Comparative study of AR infographic posters vs. offline videos for micro-video delivery in cardiology education.

Augmented reality has promised a new paradigm in medical education. Multimedia videos are the most preferred assent for augmentation. So, this study aimed to assess the effect of using an augmented reality infographic poster for delivering micro-videos on the knowledge and satisfaction of medical students in cardiology rotation. Sixty students participated in this quasi-experimental study and were allocated to three study groups; namely routine method, routine method plus offline micro-video delivery, and routine method plus micro-video delivery in an augmented reality infographic poster. The students' knowledge and satisfaction were evaluated through a multiple-choice question pre and post-test and a satisfaction questionnaire respectively. Within-group comparison of pre and post-test scores showed a significant increase in each study group (all p-values = 0.000). The highest post-test score was for the offline micro-video delivery group and pairwise comparisons of post-test scores showed a significant difference between this group and the control one (p-value = 0.013). Additionally, the augmented reality infographic poster group had the highest satisfaction score (p-value = 0.000). This experience showed the positive effect of micro-videos in clinical education. Although students were satisfied with accessing these videos through an augmented reality infographic poster, their knowledge acquisition was better when they received them offline.

Students' experience of interpersonal interactions quality in e-Learning: A qualitative research.

BACKGROUND: Online Interaction is a critical characteristic of distance learning, and effective online communication models empower students. PURPOSE: This research aimed to explain students' experiences on the quality of interpersonal interactions in e-learning. METHOD: This study was conducted from November 2021 to October 2022. The qualitative descriptive design via conventional content analysis was utilized. Purposeful and maximum variation methods recruited sixteen participants from three medical science universities in Iran. The data were collected through semi-structured, in-depth, face-to-face, or online interviews. Interviews were recorded through a digital recorder, and analysis was achieved simultaneously with data collection using Graneheim and Lundman (2004). The Lincoln and Guba criteria, including credibility, dependability, transferability, and confirmability, were used to improve the trustworthiness of the findings. RESULTS: The results indicated the importance of different dimensions related to teaching-learning. It seems crucial to develop a comfortable and safe environment to improve interpersonal interactions. Educators should be provided with pedagogical skills to support interactions. In addition, focusing on some learners' soft skills is also vital. In addition to the significance of the teacher's inclusive role, the educational content must have critical standards. Constructive feedback and the proper use of simultaneous and non-simultaneous communication tools and social networks are other important issues in strengthening interpersonal relationships. Ultimately, comprehensive and ongoing support of learners improves the quality of interpersonal interactions. CONCLUSIONS: The results indicated the significance of different dimensions of teaching-learning as facilitating factors of interpersonal interactions. The proper use of simultaneous and non-simultaneous communication tools and social networks are other important issues in strengthening interpersonal relationships. Ultimately, comprehensive and ongoing support of learners improves the quality of interpersonal interactions. IMPLICATIONS: The results of this study give teachers the insight to keep essential issues in mind when developing their online courses and students to be aware of their roles in the online learning process. Also, the characteristics of simultaneous and non-synchronous platforms, social messaging networks, and learner support are crucial.

E-portfolio as an effective tool for improvement of practitioner nurses' clinical competence.

BACKGROUND: Clinical competence is essential for providing effective patient care. Clinical Governance (CG) is a framework for learning and assessing clinical competence. A portfolio is a work-placed-based tool for monitoring and reflecting on clinical practice. This study aimed to investigate the effect of using an e-portfolio on the practitioner nurses' competence improvement through the CG framework. METHODS: This was a quasi-experimental study with 30 nurses in each intervention and control group. After taking the pretests of knowledge and performance, the participants attended the in-person classes and received the educational materials around CG standards for four weeks. In addition, nurses in the intervention group received the links to their e-portfolios individually and filled them out. They reflected on their clinical practice and received feedback. Finally, nurses in both groups were taken the post-tests. RESULTS: Comparing the pre-and post-test scores in each group indicated a significant increase in knowledge and performance scores. The post-test scores for knowledge and performance were significantly higher in the intervention group than in the control one, except for the initial patient assessment. CONCLUSION: This study showed that the e-portfolio is an effective tool for the improvement of the nurses' awareness and performance in CG standards. Since the CG standards are closely related to clinical competencies, it is concluded that using portfolios effectively improves clinical competence in practitioner nurses.

