What Happened to Simulation-Based Education in Outpatient Setting in The 21st Century: A Scoping Review

Introduction

Simulation-based education (SBE) is an instructional approach that aims to accurately recreate real-life scenarios and engage learners in the practical application of lesson content. By replicating critical elements of clinical situations, SBE facilitates a deeper understanding and better preparation for managing such conditions in actual clinical practice. SBE offers promising prospects for improving medical education and patient care in various settings, such as outpatient clinics. Therefore, this scoping review aims to determine to what extent the most effective components and standards of the simulation have been considered in outpatient education.

Methods

The present scoping review adheres to the guidelines outlined in the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist" and the "Joanna Briggs Institute (JBI) Reviewers' Manual". This review focused on articles that specifically focused on the use of simulation in outpatient education. Google Scholar, PubMed, Scopus, Embase, and ERIC were searched for keywords related to simulation, ambulatory care, outpatient clinics, and medical education from January 1, 2001, to August 12, 2023.

Results

The search indicated 513 articles, which were narrowed down by title and abstract relatedness. Twenty-nine articles entered the study's second phase, and after reviewing their full text, nine articles that explicitly reported simulation use in outpatient education remained. Based on the findings of eligible articles, the ten most frequent components of SBE that should be considered and followed discussed. These features were training facilitators, pre-briefing sessions, the type of simulation techniques, the site of simulation participation, the simulation duration, unit of participation, extent of direct participation, Simulation fidelity, feedback, and debriefing and reflection.

Conclusion

SBE is a contemporary method of practical training for medical students that involves realistic modeling or simulation of clinical situations. It enhances learning effectiveness and provides a safe, educational atmosphere for teaching and learning. Designing simulations adhering to established standards and carefully considering essential components improves efficiency and effectiveness.

Exploring the relationship between contextual factors and health-promoting lifestyle profile (HPLP) among medical students: A cross-sectional study

Background and Aims

The present study was conducted with the aim of investigating the relationship between health-promoting lifestyle profile (HPLP) among medical students and contextual factors such as gender, age, field of study, academic level, marital status, history of physical and mental illnesses, and smoking.

Methods

The present research was conducted in a cross-sectional method in 2021 on 500 students of Shiraz University of Medical Students. An e-questionnaire link was sent to them via email. The research tool was the HPLP questionnaire consisting of 52 questions in six domains in a 4-point Likert scale. Data were analyzed using SPSS software version 24 with one-sample t-test, independent t-test, analysis of variance, and Tukey's post hoc test.

Results

A total of 500 students fully answered the questions completely. All components of a healthy lifestyle-except for exercise-obtained a score higher than the cut-off point. The component of Self-Actualization (spiritual growth) (3.035 ± 0.68) had the highest score, while the lowest score was related to exercise and physical activity (2.126 ± 0.60). Married individuals had a better average health score compared to singles (p = 0.047). The average health score did not have a significant relationship with gender, but significantly related to age, field of study (p < 0.001), history of mental illnesses (p < 0.001) and Smoking (p < 0.001).

Conclusion

It seems that university officials should pay more attention to the health domain of students' lifestyles, such as nutrition, the development of exercise and physical activities, and the management of stress and mental health. Additionally, providing necessary awareness and considering training courses, as well as developing sports and recreational facilities, can be effective in creating a better environment for the growth and development of students and ensuring their well-being.

Lesson learned from assessing teachers' and students' perspectives regarding the quality of e-learning in medical education during the pandemic: a mixed-methods study

BACKGROUND

The evaluation of e-learning systems ensures the provision of quality training. The goal was to identify the perspectives of teachers and students on e-learning in medical education during the COVID-19 pandemic at Shiraz University of Medical Sciences (SUMS), Iran.

METHODS

This study utilized a convergent mixed methods research design with a two-phase approach to collect and analyze data between June and August 2022. In the first stage, a cross-sectional descriptive study was conducted to evaluate the quality of e-learning systems from the perspective of 400 students. In the second stage, semi-structured interviews were conducted with 10 virtual education professors and 10 student representatives to identify the strengths, weaknesses, opportunities, and threats of virtual education. A validated questionnaire was administered to assess the quality of the e-learning system, and data were analyzed using SPSS-21. Qualitative data were subjected to content analysis.

