Evaluation of the doctoral program in medical education of Isfahan University of Medical Sciences based on the CIPP model.

BACKGROUND: Continuous evaluation is necessary to achieve appropriate quality in educational programs. The aim of this study was to evaluate the doctoral program of medical education at Isfahan University of Medical Sciences based on the CIPP model. MATERIALS AND METHODS: This descriptive and educational evaluation study was conducted in 2020 at Isfahan University of Medical Sciences. The study population consisted of all heads of department, faculty members, students, and PhD graduates of medical education from 2010 to 2020 who were enrolled in the study by census method. The data collection tool was a researcher-made questionnaire of CIPP evaluation model which was used when validity and reliability of them were confirmed. The data obtained from the questionnaires were analyzed in two levels of descriptive statistics of mean and standard deviation and inferential statistics one-sample t-test. RESULTS: Based on the CIPP model, the mean evaluation scores from the perspective of the heads of department, faculty members, and graduates were 4.1 ± 0.1, 3.64 ± 0.42, and 3.33 ± 0.66, respectively, which were significantly higher than the average (P ≤ 0.05). However, the mean evaluation score was not significantly higher than the average from the viewpoint of the students (3.24 ± 1.17). CONCLUSION: Based on the results of the study, the status of the doctoral course in medical education at Isfahan University of Medical Sciences was assessed as appropriate by the subjects of the study including the heads of department, faculty members, and graduates. It was not, however, acceptable according to the students. Based on the results, it is suggested that evaluation be done continuously and measures are taken to correct the weaknesses and enhance the strengths.

Designing Virtual Patients for Education of Nursing Students in Cancer Course.

BACKGROUND: One of the best approaches to promote clinical reasoning in nursing education is Virtual Patient (VP). The purpose of this study was to design and implement VPs for nursing student's education in caring for cancer patients. MATERIALS AND METHODS: In the first stage, through a descriptive-exploratory qualitative study using a focus group method, topics with higher priority in cancer nursing were identified. Then, based on the VP Nursing Design Model (VPNDM) for each of these topics, a scenario and then an interactive VP was designed and implemented in the Open Labyrinth application. The content validity of VPs was evaluated by eight experts and then the face validity was examined in the pilot group including 15 nursing students. RESULTS: Topics with higher priority in cancer nursing courses were mastectomy, chemotherapy, radiotherapy, hypercalcemia, spinal cord compression, cardiac tamponade, and superior vena cava syndrome. For five scenarios based on the nursing process in three sequences (signs and symptoms, diagnosis and interventions) the VPs were designed. In this process, learning objectives, determining the critical path, adding branches at the decision point, adding feedback, completing the clinical course and related data, and adding multimedia were considered. VPs were revised based on the proposed modifications following face and content validity. CONCLUSIONS: This article presents VP design steps for use in a nursing student training course. The researchers were able to provide and validate five VPs to care for cancer patients based on the VPNDM.

Applicability of the theory of planned behavior in explaining the general practitioners eLearning use in continuing medical education.

BACKGROUND: General practitioners (GP) update their knowledge and skills by participating in continuing medical education (CME) programs either in a traditional or an e-Learning format. GPs' beliefs about electronic format of CME have been studied but without an explicit theoretical framework which makes the findings difficult to interpret. In other health disciplines, researchers used theory of planned behavior (TPB) to predict user's behavior. METHODS: In this study, an instrument was developed to investigate GPs' intention to use e-Learning in CME based on TPB. The goodness of fit of TPB was measured using confirmatory factor analysis and the relationship between latent variables was assessed using structural equation modeling. RESULTS: A total of 148 GPs participated in the study. Most of the items in the questionnaire related well to the TPB theoretical constructs, and the model had good fitness. The perceived behavioral control and attitudinal constructs were included, and the subjective norms construct was excluded from the structural model. The developed questionnaire could explain 66 % of the GPs' intention variance. CONCLUSIONS: The TPB could be used as a model to construct instruments that investigate GPs' intention to participate in e-Learning programs in CME. The findings from the study will encourage CME managers and researchers to explore the developed instrument as a mean to explain and improve the GPs' intentions to use eLearning in CME.

A Theory-Based Study of Factors Explaining General Practitioners' Intention to Use and Participation in Electronic Continuing Medical Education.