Virtual reality exposure therapy to decrease anxiety before surgical invasive procedures in hemodialysis patients: an interventional study.

BACKGROUND: Hemodialysis patients are prone to anxiety and depression due to physiological changes and psychological tensions that leave irreversible effects on the patients. In this regard, the present study was an attempt to provide a simulated situation by using virtual reality on the anxiety level of dialysis patients before performing surgical procedures. METHODS: This non-equivalent groups pre-posttest quasi-experimental study was conducted in 2022 in a hemodialysis ward of Imam Khomeini General Hospital affiliated with Tehran University of Medical Sciences. The study population was patients suffering from kidney failure referred to this hospital. The participants were 30 patients selected from the study population, who were allocated into two groups (15 in each experimental and control group). The control group received routine training in the ward. The experimental group participants watched five educational virtual reality (VR) contents in addition to the routine training. They used head-mounted display VR (VR BOX headset 2.0 virtual reality glasses) to immerse in a virtual environment similar to the real world covering the experience of entering the operating room, during the surgery, and after surgery. The data gathering instrument was a valid and reliable anxiety inventory. The collected data was analyzed at a significance level of 0.05. RESULTS: The study findings indicated that the anxiety scores of the experimental and control groups had no significant difference before intervention. However, after the intervention of virtual reality, the state and trait anxiety of the experimental group participants were significantly lower than the control group (P-value < 0.01). CONCLUSION: The application of VR for maintenance hemodialysis patients before invasive surgical procedures decreases patients' anxiety. Considering the devastating and undeniable impacts of anxiety on the lives of patients referring to hemodialysis centers, the application of VR is suggested to decrease their anxiety.

The effectiveness of digital storytelling in teaching medical information searching.

BACKGROUND: Novel technologies development has created a new path for education. Digital storytelling (DST) is one of the educational approaches used in universities and scientific centers. We aimed to investigate the effect of DST on Scientific Information Search (SIS) and Information Seeking Anxiety (ISA) in students. MATERIALS AND METHODS: This mixed-method study utilized the pre-test-post-test method containing test and control groups. We used the simple random sampling method (available) and used the formula to determine the sample size. Forty-two people participated in the study. A researcher-made questionnaire was used to collect SIS data and standard questionnaire for ISA data. The teaching approaches were accomplished using DST and the conventional methods in test and control groups, respectively. Using SPSS v. 22, we did paired-sample T-test and independent sample T-test to compare the mean score in before and after intervention in each group. Also Analysis of Covariancetest was used for considering post-test result as dependent variable, groups as independent variables and pre-test score as covariate. RESULTS: The results showed significant changes in mean score between the post-test and pre-test of both questionnaire in both groups. Also, in the post-test, compared to the control group, the experimental group obtained higher scores for SIS, which was statistically significant, and obtained lower scores for ISA, but it was not statistically significant. CONCLUSIONS: It can be concluded that the DST method has a positive impact on learning and reducing ISA compared to the conventional ones, and students' interest and participation in learning have increased using DST method.

Enhancing Medical Students' Knowledge and Performance in Otolaryngology Rotation through Combining Microlearning and Task-Based Learning Strategies.