RESULTS

Our findings revealed that the student support system, the course structure, and the infrastructure and technology subscales' mean scores were significantly higher than the average level (P < 0.001). However, the professors' methods of teaching and learning strategies were unsatisfactory. The results of the present study showed that the evaluation mean score was significantly higher among, younger, female, and undergraduate students. Virtual education has strengths and weaknesses, and innovative approaches are needed to enhance student engagement. The lack of appropriate infrastructure and virtual teaching tools for teachers and students is a significant challenge that needs to be addressed. Blended learning is effective in medical education, and the shift from teacher-centered to learner-centered teaching approaches is an opportunity to explore innovative teaching approaches.

CONCLUSION

From the perspective of students, the quality of eLearning systems at the universities was moderate. Virtual education offers both benefits and drawbacks, and there is a requirement for innovative solutions to enhance student engagement and lessen boredom.

Comparison of the teaching clinical biochemistry in face-to-face and the flex-flipped classroom to medical and dental students: a quasi-experimental study from IRAN

INTRODUCTION

Biochemistry is one of the main courses of basic sciences in the medical curriculum, along with other difficult subjects that are difficult to learn. The emergence of new technologies has made it possible to test new methods such as e-Learning. In this study, we compared two methods of Flex-Flipped Classroom (FFC) and face-to-face.

METHOD

A quasi-experimental research was done which involved both medical and dental students studying the clinical biochemistry course in the joint semester in 2019. A total of 100 medical students were trained in biochemistry through face-to-face teaching, and 60 dental students were trained in the same course through the FFC model. Three researcher-made tools were used to compare the two groups to assess the student's satisfaction, scores, and self-evaluation. The content validity of the tools was checked using the opinions of 10 experts through the CVI index. The results were analyzed using one-sample t-tests, independent t-tests, and ANOVA.

RESULTS

Both groups scored significantly more than the cut-off-point (Mean > 3.5) in their average scores of the total and sub-components of the self-evaluation questionnaire (P < 0.05). Face-to-face teaching was viewed more favorably than the FFC teaching except for considering the flexibility (4.14 ± 1.55), but the difference was not significant (P > 0.05). The students' knowledge score in the FFC was slightly higher than that in the face-to-face method, but this difference was not significant(P = 0.758).

CONCLUSION

Both face-to-face and FFC methods were effective according to the students, but the level of satisfaction with the face-to-face method was higher. It seems that teacher-student interaction is an important factor in students' preferences. However, the students preferred the flexibility of multimedia. It seems necessary to use the advantages of each method in a model appropriate to the students' conditions and available facilities.

Which educational messengers do medical students prefer for receiving healthinformation? Development and psychometrics of using health messengers questionnaire

INTRODUCTION

Individuals vary in their selection of health messengers. This research aimed to construct an instrument to measure the preferences of medical students in selecting health messengers and in the next step to validate the aforementioned questionnaire.

METHOD

This research is a descriptive survey with an approach to construct a questionnaire. The statistical population included all students studying at Shiraz University of Medical Sciences in March to June 2022 in the academic year 2021-2022. 500 participants were involved in the study. To determine the types of health messengers and review the texts, a group of 15 primary items consisting of the 6 components of academic sources (2-items), formal news sources (2-items), mass media (3-items), internet search (2-items), social networks and messenger applications (4-items), and informal conversation (2-items) were compiled. A 4-point scale was developed the content validity of which was confirmed using CVI and CVR method and the reliability index was calculated to be 0.818. Factor analysis was also used to determine the construct validity and factor loading of each item.

RESULTS

The research covers university students in different medical fields. Using factor analysis, together with KMO = 0.810 and Bartlett's sphericity index P < 0.0001, saturation and the suitability of the test were confirmed. Students' preferences based on factor load were social media (28.92%), official and unofficial health sources(10.76%), academic sources (9.08%), internet search (8.18%), and mass media (7.13%), respectively. Among social media, Telegram (0.85) had the highest factor load followed by Instagram (0.79), and WhatsApp (0.71).

