A study of medical students' experiences at Shiraz University of medical sciences from the implementation of integration in medical education: a qualitative study.

BACKGROUND: The basic science course is the foundation of medical knowledge, and how and in what form the teaching of this course is a vital issue. A successful curriculum should include everything medical students need in their future careers. Basic science education should be such that students clearly understand the relationship between the content and its application in clinical practice. Therefore, the need to change the curriculum of the general medicine course, especially course of the Basic science, in content and layout in an integrated way is felt more than before. This study was designed to explain the experiences of medical students from the Shiraz University of Medical Sciences since the implementation of integration in 2020. METHODS: The present study was qualitative research with a conventional content analysis method. Participants were selected for the interview purposefully. They included 12 Medical students from basic and clinical sciences and 5 faculty members. Data were collected through semi-structured interviews and the content analysis method. Four methods of Goba and Lincoln were used to evaluate the accuracy of the data. RESULTS: After summarizing and analyzing the data, 221 codes were extracted. They were divided into seven subcategories and finally, three main themes including Enjoyable experiences (advantages of the integration system), Upsetting experiences (Disadvantages of the integration system), Resolutions to solving integration problems were extracted. Generally, the findings indicated a positive evaluation of medical students of Shiraz University of Medical Sciences from the integration system, and they stated that the integration causes an interaction between basic and clinical sciences and also increases students' motivation. CONCLUSION: The findings indicated a positive evaluation of Shiraz's medical students of the integrated system. According to the results of this research, it can be said; that the use of integration horizontally and vertically in medical education improves the quality of education compared to traditional methods. The integration of basic and clinical science is important in the sense that can be a powerful tool for learning and acquiring skills, also, it can also help in the promotion of professional development of students and motivate them to study more in interactive manner and be loyal to lifelong learning. study generally showed that combining theoretical and practical courses has advantages and disadvantages, but its advantages are more. Paying attention to the shortcomings, especially in the supply of human resources and professors, and reforming the program with continuous revision are issues that education managers and medical educators of the general medical practice should address.

Need assessment of medical school curriculum for MOOCs: perspectives of instructors and students of Shiraz University of Medical Sciences.

INTRODUCTION: Designing, developing, and implementing a course without assessing and prioritizing instructional needs may result in inefficiency due to the disregard for the actual needs of the target population. The present study aimed to determine and prioritize medical students' instructional needs regarding Massive Open Online Courses (MOOCs) at Shiraz University of Medical Sciences. METHODS: This survey study was carried out in three stages (2020-2021) using the Delphi technique. Purposive and snowball sampling methods were used to select the instructors. The students were selected through simple random sampling. The first round of the Delphi technique involved a questionnaire consisting of one open-ended question, completed by 49 basic/clinical faculty members and 47 senior medical students. In the second round, a 5-point Likert scale-based questionnaire was used to prioritize the instructional needs. The reliability of the questionnaire was verified by Cronbach's alpha coefficient. In the third round, a focus group was used. A total of six expert faculty members and one senior medical student were invited to the focus group session to prioritize the needs. Data were analyzed using Friedman's non-parametric ranking test in SPSS version 26. RESULTS: Ten instructional needs priorities were extracted, including common pharmacotherapies (antibiotics and narcotics), prescriptions, physiology, anatomy, physical examination, electrocardiography interpretation, radiography, computed tomography scans, serum electrolyte disorders, and cardiovascular and internal (endocrine and metabolic) diseases. The chi-squared calculated value (715.584) indicated a significant difference in the importance of the questionnaire's questions (P < 0.001). These questions did not have equal value, and the importance, from the respondent's point of view and the observed distribution of ranks, was not the output of a random factor. CONCLUSIONS: The findings of this study can be used to design MOOCs, revise instructional programs, and adapt the curriculum to meet the needs of general practitioners, which will, in turn, help meet the medical needs of the general population.

Faculty development strategies to empower university teachers by their educational role: A qualitative study on the faculty members and students' experiences at Iranian universities of medical sciences.

BACKGROUND: This study aimed to identify and explain the strategies of faculty development based on their role at Iranian Universities of Medical Sciences. METHODS: We conducted a qualitative content analysis study in 2021 using purposive, snowball sampling, with a maximum variation in the faculty members' age and experience level. Twenty four participants were enrolled in this study (eighteen faculty members and six medical sciences students); data collection consisted of two phases of semi-structured interviews and a brainstorming group technique. Data were categorized into two themes and six related subthemes, based on their similarities and differences after frequent summarization. RESULTS: The data analysis yielded two themes and eight categories. The first theme was to explain competencies based on role and task with two sub-themes: Tasks and capabilities and development and excellence of personal qualities. The second theme was the best strategies for empowering the teachers with four sub-themes, including problem-based learning, integration of methods, evaluation-based education, and scholarship in education (PIES), which explains the strategies that can support the development of teachers in medical sciences universities, and all the concepts were interrelated to each other. CONCLUSION: From the experiences of faculty members, the importance of some strategies in education and empowering the teachers' professional competence dimensions should be emphasized. PIES could explain the practical strategies that can support the development of teachers in medical sciences universities.