Microlearning is recommended to be implemented within the context of a wider teaching-learning ecosystem, especially in real working environments. Task-based learning is used in clinical education setting. This study aims at assessing the effect of an integrated approach of microlearning with task-based learning on medical students' knowledge and performance in Ear, Nose and Throat clerkship rotation. A total of 59 final-year medical students participated in this quasi-experimental study which included two control groups (routine teaching and task-based learning methods) and one intervention group (combined microlearning and task-based learning method). Pre- and post-tests of students' knowledge and performance were assessed through a multiple-choice question test and a Direct Observation Procedural Skills (DOPS) instrument, respectively. Performing Analysis of Covariance for knowledge post-test scores among three groups revealed significant differences (F = 3.423, p-value = 0.040) and the intervention group had the highest score. Analyzing DOPS results showed that the intervention group achieved significantly higher scores compared to the control ones for all the expected tasks (p-values = 0.001). The findings of the present study show that the combined strategy of microlearning with task-based learning is an effective clinical teaching method for enhancing medical students' knowledge and performance in a real working environment.

Development of an Accreditation System for Evaluating Biomedical Scientific Associations Through a Participatory Process in Iran.

Background: Accreditation is used to monitor, guide, examine, and assure the quality of higher education. There is no formal evaluation system to ensure the quality and quantity of scientific associations' activities. So this study aimed to develop and implement a national accreditation system to be applied for biomedical scientific associations through a participatory process among stakeholders. Methods: Consensus development techniques, i.e., focus group and Delphi methods, were used to design the accreditation system. An expert committee, set up at the recognized accreditation body, devised the accreditation structure, procedure, and permit rules using the focus group technique. Then, we prepared the standards draft which was further modified in an expert panel in focus group sessions and finalized among the stakeholders through the Delphi technique. Finally, the procedure was performed for 66 associations. Results: The accreditation structure, procedure, and standards were determined and legitimized. Standards included 20 ones in four domains of educational activities (3 standards), research affairs (2 standards), cross-sector collaborations (2 standards), and organization and equipment (13 standards). Among 66 associations, 16 and 12 were approved and conditionally approved respectively. Conclusion: In spite of associations' influential academic and social activities, no study was found in regards to their accreditation. Standards devised in this research can be employed by scientific associations for developing their plans and enhancing their performance. This experience can be adopted for accrediting not only scientific associations but also any other academic institutions, especially non-student training ones.

What are the Factors that Enhance Metacognitive Skills in Nursing Students? A Systematic Review.

Background: Metacognitive skills have an important role in training efficient learners and competent clinicians in health professions education. The aim of this systematized review was to determine the factors enhancing metacognitive skills in nursing students. Materials and Methods: For data collection, we searched the databases of PubMed, Ovid, Cochrane, Scopus, Web of Science, ProQuest, Springer, EMBASE, Science Direct, PsycInfo, Nursing and Allied Health, and ERIC up to the end of March 2019, using the study key words. We used PRISMA flowchart diagram for reporting the results of the study. Peer-reviewed articles in English, addressing factors enhancing metacognition in nursing students, were included in our review. The Critical Appraisal Skills Program (CASP) checklist was used for assessing the quality of the included studies. Results: Out of 2355 studies, 16 were included for the review. Several factors, namely "specific curricular activities," "self-regulated e-learning modules," "e-portfolio," "cognitive apprenticeship," "specific teaching techniques for classroom and experiential settings," "metacognitive wrappers," "problem-based learning," "blended learning," "grit," and "clinical log," enhancing metacognition in nursing students, were extracted. Conclusions: The findings of our study can contribute to planning for improvement of learners' metacognitive skills. However, there is a need for future research on determining further factors influencing nursing students' metacognitive skills.

Providing a model for validation of the assessment system of internal medicine residents based on Kane's framework.