CONCLUSION

Medical students are always on the move and naturally prioritize mobile-based methods. They prefer messengers that are free from time and space restrictions. The widespread availability of mobile devices and the ability to search for and access information make it easier to test health information. Therefore, in health policy, attention should be paid to the virtual capabilities, especially mobile-based approaches.

The effect of gamification-based training on the knowledge, attitudes, and academic achievement of male adolescents in preventing substance and internet addiction

BACKGROUND

Preventing addiction through training takes precedence over treatment and plays a crucial role in enhancing the well-being of adolescents. Utilizing inclusive and participatory methods can significantly enhance the effectiveness of education. Numerous studies have demonstrated that gamification, as an interactive and comprehensive approach, has the potential to boost teenagers' motivation to engage in learning and contributes to better comprehension.

AIM

This study aimed to assess the impact of gamification-based training to prevent substance and internet addiction on the knowledge and attitudes of male adolescents. Additionally, the study examined this educational program's effects on male adolescents' academic achievement.

METHODS

This study employed a quasi-experimental design with a control group. One hundred fourteen male adolescents were randomly assigned to the intervention or control groups. They completed a pre-intervention questionnaire assessing addiction-related knowledge, attitudes, and academic achievement. Subsequently, the intervention group received the gamification-based drug and internet addiction prevention training. Post-tests were conducted immediately after the training and again one month later for both groups.

RESULTS

Before the intervention, there were no significant differences in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement between the intervention and control groups (P > 0.05). However, after the intervention, the intervention group demonstrated significantly higher scores in knowledge of substance and internet addiction, attitudes toward substances and the Internet, and academic achievement compared to the control group (P < 0.001).

CONCLUSION

The current study highlights the positive impact of gamification-based training on enhancing male adolescents' knowledge, attitudes, and academic achievement.

Outpatient education, a momentous in clinical education: a qualitative study of medical students', faculty members', and residents' perspectives

BACKGROUND

Even though a lot of scholars have been looking at outpatient education lately because it has become more popular and they want to know about its successes, failures, and problems, we have not been able to find a complete study. Therefore, our study aims to gain a deeper understanding of the various aspects of outpatient education based on the actual experiences of medical students, faculty, and residents.

METHODS

Face-to-face and semi-structured interviews were used to collect data for this qualitative study. Until data saturation was reached, the interviews continued. A total of 21 participants from Shiraz University of Medical Sciences, including medical students, residents, and teachers, were enrolled. The Guba and Lincoln-first written standards for scientific accuracy in qualitative research were used to figure out how reliable the data were.

RESULTS

Fourteen categories were extracted from four main themes. The results show that four categories: "physical space and equipment," "prerequisites related to the curriculum," "teaching skills development," and "near-peer teachers" should be considered for outpatient education preparation. Theme 2, "implementation requirements," included "student dimension," "faculty's commitment to planning," and "program supervision." Theme 3, "challenges of outpatient education," was described by five related categories, including "curriculum implementation challenges," "student challenges," "faculty challenges," "system-related challenges," and "patient-related challenges." Finally, two categories emerged about facilitators of outpatient education: internal and external facilitators.

CONCLUSION

Outpatient clinics represent a crucial aspect of medical practice. To effectively leverage this resource, preliminary planning, considering all the prerequisites, paying attention to the implementation requirements, getting to know the challenges, and trying to solve them, especially with incentives, are essential.

The effect of flipped approach in teaching critical respiratory care among nurses during the COVID-19 era

OBJECTIVES

This study investigated the efficacy of flipped approach on the nurses' knowledge and motivation regarding critical respiratory care during the COVID-19 pandemic.

RESULTS

This pretest-posttest quasi-experimental study was performed in a hospital affiliated with Shiraz University of Medical Sciences during March-December 2021. One hundred and twenty eligible nurses selected by convenience sampling underwent a seven-day flipped approach respiratory intensive care training. The nurses' motivation and knowledge were evaluated using the Students' Motivation Towards Science Learning (SMTSL) and a 20-researcher-made four-option questionnaire before and two weeks after the intervention, for knowledge assessment respectively. The nurses' knowledge and learning motivation were significantly higher after the intervention (P < 0.001). The flipped approach can improve learning motivation and nurses' knowledge of critical respiratory care.

