Comparing the Effects of Gamification and Teach-Back Training Methods on Adherence to a Therapeutic Regimen in Patients After Coronary Artery Bypass Graft Surgery: Randomized Clinical Trial.

BACKGROUND: Patients undergoing coronary artery bypass graft surgery (CABGS) may fail to adhere to their treatment regimen for many reasons. Among these, one of the most important reasons for nonadherence is the inadequate training of such patients or training using inappropriate methods. OBJECTIVE: This study aimed to compare the effect of gamification and teach-back training methods on adherence to a therapeutic regimen in patients after CABGS. METHODS: This randomized clinical trial was conducted on 123 patients undergoing CABGS in Tehran, Iran, in 2019. Training was provided to the teach-back group individually. In the gamification group, an app developed for the purpose was installed on each patient's smartphone, with training given via this device. The control group received usual care, or routine training. Adherence to the therapeutic regimen was assessed using a questionnaire on adherence to a therapeutic regimen (physical activity and dietary regimen) and an adherence scale as a pretest and a 1-month posttest. RESULTS: One-way analysis of variance (ANOVA) for comparing the mean scores of teach-back and gamification training methods showed that the mean normalized scores for the dietary regimen (P<.001, F=71.80), movement regimen (P<.001, F=124.53), and medication regimen (P<.001, F=9.66) before and after intervention were significantly different between the teach-back, gamification, and control groups. In addition, the results of the Dunnett test showed that the teach-back and gamification groups were significantly different from the control group in all three treatment regimen methods. There was no statistically significant difference in adherence to the therapeutic regimen between the teach-back and control groups. CONCLUSIONS: Based on the results of this study, the use of teach-back and gamification training approaches may be suggested for patients after CABGS to facilitate adherence to the therapeutic regimen. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20111203008286N8; https://en.irct.ir/trial/41507.

Exploring the components of student support system in blended learning for Iranian Universities of Medical Sciences: A thematic analysis.

BACKGROUND: Support services are a very important element for all educational institutions. The aims of this study were to explore the components of the student support system in blended learning for universities of medical sciences in Iran. MATERIALS AND METHODS: The present study was performed qualitative with exploratory approach. The tool used to collect data was a semi-structured interview, after conducting interviews with 17 e-learning experts and specialists of universities of medical sciences, we reached information saturation. The study was conducted at Aja University of Medical Sciences in Tehran in 2020. Data analysis was performed as Thematic Content Analysis by Attride-Stirling method. RESULTS: From the content analysis of the interviews, 6 main themes and 19 sub-themes were obtained. Main themes included "Scientific- cognitive Support", "Systematic Support", "Human Resource Support", "Emotional Support", "Technical Support" and "Financial- economic Support". CONCLUSION: Based on the results of this study, 6 basic components and its subcomponents of the student support system were obtained. It is suggested that the educational officials of medical universities with blended learning use the results of this study in setting up their student support system for academic success in e-learning and medical students.

An interesting result of a qualitative research: Academic exhaustion barrier to professionalism in medical students.

INTRODUCTION: Professionalism is an important measure of the efficacy of the medical education. Some studies showed that dominant values changed during clinical education, and some negative values might replace positive ones. In this regard, this study aimed to explore barrier to professionalism in clinical medical education. METHODS: This was a qualitative study conducted with the content analysis method. A total of 34 interviews with 23 participants were done. RESULTS: Two hundred forty-eight original codes were extracted from the research data, which were classified under the theme of "Academic Exhaustion" and the four following categories: "stressful environment, "human conflict," "Poor Inter professional collaboration," and "emotional exhaustion." DISCUSSION: It can be admitted that having full knowledge of the factors influencing professionalism from the viewpoint of stakeholders can improve the environmental and organizational conditions to prevent professional misconduct.

Challenges to the Implementation of Interprofessional Education in Health Profession Education in Iran.