BACKGROUND: Kane's validity framework examines the validity of the interpretation of a test at the four levels of scoring, generalization, extrapolation, and implications. No model has been yet proposed to use this framework particularly for a system of assessment. This study provided a model for the validation of the internal medicine residents' assessment system, based on the Kane's framework. MATERIALS AND METHODS: Through a five stages study, first, by reviewing the literature, the methods used, and the study challenges, in using Kane's framework, were extracted. Then, possible assumptions about the design and implementation of residents' tests and the proposed methods for their validation at each of their four inferences of Kane's validity were made in the form of two tables. Subsequently, in a focus group session, the assumptions and proposed validation methods were reviewed. In the fourth stage, the opinions of seven internal medicine professors were asked about the results of the focus group. Finally, the assumptions and the final validation model were prepared. RESULTS: The proposed tables were modified in the focus group. The validation table was developed consisting of tests, used at each Miller's pyramid level. The results were approved by five professors of the internal medicine. The final table has five rows, respectively, as the levels of Knows and Knows How, Shows How, Shows, Does, and the fifth one for the final scores of residents. The columns of the table demonstrate the necessary measures for validation at the four levels of inferences of Kane's framework. CONCLUSION: The proposed model ensures the validity of the internal medicine specialty residency assessment system based on Kane's framework, especially at the implication level.

Applying digital storytelling in the medical oncology curriculum: Effects on students' achievement and critical thinking.

BACKGROUND: Digital storytelling (DST), which combines traditional storytelling with digital tools, can provide a narrative pedagogy that promotes critical thinking (CT). However, we found no previous study in medical education. MATERIALS AND METHODS: The aim of the study was to investigate if DST can promote CT and, if so, which CT skills were improved. Thirty-two students participated in a non-equivalent control group pretest-posttest research study, with 16 in each group. The participants were fifth-year medical students on a hematology rotation. We compared the routine instructional method (control group) with DST (intervention group). The measures of CT used for the pre- and post-test in both groups was the Health Science Reasoning Test (HRST) and knowledge test. We also evaluated the satisfaction of the students in DST group. We used Paired and independent t-tests for comparing the mean scores. To eliminate the confounding effect of pre-test on the results of the intervention, the ANCOVA test was used. RESULTS: There was no significant difference in the overall CT pretest scores (P-value = 0.51) between the control and intervention groupsbut the difference was significant for the post-test scores (P-value = 0.03). Although post-test scores showed a significant increase (P-value = 0.002) compared to pre-test scores in the intervention group, no significant increase was observed in the control group (P-value = 0.26). Most students considered that DST improved their CT, deep learning, communication skills and team-working. CONCLUSIONS: The study demonstrated that DST promoted CT. We recommend the use of DST to promote CT in clinical education placements.

How Digital Storytelling Applied in Health Profession Education: A Systematized Review.

INTRODUCTION: Storytelling is one of the earliest ways to share scientific advancements and discoveries. The advent of technology has updated this ancient art into a digitalized form. The boundaries between the digital storytelling (DST), and other types of videos are unclear. Therefore, in this review, the process, aim, producers, and uses of DST in health profession education have been reviewed. METHODS: This study is a systematized review, which is in nature like a systematic review with only a few differences in the comprehensive search and quality assessment procedure. All studies, whose duplicates were removed, were retrieved from Science Direct, PubMed, and Scopus databases or through google scholar search engine screened in 3 stages: title, abstract and full study. All journal articles including experimental, case study and case report, mixed method, and qualitative studies in English language in the field of health profession education were chosen for this review after being evaluated based on QUESTS dimensions. RESULTS: In total, 35 articles were included in the review. The studies had been done in health promotion, nursing education, medical education, patient education, social work education, and community health education. In some of these studies, the producers and users of digital stories were different, which is in contrast with center for digital storytelling that emphasizes the process of DST. The results of this review showed that all stakeholders of health system could be producers of digital stories with various aims; e.g. community health, empathy promotion, attitude and behavior change, clinical thinking, and skills improvement. CONCLUSION: This systematized review indicated that DST has some applications in different subjects in different fields of health professions and with a potential to be used by different stakeholders of health system. According to the definition of DST, digital storytelling involves the process of writing a script to produce a digital story by one individual or a group. Consequently, there is a difference between DST and producing a digital story. Therefore, researchers should consider the correct use of this term in their studies. Although few interventional and high-quality studies have been conducted in this area, further quantitative and qualitative research is suggested.