Investigating the effectiveness of Case-Based Technology-Enhanced workshops (e-Flipped vs. Online) among health worker nurses during the COVID-19 pandemic

AIM

This study aimed to compare the efficacy of e-flipped and online case-based workshops on the nurses' knowledge, attitude and behaviour regarding thalassemia during the COVID-19 pandemic.

DESIGN

A pre-test-posttest interventional study was conducted with two intervention groups and a control group.

METHODS

One hundred and fifty nurses were recruited from comprehensive urban health centres in June-December 2020. The nurses were randomly allocated to one of the three groups: case-based e-flipped workshop (n = 50), case-based online workshop (n = 50) and control (n = 50). A researcher-made questionnaire was completed by eligible subjects at baseline, after the end of the training sessions and 4 weeks after interventions to assess their knowledge, attitude and behaviour. Data were analysed in IBM SPSS v16.0. ANOVA and Tukey's post hoc tests were used to compare the three groups.

RESULTS

The mean knowledge, attitude and behaviour scores in the intervention groups increased significantly more than that in the control group (p < .001). One week and 4 weeks following the intervention, the mean score of knowledge, attitude and behaviour in the e-flipped group was greater than that in the online group (p < .001). According to the results, e-flipped and online case-based workshops can improve nurses' knowledge, attitude and behaviour regarding thalassemia.

The effect of video-based multimedia training on knowledge, attitude, and performance in breast self-examination

Background/Objectives

Breast neoplasm is one of the most common cancers in Iranian women due to the late diagnosis. Awareness of breast neoplasm and using Breast Self-Examination (BSE) assist in the early detection and treatment of cancer. This study examined the effectiveness of video-based multimedia training versus face-to-face training in awareness of breast neoplasm and BSE and possible factors affecting their effectiveness.

Methods

This research was a pre-test, a post-test experimental study comparing the knowledge, attitude, and performance of women about BSE across two training intervention groups (face-to-face versus video-based multimedia). The study was conducted at Shiraz University of Medical Sciences (SUMS), and 100 women between 20 to 60 years old were allocated to each intervention group via multi-stage cluster sampling (n:110). Three valid and reliable researcher-made questioners were used. Data were analyzed using SPSS 24 with independent t-test, paired t-test, and ANOVA.

Results

Both video-based multimedia and face-to-face training methods significantly increased the participant's knowledge, attitude, and skills about breast self-examination (P < 0.001). In the sub-categories, the results showed that the face-to-face training improved negligence and forgetfulness in applying BSE (P = 0.03) and correcting or modifying the previous knowledge around the issue (P = 0.02). The effect of the video-based method on participants with university education was more than on non-university (P = 0.04).

Conclusion

Incorporating video-based multimedia training in awareness of breast neoplasm and breast self-examination provides an easy, flexible, and affordable way for detection, particularly considering crisis restrictions. This can be of particular attention in more populated, developing/low-income countries and rural and remote areas to enhance equitable access to training and facilitation diagnosis and treatment if applicable.

Comparison of the effectiveness of the electronic portfolio and online discussion forum methods in teaching professional belonging and ethical behaviors to nursing students: a randomized controlled trial

BACKGROUND

Nursing is a profession that has had many ethical aspects and understanding professional belonging and ethics as a deep and complex process is one of the basic concepts in this field. This study aimed to compare the effectiveness of training professional belonging and ethical behaviors in two methods: electronic portfolio and online discussion forum in nursing students.

METHODS

This study is a single-blinded randomized-controlled trial (RCT) with two parallel intervention groups and a third control group. The sample size was 90 selected by block randomization method. The educational contents of professional belonging and ethical behaviors were presented to the participants in two ways: electronic portfolio and online discussion forum. Demographic information form, professional belonging questionnaire, and ethical behaviors questionnaire were applied to collect data. Data were analyzed using SPSS version 24 software. Respectively mean, standard deviation and repeated measured, analysis of variance tests was used in descriptive and analytic statistic. (P value < 0.05).