INTRODUCTION: Electronic modes of continuing medical education (eCME) can provide an appropriate and scalable way of updating the knowledge and skills of general practitioners (GPs). To optimize the adoption of eCME and develop efficient and cost-effective eCME programs, factors explaining GPs' intention to use eCME must first be elucidated. METHODS: Using the Theory of Planned Behavior as a framework, we developed a questionnaire and administered it to GPs in seven CME seminars in Isfahan, Iran, in 2014. Three domains of GPs' intention to use eCME were measured: attitudes, perceived behavioral control, and subjective norms. We used linear and logistic regression to identify the main predictors of intention and behavior. RESULTS: GPs who had high score in perceived behavioral control and a more positive attitude toward e-learning had a higher intention to adopt it for CME. In contrast, subjective norms (eg, social pressures to use eCME) were not a predictor. Attitude toward usefulness of eCME was the main predictor of being an actual eCME user. DISCUSSION: Perceived behavioral control and attitude constitute the main predictors of the intention to use eCME. Establishing discussions forums and strengthening organizational support for eCME through an increased awareness among clinical superiors and CME managers would be expected to increase GPs' intention to use eCME.

The relationship between residents' interest to their specialty field and their level of anxiety.

INTRODUCTION: Studies showed that lack of interest in the field of study in the 1(st) year of residency could create stress and then causing psychological problems like anxiety. The purpose of this study was the evaluation of relationship between interest to the specialized field of study and the level of medical residents' anxiety in 2010. MATERIALS AND METHODS: This study was a cross-sectional study. The statistical population of this study was the medical residents (1(st)-4(th) year) from the Universities of Medical Sciences of Isfahan, Gilan, Sanandaj and Kashan (370 residents). They were selected by stratified sampling method proportional to size and were included in this study. Data was collected by using the researcher-made questionnaire of demographic characteristics, the questionnaire about the field of study selection and Zung anxiety self-assessment standard questionnaire. The findings were analyzed by using the SPSS statistical software version 16, descriptive and analytical tests (t-test, one-way ANOVA and Pearson). The significance level was considered as P ≤ 0.05. RESULTS: The results showed that more than 92% of the surveyed residents did not have anxiety and were in the normal group. There was a significant correlation between the specialized field of interest and anxiety scores of the residents (P < 0.05). In particular, the following cases had a direct effect on interest rates and anxiety in residents: the amount of time for visiting and patient care, job stress, time for personal affairs, the ability to predict the agenda and job security. CONCLUSIONS: The relationship between various factors and anxiety level was corroborated that the residents' interest and success in studying was the result of their choices and management plans to eliminate barriers for the selection of the field and the favorite city by the officials and planners.

Augmented reality in healthcare education: an integrative review.

Background. The effective development of healthcare competencies poses great educational challenges. A possible approach to provide learning opportunities is the use of augmented reality (AR) where virtual learning experiences can be embedded in a real physical context. The aim of this study was to provide a comprehensive overview of the current state of the art in terms of user acceptance, the AR applications developed and the effect of AR on the development of competencies in healthcare. Methods. We conducted an integrative review. Integrative reviews are the broadest type of research review methods allowing for the inclusion of various research designs to more fully understand a phenomenon of concern. Our review included multi-disciplinary research publications in English reported until 2012. Results. 2529 research papers were found from ERIC, CINAHL, Medline, PubMed, Web of Science and Springer-link. Three qualitative, 20 quantitative and 2 mixed studies were included. Using a thematic analysis, we've described three aspects related to the research, technology and education. This study showed that AR was applied in a wide range of topics in healthcare education. Furthermore acceptance for AR as a learning technology was reported among the learners and its potential for improving different types of competencies. Discussion. AR is still considered as a novelty in the literature. Most of the studies reported early prototypes. Also the designed AR applications lacked an explicit pedagogical theoretical framework. Finally the learning strategies adopted were of the traditional style 'see one, do one and teach one' and do not integrate clinical competencies to ensure patients' safety.

A comprehensive test of clinical reasoning for medical students: An olympiad experience in Iran.

BACKGROUND: Although some tests for clinical reasoning assessment are now available, the theories of medical expertise have not played a major role in this filed. In this paper, illness script theory was chose as a theoretical framework and contemporary clinical reasoning tests were put together based on this theoretical model. MATERIALS AND METHODS: This paper is a qualitative study performed with an action research approach. This style of research is performed in a context where authorities focus on promoting their organizations' performance and is carried out in the form of teamwork called participatory research. RESULTS: Results are presented in four parts as basic concepts, clinical reasoning assessment, test framework, and scoring. CONCLUSION: we concluded that no single test could thoroughly assess clinical reasoning competency, and therefore a battery of clinical reasoning tests is needed. This battery should cover all three parts of clinical reasoning process: script activation, selection and verification. In addition, not only both analytical and non-analytical reasoning, but also both diagnostic and management reasoning should evenly take into consideration in this battery. This paper explains the process of designing and implementing the battery of clinical reasoning in the Olympiad for medical sciences students through an action research.