Entrustability levels of general internal medicine residents.

BACKGROUND: Entrustable professional activities (EPAs) are those activities that a health professional can perform without direct supervision in a defined environment. Bridging the gap between competencies and learning objectives, EPAs have made assessing the performances of health professional more realistic. The main objective of the present study was developing and customizing EPAs for Iranian Internal Medicine Residency Programs. RESULTS: After reviewing the publications, residency curricula and logbooks, and collecting experts' ideas, the initial list of EPAs was developed. Then, in a focus group, the list was refined, the entrustability level of each residency year was determined, and finally, the EPA-competency cross-tab was established, and in the next step, through a one- round Delphi, the results were validated. Twenty-eight EPAs were developed. Some of them were definitely suitable for the higher levels of residency, such that they had to be accomplished under direct supervision until the end of the program. On the other hand, some of EPAs were those that residents, even from the first year, are expected to perform independently or under indirect supervision. Most of the EPAs cover a wide range of competencies. CONCLUSION: Determining the entrustability level of each residency year in each EPA as well as the competency- EPA matrix has crucial effect on the quality of the graduates. It seems that our findings are applicable in developing countries like Iran.

Initial drafting of telemedicine's code of ethics through a stakeholders' participatory process.

Telemedicine can improve access to healthcare services; however, it has raised ethical concerns demanding special considerations. This study aimed at developing the codes of ethics for telemedicine, and hence several approved national and international ethical guidelines related to telemedicine practice were reviewed, and 48 semi-structured interviews were conducted with medical ethics and medical informatics experts as well as with physicians and patients who had telemedicine experiences. Content analysis was then performed on the interviews' transcripts and a draft on code of ethics was prepared, which was further reviewed by the experts in the focus group meetings to reach a consensus on the final document. The final document consisted of a preface, five considerations, and 25 ethical statements. Considering the growing trend of adopting telemedicine worldwide, this document provides an ethical framework for those who use telemedicine in their medical practice.

Devising ethical codes for e-contents in e-learning.

Background: Promoting ethics is one of the goals of education, but the free flow of communication and divulging unethical behaviors in e-learning make the urgent need to clarify ethical values. Therefore, the aim of this study was to prepare ethical codes to develop and deliver e-contents. Methods: A draft of e-content ethical codes was prepared based on the literature review. Then, it was further revised by e-learning, medical education, ethics, and e-content experts. Finally, the draft was finalized through a 2-round Delphi process among related experts all over the country. Results: The final document of e-content ethical codes, including introduction, definitions, and 7 ethical code statements, was devised. Conclusion: Considering the difference between e-content and other kinds of publications, this set of ethical codes can be used straightforwardly to assess ethical aspects of e-contents.

The effect of test-enhanced spaced learning on the otolaryngology board and annual examination results: A quasi-experimental study.

INTRODUCTION: In the test-enhanced spaced learning, educational contents are presented in small packages of well-developed test questions with a defined frequency to the learners. It is not clear that applying this educational style might have a positive impact on the summative assessment. Therefore, in this study, we assessed the effect of the test-enhanced spaced learning on the otolaryngology board and annual examinations of residency training. METHODS: In a quasi-experimental study with consecutive sampling, all forty-four residents of otolaryngology in four levels of training in 2016 at Tehran University of Medical Sciences (TUMS) received daily-standardized multiple-choice questions with a twice-repeated frequency of 10 days. Individual feedback according to one's response to each test was provided. The results of national board and annual exam were compared with the same results of all residents of other universities and previous year TUMS' residents for whom spaced learning were not applied and they were considered as the control groups. The board exam had two parts, multiple-choice questions, and computer-based clinical examination. The annual exam format was multiple choice questions. The total score for each one was 150. Student's t-test and Mann-Whitney U test were used for comparative analyses. RESULTS: The mean of the board exam results showed statistically significant improvement compared to other medical schools (113.6±10.7 vs. 102.9±13.4 in multiple-choice questions, p-value= 0.048, 118.7±12.5 vs. 54.1±60.0 in the computer-based clinical examination, p-value<0.001), while similar comparison results in the previous year did not show any significant difference. CONCLUSION: Spaced learning with testing effect may be useful in the clinical education setting to improve the learning outcomes.