RESULTS

Comparison of the mean score of professional belonging and ethical behavior in the three stages of pretest, immediately after the test and four weeks after the test in all three groups was significant (P < 0.001). The control group had a higher mean score of professional belonging immediately after the test (108.18 ± 48.9) compared to the other two groups. Also, the online discussion forum group had a higher mean score on ethical behavior in four weeks after the test (104.2 ± 0.8) compared to the other two groups.

CONCLUSION

Training based on two methods of the electronic portfolio and online discussion forum increases and enhances the level of ethical behaviors in students. Therefore, the implementation of such methods of training can be useful in improving, promoting, and learning ethical behaviors in nursing students. On the other hand, training based on the two methods had a negative impact on professional belonging. Therefore, it is suggested that future studies be conducted with a greater focus on areas of professional belonging.

TRIAL REGISTRATION

This research has been registered in Iranian Clinical Trial Registration Center (IRCT) with registration number "IRCT20180612040063N1" and registration date "16/07/2018".

Effect of the e-flipped learning approach on the knowledge, attitudes, and perceived behaviour of medical educators

Objectives

Using the Kirkpatrick evaluation model, investigate the effect of the e-flipped learning approach on the knowledge, attitudes, and perceived behaviour of medical educators.

Results

This interventional study was conducted on 140 eligible medical educators at Shiraz University of Medical Sciences (SUMS) from 2019 to 2021. A researcher-made questionnaire was developed to assess the impact of the course on three levels of reaction, knowledge, and perceived behaviour using the Kirkpatrick evaluation model. According to the findings, the average reaction and knowledge scores are higher than the desired level, but the perceived behaviour score is slightly lower than the desired level. The e-flipped learning approach can improve medical educators’ knowledge, attitude, and behaviour regarding online teaching.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06119-8.

Video-based versus educational booklet training on self-care performance of patients with cataract

Background and Objective: Training patients can increase their knowledge and skills in self-care performance after cataract surgery. The present study compared the effect of videobased training and educational booklet methods on the self-care performance of patients with cataracts. Methods and Material: In this interventional study,83eligible patients a day prior to their cataract surgery were enrolledin the study based on the convenient sampling method conducted in 2020.Then, the patients were allocated into a video-based training group (n= 40) and educational booklet (n=43) group by the permuted block random sampling method. The patients completed a researcher-made questionnaire one day before and one day after the intervention to be assessed for their knowledge and self-care performance after cataract surgery. Face as well as content validity (CVR = 0.99, CVI = 0.8) and reliability (0.839) of the data collection tool were confirmed. For statistical analysis, independent t-test and analysis of covariance were used, using SPSS16 software. Results and Discussion: Based on the results, video-based training and educational booklet had the same effect on increasing the level of knowledge among the patients. Also, the mean score of self-care performance was significantly higher in the videobased training compared to the booklet group after the intervention (P=0.014). Conclusion: Video-based training can significantly enhance patients’knowledge and self-care performance regarding cataract than training the patients via the educational booklet. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 601-609

Effect of a multimedia training programme for pain management on pain intensity and depression in patients with non-specific chronic back pain

OBJECTIVES

To determine the effect of multimedia training on pain intensity and depression in patients with chronic low back pain.

METHODS

In this randomized controlled trial study, the intervention group was trained about pain management consisted of communication skills, assertiveness, stress management, lifestyle enhancement skills and physical activity prepared in seven CDs using multimedia method and the control group received routine training included physician's visits, medication prescriptions and receiving the recommendations of the physician and healthcare providers. Beck Depression Inventory and Jensen Pain Questionnaire were completed for the two groups in three stages: pre-training, post-training and 2 months thereafter.

RESULTS

The results showed that there were no significant statistical difference between two groups in terms of demographic variables indicated homogeneity of research groups. Repeated measure ANOVA showed that the mean scores of pain intensity and depression changed significantly over time in both control and intervention groups (p<0.001); however, the effect of the group was not significant (p=0.565, p=0.748, respectively). Hence, the results of time-group interaction showed that there was significant difference between the two groups in terms of pain intensity and depression (p<0.001, p=0.003, respectively). The effect size revealed that the difference between mean scores of depression before and after the intervention in the both group was high (1.04 and 1.45, respectively).