BACKGROUND: Changes in the structure and nature of health care highlight the need for better collaboration between professions focusing on patient or health-care users. Interprofessional education (IPE) has attracted a lot of attention at the international level, and its positive consequences in different areas of health care have been investigated and approved. This study explored the opinions and viewpoints of professors and experts regarding the challenges to the implementation of interprofessional education in health profession education in Iran in 2018. METHODS: This qualitative study was conducted with 15 IPE professors and experts using semi-structured interviews. We used an inductive approach to content analysis as developed by Elo et al. The interviews were analyzed using Graneheim and Lundman method by MAXQDA software version 12. RESULTS: The main challenges to the implementation of IPE were categorized into educational system, structural and cultural challenges. The educational challenges were the professors' lack of ability, a non-flexible and single-disciplined curriculum, and weaknesses in the current education. The professors and experts felt that the most important structural challenges included centralism, hierarchy of power, poor educational groundwork, and lack of support of organizations. Cultural challenges mainly related to the attitudes of managers, professors, and even students regarding IPE and the need for change. CONCLUSION: Designing and implementing IPE in Iran face major challenges. Cultural and attitude issues were the greatest challenges to be addressed in the context of implementing IPE in health-care education.

Determination and Comparison of the Factors Related to Effective Blended Learning in Medical Sciences from the Viewpoints of Instructors and Learners.

INTRODUCTION: According to rapid growth of innovation in use of technologies in education and learning, blended learning has become an effective method in the student's education. The purpose of this study was to extract the factors related to effective blended learning and compare the viewpoints of students and instructors in this regard. METHODS: Mixed method model was used in this study. A content analysis approach was employed in the qualitative phase of the study. Seven faculty members and eight master's students of medical sciences selected through purposive sampling participated in the qualitative phase. Individual semi-structured interviews were conducted for data collection. In the quantitative phase, appropriate and relevant items were designed based on the main concepts of theoretical and practical definitions that were extracted in the qualitative phase. RESULTS: The results of the qualitative phase were 5 categories and 40 subcategories, including student's capabilities, teacher merits, technological aspects, pedagogic topics and supportive environment. DISCUSSION: The results of the questionnaire analysis showed no significant difference in student capabilities and supportive environment between the viewpoints of students and faculty members while there were significant differences in other categories. Although new technologies have offered promising opportunities, they do not result in effective education. The results of the present study suggest that a major revision in student and instructor admission and provision of required technical facilities can promote the status of this type of education. On the other hand, instructor empowerment programs in this field can enhance the effectiveness of virtual education.

Challenges and opportunities of acquiring scientific authority in medical sciences: determination of the experts' views based on qualitative content analysis.

INTRODUCTION: Capability is built upon knowledge and wisdom, and scientific progress and development is associated with wealth production, national and international authority, and independence. To promote scientific development, as a prerequisite to the country's progress in other areas, there is a need for strategic planning and creating scientific capacities. Today's world is facing a rapid growth and development in science and technology, and universities and higher education centers have an important role in the society's development and progress in the areas of human resources training, science and technology production, and solving different problems. Considering the Iran's health scientific road map and communication of innovation and reform plans, and since universities are required to identify the areas of authority, this study was conducted to determine the challenges of scientific authority promotion and proper courses of action. METHODS: In this study, content analysis was used as a qualitative research method. The triangulation method was applied for data collection. Purposive sampling was done to select the participants for focused group discussion and data collection continued until data saturation was achieved. The participants were 19 higher education experts and MOHME policymakers. The ATLAS.ti software version 5.2 was used for analysis of data. RESULTS: The results of the analysis of transcripts obtained from FGD with higher education experts and MOHME policymakers showed 4 themes, 10 categories and 43 sub-categories. The resulting themes included: "Experienced perceptions of scientific authority", "Requirements of scientific authority", "Challenges of scientific authority", and "Strategies for promoting scientific authority". CONCLUSION: Universities and governmental sectors do not represent all the capacities, and there are much more capacities that can be exploited with participation of different sectors and institutions, especially inter-sectoral and inter-university collaborations. Many advances in new sciences have occurred in interdisciplinary majors, and these collaborations help to take solid steps towards scientific authority.