Effectiveness of Integrating Simulation with Art-Based Teaching Strategies on Oncology Fellows' Performance Regarding Breaking Bad News.

The task of breaking bad news (BBN) may be improved by incorporating simulation with art-based teaching methods. The aim of the present study was to assess the effect of an integrating simulation with art-based teaching strategies, on fellows' performance regarding BBN, in Iran. The study was carried out using quasi-experimental methods, interrupted time series. The participants were selected from medical oncology fellows at two teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran. Participants were trained through workshop, followed by engaging participants with different types of art-based teaching methods. In order to assess the effectiveness of the integrating model, fellows' performance was rated by two independent raters (standardized patients (SPs) and faculty members) using the BBN assessment checklist. This assessment tool measured seven different domains of BBN skill. Segmented regression was used to analyze the results of study. Performance of all oncology fellows (n = 19) was assessed for 228 time points during the study, by rating three time points before and three time points after the intervention by two raters. Based on SP ratings, fellows' performance scores in post-training showed significant level changes in three domains of BBN checklist (B = 1.126, F = 3.221, G = 2.241; p < 0.05). Similarly, the significant level change in fellows' score rated by faculty members in post-training was B = 1.091, F = 3.273, G = 1.724; p < 0.05. There was no significant change in trend of fellows' performance after the intervention. Our results showed that using an integrating simulation with art-based teaching strategies may help oncology fellows to improve their communication skills in different facets of BBN performance. Iranian Registry of Clinical Trials ID: IRCT2016011626039N1.

Psychometric properties of the communication skills attitude scale (CSAS) measure in a sample of Iranian medical students.

INTRODUCTION: Communication skill (CS) has been regarded as one of the fundamental competencies for medical and other health care professionals. Student's attitude toward learning CS is a key factor in designing educational interventions. The original CSAS, as positive and negative subscales, was developed in the UK; however, there is no scale to measure these attitudes in Iran. The aim of this study was to assess the psychometric characteristic of the Communication Skills Attitude Scale (CSAS), in an Iranian context and to understand if it is a valid tool to assess attitude toward learning communication skills among health care professionals. METHODS: Psychometric characteristics of the CSAS were assessed by using a cross-sectional design. In the current study, 410 medical students were selected using stratified sampling framework. The face validity of the scale was estimated through students and experts' opinion. Content validity of CSAS was assessed qualitatively and quantitatively. Reliability was examined through two methods including Chronbach's alpha coefficient and Intraclass Correlation of Coefficient (ICC). Construct validity of CSAS was assessed using confirmatory factor analysis (CFA) and explanatory factor analysis (PCA) followed by varimax rotation. Convergent and discriminant validity of the scale was measured through Spearman correlation. Statistical analysis was performed using SPSS 19 and EQS, 6.1. RESULTS: The internal consistency and reproducibility of the total CSAS score were 0.84 (Cronbach's alpha) and 0.81, which demonstrates an acceptable reliability of the questionnaire. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI/Ave) demonstrated appropriate results: 0.97 and 0.94, respectively. An exploratory factor analysis (EFA) on the 25 items of the CSAS revealed 4-factor structure that all together explained %55 of the variance. Results of the confirmatory factor analysis indicated an acceptable goodness-of-fit between the model and the observed data. [χ2/df = 2.36, Comparative Fit Index (CFI) = 0.95, the GFI=0.96, Root Mean Square Error of Approximation (RMSEA) = 0.05]. CONCLUSION: The Persian version of CSAS is a multidimensional, valid and reliable tool for assessing attitudes towards communication skill among medical students.