The role of continuing medical education programs in promoting iranian nurses, competency toward non-communicable diseases, a qualitative content analysis study.

BACKGROUND: Continuing medical education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and nurses' vital role in improving health care. It is, therefore, imperative to explore the nurses' experience of CME courses and the extent to which such programs are effective. OBJECTIVE: The present qualitative study aimed to explore and describe nurses' experiences of the effect of CE programs in promoting their competencies toward non-communicable diseases. METHODS: This qualitative content analysis study was conducted from December 2019 to April 2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran) and based on the principles of conventional content analysis. The target population was nurses who actively worked in the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including nine nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews guided by an interview guide, and data collection continued until data saturation was achieved. Each interview took about 30-45 min. Follow up questions were used for clarification when needed. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln. RESULTS: Analysis of the interview data resulted in 230 primary codes, based on 8 categories, and three themes were identified. The extracted themes were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. The associated categories were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. CONCLUSION: Professional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning, and implementation of training programs based on professional needs and effective assessment of the teaching/learning process.

The blacksmith approach: a strategy for teaching and learning in the medical anatomy course (a qualitative study).

BACKGROUND: Anatomy is a symbolic, essential core topic and one of the fundamental pillars of medical and paramedical knowledge. Nevertheless, few exploratory data analyses have focused on how students approach learning anatomy. This study examined how students perceive their learning experience during anatomy lessons and how to make a model which promotes their meaningful learning and professional identity. METHODS: Using purposive sampling with maximum variation, we conducted a qualitative content analysis at the Shiraz University of Medical Sciences in Iran (2020 to 2021). Twenty-four medical students and twelve faculty members of Iran's medical science universities were enrolled in the study. The data were collected through semi-structured interviews and analyzed according to the theme. RESULTS: A conceptual model emerged from the data analysis with the main theme called the blacksmith approach, which included Three sub-themes: (1) making a new forge (adequate preparation and mindful beginning), (2) heating the students' hearts (considering supporting systems that learners need) and (3) using Sledgehammer's approach (teaching anatomy by using more active methods and engaging all neuroanatomical regions) and (Using fun for enjoyable learning). All the concepts were related to each other. CONCLUSION: Medical students experience a challenging fundamental evolution into professional doctors. Educational systems focus primarily on teaching and learning, while students' transition can be facilitated by a three-step model called the Blacksmith Approach. It best serves as an educational framework for any pivotal, preclinical course capable of helping students acquire new roles and tackle challenges. Further research should be conducted to confirm how hard work leads to satisfying results with the opportunity to create enjoyable learning.

The effect of a stress and anxiety coping program on objective structured clinical examination performance among nursing students in shiraz, Iran.

BACKGROUND: Evaluation of the competence and practical skills of nursing students, using the objective structured clinical examination (OSCE), is an integral part of the nursing education program. However, their performance could be negatively influenced by a significant level of stress and anxiety prior to the test. The present study aimed to evaluate the effect of an anxiety coping program on the OSCE performance level of first-year nursing students in Shiraz, Iran. METHODS: The present quasi-experimental study was conducted among 76 nursing students; control group (n = 35) and intervention group (n = 41). To attain the study purpose, the intervention group received a pre-exam anxiety coping program that included relaxation and soothing techniques, diaphragmatic breathing training, and progressive muscle relaxation training accompanied by light instrumental music, while the control group received no intervention before the exam. Data collection instruments included a demographic characteristics form and State-Trait Anxiety Inventory (STAI) questionnaire. Demographic characteristics of the participants indicated an overall homogeneity within the study population. The STAI questionnaire was filled in before and after the OSCE and the results were compared with those of the control group. The data were analysed using SPSS software (version 22.0). P < 0.05 was considered statistically significant. RESULTS: As a result of the anxiety coping program, a substantial reduction in the anxiety score (by 11.61 units) in the intervention group was observed. There was a significant difference in the pre- and post-exam anxiety scores between the control and intervention groups (P < 0.001). The anxiety coping program improved the examination results of nursing students in the final exam compared to the midterm results (an increase of 0.9487 units, P < 0.001). CONCLUSION: The anxiety coping program reduced the anxiety level among nursing students and improved their OSCE results. Our findings can be utilized to better evaluate clinical activities in different medical and paramedical groups. Moreover, educators can implement such coping programs prior to evaluations in order to effectively assess the knowledge, attitude, and performance of the students.