CONCLUSIONS

The study results indicated that multimedia training has the potential in relieving pain intensity and depression in patients with non-specific chronic low back pain.

Medical education and COVID-19 pandemic: a crisis management model towards an evolutionary pathway

The COVID-19 crisis has had a profound effect on higher education, especially medical education due to its sensitive nature, dealing with people's life and wellbeing. This study presented a crisis management model of how to direct medical education during crises. A qualitative design was used via a focus group among 83 medical education administrators at Shiraz University of Medical Sciences. Four major challenges emerged regarding medical education during the COVID-19 pandemic including "The health and wellbeing of faculty members and students"; "Spatial constraints"; "Time constraints", and "Access to resources". A total of 13 strategies were suggested to tackle the challenges, including virtualization, technological support, empowerment, participation, sharing, helping, integration, compression, omission, flexibility and diversity, severance, protection; and monitoring. For a sustainable educational pathway in medical education, personalized approach to education via the incorporation of technology is essential. This provides opportunities to tackle the issues caused by the crisis, by provision of any time and anywhere approach to education via flexible technologies/platforms adjusted based on the audiences. The scope of crisis management expands not only on individual and academic levels but also on social and global relations.

The effect of multi-stage mobile training based on Gagne instructional design on learning, retention, and satisfaction of health volunteers

BACKGROUND

One of the most important ways to acquire knowledge in the present age is education based on new technologies, including mobile learning. The purpose of this study was to investigate the effect of a multi-stage mobile training based on Gagne instructional design on learning, retention, and satisfaction of health volunteers.

MATERIALS AND METHODS

In this interventional study, 112 health volunteers a Health Centre in Mashhad during 2019-2020 were enrolled. The participants were randomly divided into two groups: mobile education based on Gagne model (n = 56) and conventional lecture (n = 56). A researcher-made questionnaire was completed by the eligible subjects before, after, and 2 months after the intervention to assess their learning, retention and satisfaction in educational methods. Face validity, content validity, and reliability of the data collection tool and model fitness indices were confirmed. Content validity of data collection tools verified by experts and its reliability was calculated to be 0.78. The collected data were analyzed in SPSS-25, using descriptive (mean and standard deviation [SD]) and analytical statistical tests (independent t-test).

RESULTS

The results showed that 2 days and 2 months after the intervention, learning, and retention rate was significantly higher in the mobile learning based on Gagne model group in comparison to conventional lecture group (P < 0.001). Furthermore, the intervention group was generally satisfied with the mobile training method.

CONCLUSION

Mobile learning based on Gagne model is recommended for improving learning, retention among health-care workers.

An investigation of the effect of smartphone-based pain management application on pain intensity and the quality-of-life dimensions in adolescents with chronic pain: a cluster randomized parallel-controlled trial

INTRODUCTION

Chronic pain negatively affects adolescents' quality of life. Therefore, it is important to seek for ways to effectively manage pain, which may, in turn, promote quality-of-life dimensions in this population. However, there are many barriers including geographical distance which prevent most adolescents from receiving an effective treatment for chronic pain. The present study aimed to investigate the effect of a smartphone-based pain management application compared with face-to-face pain management program and wait-list control on the pain intensity and quality-of-life dimensions in adolescents with chronic pain.

METHODS

This study used a cluster double-blinded randomized parallel-group design with school as the unit of randomization. Participants included were 192 adolescents with chronic pain. The questionnaires (pain intensity and quality of life measuring physical, emotional, social, and school dimensions) were completed at the baseline, immediately at the end of pain management program and three months after the end of the program.

RESULTS

Repeated measures ANOVAs with adjustment for clustering effect showed that there were significant main effects of time on ratings of pain intensity (p < 0.01), physical (p < 0.005), emotional (p < 0.008), social (p < 0.001), and school (p < 0.005) dimensions of quality of life. There was also a significant main effect of group on ratings of emotional (p < 0.001), social (p < 0.009), and school (p < 0.002) dimensions. The interaction of group × time for emotional (p < 0.004), social (p < 0.001), and school (p < 0.005) dimensions of quality of life was statistically significant.