Self- directed learning barriers in a virtual environment: a qualitative study.

INTRODUCTION: There is a growing trend in online education courses in higher education institutes. Previous studies have shown that high levels of self-direction are essential for successful online learning. The present study aims to investigate challenges of and barriers to self-directed virtual-learning among postgraduate students of medical sciences. METHOD: 23 postgraduate virtual students of medical sciences in Iran, collected through maximum variation purposive sampling and semi-structured interviews, served as the sample of this study. The collected data were analyzed using the inductive content analysis method. RESULTS: Three themes and six sub-themes were identified as barriers to self-directed learning in virtual education, including cognitive barriers (information overload and lack of focus on learning or mind wondering), communication barriers (inadequate coping skills and inadequate writing skills) and educational environment barriers (heavy workload and role ambiguity). CONCLUSION: By the importance of self-direction in online education, the present study results can be used by virtual education planners in the review and design of courses, so as to adequately equip students, obviate barriers to self-directed virtual education, and ultimately train highly self-directed learners in online medical education.

Quality of Life in Medical Students With Internet Addiction.

The widespread use of internet has caused new psychological, social, and educational problems for the students. The aim of this study was to examine the quality of life in medical students who suffer from internet addiction. This cross-sectional survey was carried out in Tehran University of Medical Sciences, and a total of 174 fourth-to seventh-year undergraduate medical students were enrolled. The quality of life was assessed by WHOQOL-BREF questionnaire which covers four domains of physical health, psychological, social relationships, and the environment. For assessing internet addiction, we used Internet Addiction Test (IAT) of Young. The students with IAT score higher than 50 were considered as addicted. For evaluating academic performance, the students were requested to report their grade point average (GPA). The mean IA score (±SD) was 34.13±12.76. Twenty-eight students (16.90%) had IAT score above 50. The mean quality of life score in internet addicted group was 54.97±11.38 versus 61.65±11.21 in normal group (P=0.005). Furthermore, there was a negative correlation between IA score and physical domain (r=-0.18, P=0.02); psychological domain (r=-0.35, P=0.000); and social relation domain (r=-0.26, P=0.001). Mean GPA was significantly lower in the addicted group. It seems that quality of life is lower in the internet addicted medical students; moreover, such students academically perform poorer in comparison with non-addicts. Since internet addiction is increasing at a rapid pace which may provoke considerable academic, psychological and social implications; as a result, it may require screening programs to the immediate finding of such problem to give consultations to prevent unwanted complications.

Concise, intensive or longitudinal medical education courses, which is more effective in perceived self-efficacy and development of faculty members?

BACKGROUND: Teachers' self-efficacy and development may be conceptualized as their beliefs in their own ability to plan, organize and carry out activities that are required to attain educational goals. In this study, we examined the effect of different medical education training courses (six-day, one- month short- term and sixmonth long- term courses) on perceived self-efficacy and development. METHODS: This before-after quasi-experimental study was performed on 39 faculty members of Tehran University of Medical Sciences who participated in faculty development courses in 2013. We used valid and reliable scales to measure their perceived self-efficacy and empowerment. RESULTS: The results revealed a significant increase in faculty members' perceived self-efficacy in pre and posttests in one-month and six-month courses, but no significant difference was found in the six-day course (p=0.004, p<0.001 and p=0.235, respectively). These results were the same for perceived empowerment (p<0.001, p<0.001 and p=0.716 for one-month, six-month and six-day courses, respectively). A significant difference was detected in perceived self-efficacy and participant empowerment components based on the training course (p=0.005; Wilk's Λ=0.345, Partial η2=0.413). CONCLUSION: This study revealed that long- term courses were more effective than the short- term ones. Thus, longitudinal courses are recommended for more effectiveness.