The journey of thesis supervisors from novice to expert: a grounded theory study.

BACKGROUND: Supervision is a well-defined interpersonal relationship between the thesis supervisors and their students. The purpose of this study was to identify the patterns which can explain the process of expertise attainment by thesis supervisors. We aimed at developing a conceptual framework/model to explain this development based on the experience of both students and supervisors. METHODS: We have conducted a qualitative grounded theory study in 20 universities of medical sciences in Iran since 2017 by using purposive, snowball sampling, and theoretical sampling and enrolled 84 participants. The data were gathered through semi-structured interviews. Based on the encoding approach of Strauss and Corbin (1998), the data underwent open, axial, and selective coding by constant comparative analysis. Then, the core variables were selected, and a model was developed. RESULTS: We could obtain three themes and seven related subthemes, the central variable, which explains the process of expertise as the phenomenon of concentration and makes an association among the subthemes, was interactive accountability. The key dimensions during expertise process which generated the supervisors' competence development in research supervision consisted maturation; also, seven subthemes as curious observation, evaluation of the reality, poorly structured rules, lack of time, reflection in action, reflection on action, and interactive accountability emerged which explain the process of expertise attainment by thesis supervisors. CONCLUSIONS: As the core variable in the expertise process, accountability must be considered in expertise development program planning and decision- making. In other words, efforts must be made to improve responsibility and responsiveness.

Management of Stress and Anxiety Among PhD Students During Thesis Writing: A Qualitative Study.

Today, postgraduate students experience a variety of stresses and anxiety in different situations of academic cycle. Stress and anxiety have been defined as a syndrome shown by emotional exhaustion and reduced personal goal achievement. This article addresses the causes and different strategies of coping with this phenomena by PhD students at Iranian Universities of Medical Sciences. The study was conducted by a qualitative method using conventional content analysis approach. Through purposive sampling, 16 postgraduate medical sciences PhD students were selected on the basis of theoretical sampling. Data were gathered through semistructured interviews and field observations. Six hundred fifty-four initial codes were summarized and classified into 4 main categories and 11 subcategories on the thematic coding stage dependent on conceptual similarities and differences. The obtained codes were categorized under 4 themes including "thesis as a major source of stress," "supervisor relationship," "socioeconomic problem," and "coping with stress and anxiety." It was concluded that PhD students experience stress and anxiety from a variety of sources and apply different methods of coping in effective and ineffective ways. Purposeful supervision and guidance can reduce the cause of stress and anxiety; in addition, coping strategy must be in a thoughtful approach, as recommended in this study.

The relationship between spiritual health, quality of life, stress, anxiety and depression in working women.

Background: While there are benefits to women entering the workforce, there are also drawbacks, such as stress, anxiety, and depression, which can lower quality of life. However, some research indicates that women's spiritual health may be a protective factor in these situations. This study is to explore the relationship between spiritual health and quality of life, stress, anxiety, and depression among a population of women working in health care centers, given the existence of such a relationship among women. Methods: In 2022, 500 women who worked in health centers in Izeh City, Iran, participated in this cross-sectional survey. The clustered census sampling approach was used for the sample. The research participants completed a 12-item quality of life questionnaire on spiritual health, stress, anxiety, and depression as part of the data gathering process. The data were examined using independent t tests, one-way variance, and Pearson correlation after being entered into SPSS-24. Results: Of the participants, 18% were single and 68% were married. In terms of depression, stress, and anxiety, the mean and standard deviation were 8.26 ± 5.78, 11.26 ± 4.89, and 7.91 ± 0.98, respectively. The quality of life had a mean and standard deviation of 30.82 ± 3.56. Women who were unmarried and had more work experience reported a considerably greater quality of life (p < 0.05). The findings indicated that stress and spiritual health (p = 0.001), anxiety and spiritual health (p = 0.032), and depression and spiritual health (p = 0.024) all had a significant and inverse association. Furthermore, a strong and positive correlation was found (p = 0.001) between spiritual health and quality of life. Conclusion: The study's conclusions demonstrated a clear link between spiritual health and life satisfaction, suggesting that working women's quality of life may be raised by treatments that support spiritual health. Furthermore, the findings demonstrated a significant inverse relationship between spiritual health and the psychological variables of stress, anxiety, and depression. This suggests that by understanding the factors influencing mental health and the role of spiritual health moderator, it may be possible to improve the psychological state of employed women.

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.