of descriptive statistics and two-way ANOVA. Results: The female participants (50. 07± 0. 342) significantly outperformed the males (46. 08± 0. 461). In addition, the scores of the medical participants (49. 31± 0. 44) were higher than those of paramedical participants (46. 84± 0. 24) and statistically significant. Conclusion: Considering the significant impact of gender and field of study on MHLE performance results and in order to prevent possible bias, it is necessary to review participants’ answers to individual items using one of the higher order analysis techniques such as Differential Item Functioning (DIF). This can prevent possible compromised test validity and decisions that are biased towards a particular group of participants in terms of gender and/or field of study.

Introduction: Considering the increasing importance of examining the effectiveness of faculty development programs in medical universities, the current study aimed to review various aspects of evaluation of the faculty development programs in medical education. Methods: This review study was conducted by searching the databases of Google Scholar, Medline, Eric, Scopus, Ovid, Science Direct, Medical Education, Medical teacher, PubMed, BMC, SAGE, and Magiran using the keywords staff training/development, in-service training, medical faculty, faculty training/ development, and program evaluation and their combinations. The aspects of faculty development programs evaluation were then reviewed. Results: A total of 62 articles were found of which 29 were selected for review. The aspects of development program evaluations were classified into four categories: theoretical evaluation model, evaluation data collection method, source of evaluation data, and evaluation findings. Most of the studies conducted to evaluate development programs followed Kirk Patrick’ s model. Questionnaire was the most common data collection tool. The sources of the data were mostly program attendants (faculty members), and evaluation results indicated the faculty’ s high satisfaction with the development programs. Conclusion: The results suggest that development program evaluations should utilize mixed evaluation methods and that the changes resulted from faculty development programs and the extent of using learned materials should be evaluated at the organizational level and workplace respectively.

Introduction: Attention to scientific and cultural motivation and progress of students is very important. Academic engagement is one of the main factors of academic achievement and success. The purpose of this study was to explain the relationship between the variables “ academic engagement” and “ individual and academic factors” and therefore, to present a model for promoting academic engagement. Method: This mixed method (qualitative-quantitative) study was carried out in Islamic Azad University, Tehran Medical Branch. A total of 364 students were selected using combination sampling method. Data collection tools were interview in the qualitative part and a valid and reliable questionnaire in the quantitative part. The qualitative data were analyzed through open, axial and selective coding. The quantitative data were analyzed in LISREL software by means of descriptive statistics including frequency, percentage frequency, mean, standard deviation and variance, and inferential statistics including one-sample t-test, Pearson correlation coefficient, exploratory factor analysis, regression coefficient, confirmatory factor analysis, and structural equation modeling. Results: The mean score of academic engagement was 3. 47± 0. 47 (total=5) and above the average. There was a positive (0. 58) and significant correlation between individual factors and academic engagement at the 0. 01 level. There was also a positive (0. 40) and significant correlation between academic factors and academic engagement at the 0. 01 level. Results of the structural part of the promotion model showed that the individual and academic factors were influential in promoting academic engagement by a 0. 79 and 0. 23 coefficient respectively. These two factors explained 84% of the variance of academic engagement. Conclusion: Reinforcement of individual and academic factors can promote academic engagement in medical sciences students.

Introduction: Nurses must be equipped with scientific and practical competencies and skills in teaching drug abuse prevention and control as well as addiction treatment. Thus, this study aimed to determine the educational needs of nursing students for working in addiction counseling and treatment centers. Methods: This descriptive study was conducted in Isfahan in the 2015-16 academic year. The statistical population was comprised of faculty members of the nursing and midwifery school, physicians, nurses and the service recipients provided by addiction counseling and treatment centers. Using a three-round Delphi Technique, the data were collected by a valid and reliable researcher-made questionnaire and analyzed by means of descriptive statistics. Results: In the first, second and third rounds of Delphi Technique, 129 (out of 140), 79 (out of 80), and 20 (out of 20) people responded to the questionnaire respectively. Of the 150 educational needs that were identified, 69 were related to the cognitive domain, 39 to the emotional domain and 42 were related to the psychomotor domain. Conclusion: Most of the nursing students’ educational needs of nurses for working in addiction counseling and treatment centers were related to the cognitive and psychomotor domain. It is suggested that training courses be held for nursing students in relation to these needs and an educational package be developed accordingly.