DISCUSSION

The findings suggest that smartphone-based pain management program, which is a highly accessible and cost-effective intervention, may provide benefits similar to a face-to-face intervention and shows promise for being effective on emotional, social, and school dimensions of quality of life in adolescents with different types of chronic pain. The study was registered within the Iranian Registry of Clinical Trials (IRCT20180808040744N2).

E-professionalism in medical sciences: A Hybrid Concept Analysis

BACKGROUND

Professionalism is one of the most important and vital concepts in the medical sciences. With the rapid growth of e-learning in the medical sciences in the past few years, the concept of virtual professionalism has emerged. This study was conducted as a hybrid concept analysis on describing e-professionalism in medical sciences.

MATERIALS AND METHODS

This is a qualitative study with a hybrid concept analysis approach, consisting of theoretical stage, field research, and analysis. In the theoretical stage, the concepts of e-professionalism in medical sciences were identified through a review of the literature. During the fieldwork stage, in-depth interviews were conducted with five medical students who were intentionally selected. Finally, after analyzing the literature and the qualitative interviews, a theoretical description of e-professionalism concept in the field of medical sciences was extracted.

RESULTS

the themes (3 numbers) and the subthemes (4 numbers) were extracted from 62 codes. These themes include information and communion technology and educational strategies professionalism in medical education.

CONCLUSIONS

For describing professionalism, it is necessary to consider education and culture, role models, by emphasizing on the acceptance of professional responsibility, developing and improving social media policies, determining the scope of communication and interaction between individuals, and identifying the boundary between local laws and customs.

Nursing process education: A review of methods and characteristics

The concepts of the nursing process have been assigned as important plans for the curricula and continuing education programs in the nursing discipline. This paper focuses on the main characteristics of the educational methods applied in training programs in the nursing process or nursing care plan. The original studies were extracted from the PubMed, ProQuest, Scopus, Science Direct and, Web of Science databases, following two-step screening by two reviewers. Accordingly, 21 papers were included in the study based on inclusion criteria. According to the results, 42.85% of educational methods were computer-based while 57.15% were non-computer based. Computers were used as the main educator (14.28%) or as an assisted-tool (25.57%). The lecture-based training, as one of the non-computer based educational tools, was the most frequent method observed across the studies (33.3%). There are two frequently used measures of evaluating the educational programs learner's knowledge of nursing process (28.75%) and their attitude toward the program (23.80%). The results suggested that in order to improve educational methods for the nursing process, computers, mobile phones, and other available technologies should be integrated with the traditional educational methods. Also, comprehensive measures should be applied for evaluating them.

The effects of mindfulness training on the level of happiness and blood sugar in diabetes patients

Purpose

The present study aimed at investigating the effect of mindfulness training on the level of happiness and blood glucose in diabetic patients in Zarghan city, Iran.

Methods

This quasi-experimental study was conducted in 2018 in Fars province, Iran. 136 diabetic patients who were eligible (had diabetes for more than one year, older than 18 years, willingness to participate in the research, and reside in Zarqan city) were selected based on convenience sampling method. Next the participants were randomly divided into two groups, each comprising 68 individuals. Both of the study samples and statistical analyser were blinded to intervention group (mindfulness training) and control group (without intervention). Before and three month after the intervention the patients' levels of happiness (based on Oxford Happiness Questionnaire), fasting blood sugar (FBS) and Glycated Hemoglobin test (HbA1c) were measured.

Results

The results indicated that after the sessions, the level of happiness in the Intervention group was significantly higher than the control group (p value <0.001). Also, the level of blood glucose and HbA1c after the sessions was significantly lower in the Intervention group compared to the control group (p value<0.001, p value = 0.004). After the intervention, there was a significant correlation between mean blood glucose levels and mean HbA1c levels in the Intervention group and their level of happiness (p value<0.01 and p value<0.001).

Conclusion

The findings revealed that the mindfulness-based educational intervention can increase happiness in people with diabetes and regulate their blood glucose.

Effect of an Interactive Training on Choosing Delivery Method among Primiparous Pregnant Women: An Interventional Study

OBJECTIVES

To evaluate the effect of interactive training conducted during pregnancy on choosing delivery method among primiparous women.

METHODS

Quasi-experimental study carried out in 2017 in two hospitals in the city of Bushehr (Iran), with the participation of 108 primiparous pregnant women in an educational program consisting of eight 2-hour sessions every two weeks in which interactive training activities were performed (group discussions, classroom sessions, and delivery of printed educational material) on themes related with physiological delivery, painless vaginal delivery methods, and complications of cesarean delivery without indication, among others. Before and after the intervention, the Knowledge and Preferred Method of Delivery Questionnaire by Moradabadi et al., was used to obtain information.

RESULTS

The results indicated that the level of knowledge in the group of mothers increased significantly between the pre-intervention and post-intervention assessment (13.2 versus 19.4, of 20 possible maximum points; p < 0.001). Additionally, significant difference was observed in the selection of the vaginal delivery method before and after the intervention (74.1% versus 98.1%; p < 0.001).

CONCLUSIONS

Implementation of interactive training increased knowledge of pregnant women on the delivery and induced a positive effect to encourage the primiparous mothers to have a vaginal delivery.

Interactive Multimedia Training in Osteoporosis Prevention of Female High School Students: An Interventional Study

Given the limitations of traditional teaching methods in the learning process of adolescents, this study was designed to investigate the effects of osteoporosis prevention training through interactive multimedia method on the degree of knowledge and self-efficacy of female high school students. In this interventional study which was conducted in 2016 in Fars province, Iran, 120 high school students were selected through proportional stratified sampling from schools and different classes at first, second, third, and pre-university grades. The participants were randomly divided into two groups, each containing 60 students. Educational interventions for the test group included an interactive multimedia CD, and for the control group was an educational booklet. Before and one month after the intervention the students' level of knowledge and self-efficacy was measured. The spss 19 statistical software was used, and descriptive and analytical tests were performed to analyze the data. Results showed a significant difference in self-efficacy scores after the intervention (P=0.012) with the test group obtained a higher self-efficacy score than the control group. Also, a significant increase was observed in the knowledge score of both groups after the training (P<0.001), but the knowledge score between the two groups was not statistically significant (P=0.38) after the intervention. The use of new training methods like interactive multimedia CD for public education, particular adolescents about health and hygiene is recommended.

A comparison of educational strategies for the acquisition of nursing student's performance and critical thinking: simulation-based training vs. integrated training (simulation and critical thinking strategies)

BACKGROUND

There is a need to change the focus of nursing education from traditional teacher-centered training programs to student-centered active methods. The integration of the two active learning techniques will improve the effectiveness of training programs. The objective of this study is to compare the effects of the integrated training (simulation and critical thinking strategies) and simulation-based training on the performance level and critical thinking ability of nursing students.

METHODS

The present quasi-experimental study was performed in 2014 on 40 students who were studying practical nursing principles and skills course in the first half of the academic year in Shiraz University of Medical Sciences. Students were randomly divided into control (n = 20) and experimental (n = 20) groups. After training students through simulation and integrated education (simulation and critical thinking strategies), the students' critical thinking ability and performance were evaluated via the use of California Critical Thinking Ability Questionnaire B (CCTST) and Objective Structured Clinical Examination (OSCE) comprising 10 stations, respectively. The external reliability of the California Critical Thinking questionnaire was reported by Case B.to be between 0.78 and 0.80 and the validity of OSCE was approved by 5 members of the faculty. Furthermore, by using Split Half method (the correlation between odd and even stations), the reliability of the test was approved with correlation coefficient of 0.66. Data were analyzed using t-test and Mann-Whitney test. A significance level of 0.05 was considered to be statistically significant.

RESULTS

The mean scores of the experimental group performance level were higher than the mean score of the control group performance level. This difference was statistically significant and students in the experimental group in OSCE stations had significantly higher performance than the control group (P <0.001). However, the mean scores obtained for the critical thinking did not increase before and after the intervention.

CONCLUSION

The results showed that, the students' performance level was increased by the application of integrated training (simulation and critical thinking strategies).