Introduction: Identifying the source of stress is essential to design tailored programs for promoting mental health of students. Medical Student Stressor Questionnaire (MSSQ) is an instrument to assess the source of stress in medical students. The aim of the present study was to determine the validity and reliability of the Persian version of the Medical Student Stressor Questionnaire. Methods: This study was a methodological survey with a descriptive, cross-sectional design and was conducted in all medical universities of Tehran in 2016-17. The questionnaire was first back translated from English to Persian. The final Persian version of the questionnaire was completed by 200 fifth-to seventh-year medical students and fourth-year midwifery and nursing students. Exploratory factor analysis was used to assess construct validity, and confirmatory factor analysis was used to determine the number of factors and fitness of the model. The reliability of the instrument was assessed by internal consistency. Test-retest was used to assess temporal repeatability. Results: The results confirmed the validity and reliability of the Persian version of MSSQ questionnaire. The results of face and content validity confirmed all of the questionnaire items. The Exploratory factor analysis yielded six factors which explained 75. 99% of the variance observed. Also, Cronbach’ s alpha coefficient was 0. 92 and intra-class correlation coefficients of the sub-scales were at acceptable level, ranging from 0. 81 to 0. 90. Conclusion: This questionnaire is a useful and valid instrument in terms of implementation and ease of scoring, and can assess the stressors in medical students. Therefore, it can be used as a reliable instrument in research.

Introduction: Academic entrepreneurship and its development within medical universities are now one of the prerequisites for dynamic economic development in developed countries. Thus, the purpose of the present study was to rank and compare the universities of Mazandaran Province in the field of academic entrepreneurship. Methods: This descriptive applied research was conducted in 2015. The statistical population was comprised of the university faculty members and experts in incubation centers of the universities of Mazandaran Province. Samples were selected by purposive sampling method. Data were collected through questionnaire and interview and analyzed in the MATLAB software using the TOPSIS and simple additive weighting (SAW) techniques. Results: Babol University of Technology (W=0. 1443; 0. 1812) had the highest score in the field of academic entrepreneurship. Sari University of Medical Sciences (W=0. 1366; 0. 1643), and Babol University of Medical Sciences (W=0. 1277; 0. 1990) ranked second and third respectively. Conclusion: Considering the rather appropriate rank of medical universities among the universities of Mazandaran Province, it is essential that the medical universities increase their capacity and ability to provide new functions by developing the necessary infrastructures for development of entrepreneur university.

Introduction: Simulation is an educational technology that facilitates learning and improves learner’ s performance. The aim of this study was to introduce simulation-based clinical training in operating room. Methods: In this review article, the keywords “ simulation, training, clinical education, operating room training, and simulation in operating room” were used to find Persian and English articles published from 2000-2018 andin the databases of Science Direct, Google scholar, PubMed, SID, and Magiran. Articles related to introduction and application of simulation-based training in operating room were selected and reviewed. Results: Forty-Two articles had addressed the history and importance of using simulation in clinical education, their development methods, types of simulators used in the operating room and importance and types of models designed to evaluate the simulation methods. Examples of these simulations included lowfidelity physical simulators, web-based educational tools, computer-based video training, virtual learning environment systems, learning management systems, laparoscopic surgery such as “ McGill Inanimate System” for training and evaluation of laparoscopic skills, simulation-based surgical methods, and realistic computer-controlled mannequins such as “ Sim Man 3G” . Conclusion: A wide variety of simulators and models can be used for designing, implementation and evaluation of operating room training. Many of the existing challenges can be overcome with proper planning and educational institutions can develop and expand simulation-based trainings in operating room by understanding the educational potential of this method.

Introduction: One of the basic principles of the educational process is the periodic review of the curriculum for each discipline and at each academic level. Because of previous work experience, the operating room noncontinuous undergraduates have to retake some courses they have already passed. Therefore, the purpose of this study was to investigate the operating room students, graduates and faculty members’ experiences of the curriculum of operating room noncontinuous undergraduate program. Methods: This qualitative study was conducted in 2016-17 using the conventional content analysis method. Subjects were selected by means of purposive sampling. Data were collected through 13 semi-structured interviews. Interview transcriptions were analyzed in MaxQDA2 software using the content analysis method. Results: The data were classified into three main categories namely “ disproportionate structure of the curriculum” with the subcategories of inappropriate organization of teaching content, teaching method and ineffective apprenticeship; “ deterrents” with the subcategories of employment during education, family management, and difficult commuting; and “ motivational factors” with the subcategories of financial growth, job promotion, and social identity. Conclusion: Results suggest that it is necessary to reform the structure and implementation of the curriculum of operating room noncontinuous undergraduate program so that it will be commensurate with learners’ needs.

Introduction: The growth of social networks has led to definition of new applications, including informal and tacit trainings (visual, auditory and written) for this tool. The present study aimed to examine the effect of using telegram social network on the effectiveness of nurses' professional trainings. Methods: This study utilized a multi-group pretest-posttest design. Based on the inclusion criteria, 90 nurses were selected from one of the private specialized hospitals in Tehran and randomly divided into three groups of 30. Each group was assigned to one type of training (face-to-face, self-reading and telegram-based). Statistical analysis was performed using descriptive statistics, one-way ANOVA and factor analysis. Results: The mean score of the telegram-based group was 3. 7 points higher than that of the self-reading group and 1. 66 points higher than that of the face-to-face group. The mean score of the face-to-face group was 2. 3 points higher than that of the self-reading group. In addition, the two variables working hours (-0. 19) and teaching method (0. 33) and the two variables age (0. 178) and job experience (-0. 08) had a direct and indirect effect respectively on the participants’ scores. The greatest effect was related to the teaching method (0. 53) and the smallest effect was related to the job experience. Conclusion: Nursing managers can use mobile social networks to improve the effectiveness of nursing inservice training programs. The results of this study can serve as a useful guide for supervisors.

Introduction: Appropriate clinical environment has an important role in preparing students to use learned knowledge in practice by providing learning opportunities. With regard to the recent complexities of clinical teaching, sensitivity to various environmental factors, recent changes in clinical environments and multiple roles of clinical faculty, a comprehensive study of this phenomenon seemed necessary. Therefore, the aim of this study was to explain emergency medicine faculty members’ experiences of clinical training environments. Methods: This qualitative study utilizes a conventional content analysis method. Data were collected through purposive sampling, semi-structured individual interviews with the emergency medicine faculty members of Isfahan University of Medical Sciences, and field observations in 2017-18 academic year. The data were analyzed in MAXQDA using the inductive method. Open codes were first extracted and classified into subcategories that, in turn, were organized under the main categories based on their meaning similarities. Results: Three main categories and six subcategories were extracted: structure and characteristics of the emergency department trainings (administrative support, physical structure), clinical reasoning methods (autonomic, automatic), and processing of the clinical learning environment (formal teachings, informal teachings). Conclusion: The results of this study can help managers and curriculum planners better understand the process of faculty members’ perception of clinical learning environments. A deeper understanding of these perceptions can improve the faculty members’ perception of these environments and consequently, students can be guided toward developing their personal and professional talents and competencies.

Introduction: Considering the importance of professional ethics in managerial decision-making and promotion of organizational commitment and justice in providing high-quality services, the purpose of this study was to explore the relationship between professional ethics and organizational commitment mediated by organizational justice in Ministry of Health and Medical Education, Deputy of Education. Methods: The research population of this descriptive, correlational study included all the staff of Ministry of Health and Medical Education, Deputy of Education in Tehran. A sample of 260 individuals was selected by means of systematic random sampling and Morgan’ s table. Research instruments were Cadozier’ s professional ethics questionnaire, Meyer and Allen’ s organizational commitment scale, and Niehoff and Moorman’ s organizational justice scale. Reliability and validity of the instruments were verified using Cronbach’ s alpha. The data were analyzed by means of Pearson correlation coefficient and structural equation modeling Results: There were positive and significant relationships between professional ethics and organizational commitment (r=0. 69, p≤ 0. 01), professional ethics and organizational justice (r=0. 81, p≤ 0. 01), and organizational justice and organizational commitment (r=0. 74, p≤ 0. 01). Conclusion: The structural equation model for the relationships between professional ethics and organizational commitment mediated by organizational justice showed a good fit for the population in question. Accordingly, it is applicable to this selected population.