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The research team proposed the Gamified Online Tutorial based on the Self-Determination Theory (GOT-SDT) framework in their previous study to design an appropriate online tutorial. This framework was employed in this study to design, develop, and evaluate a gamified online tutorial for teaching systematic searching in PubMed and Scopus. The content was designed and revised by two instructors. 73 multiple-choice questions were formulated and reviewed by some experts. Of the questions, 41 items were considered as pre-test and post-test. In the next step, the online tutorial was designed based on this framework. A one-group pre-test-post-test design was used to examine the effectiveness of tutorials in the learning level of learners. Learners comprised of the first semester MSc students in Kashan University of Medical Sciences. The validity of the pre-test-post-test questionnaire was determined based on the ideas of 10 librarians and instructors. Cronbach's alpha coefficient of 30 questionnaires equaled 0.94. This study was conducted based on the SDT. The Situational Motivational Scale was employed to evaluate the four constructs of SDT, including intrinsic motivation (IM), identified regulation (IR), external regulation (ER), amotivation (AM). Quantitative analysis of questionnaire was done by using descriptive and inferential (Wilcoxon test, Friedman test, and Correlation Spearman Test) indicators. Data analysis was performed through SPSS16 software. The online tutorial was designed based on the GOT-SDT and became accessible for students through http: //pelearn.ir. According to the comparison between pre-test (25) and post-test (40) med rates, the difference (15) is statistically significant. Accordingly, there was a considerable rise in learning level after using the tutorial. SIMS was used to examine the motivational levels. IM (6.68) and IR (6.81) obtained the highest mean values, while ER (1.34) and AM (1) had the lowest mean values. According to the results of the Spearman correlation, there was a significant relationship between IM, IR, and ER. Spearman correlation between IM and IR equaled 0.871, between IM and ER equaled -0.946, and between IM and IR equaled -0.872. There was a significant relationship between motivational levels and post-test scores. The correlation between post-test score and IM equaled 0.633, between post-test score and IR equaled 0.575, and between post-test score and ER equaled -0.560. Results indicated that gamification can serve as an inclusive technique for using game elements to improve experiences and increase learners' engagement and motivation in educational environments, especially in e-learning. The results of this study confirmed the effectiveness of the SDT-based gamified online tutorials. Integration of certain items with the structural, content, and educational elements of an online tutorial can increase its effectiveness; these items include game elements and motivational strategies for the three needs of autonomy, competence and relatedness. • Researchers, students, physicians, and librarians should know systematic searching, which is a substantial part of the systematic review. • GOT-SDT can be applied as a proper framework to design online learning environments, because this framework has considered online tutorial capabilities and game elements based on the SDT. Gamification can serve to improve experiences, to increase engagement and motivation of learners in educational environments, especially in e-learning. • According to the comparison between pre-test and post-test med rates, the difference is statistically significant. There was a considerable rise in learning level after using the tutorial. • IM and IR obtained the highest mean values, while ER and AM had the lowest mean values. • There was a significant relationship between motivational levels and post-test scores. [ABSTRACT FROM AUTHOR]

• The most important result of this study indicates that most of the identified errors are action errors, which can be reduced by providing appropriate instructions, training nurses, creating a reporting and error recording system, management controls, and promoting safety culture. • The results of this study can help hospital managers make decisions to reduce action errors to prevent human errors and increase safety at the hospital level. • This study showed that the SHERPA technique is applicable to healthcare settings. Human errors are the underlying cause of many occupational accidents. In recent years, human errors have increased in the healthcare sector. This study aimed to identify human errors committed by emergency department (ED) nurses working at Shahid Beheshti Hospital in Kashan using the SHERPA method. This study is a descriptive cross-sectional study performed in the emergency department of Shahid Beheshti Hospital. Human errors were first identified and analyzed using the Hierarchical Task Analysis (HTA) technique and then studied using the SHERPA method. In total, 426 errors were identified including 263 action errors, 108 checking errors, 35 selection errors, 12 retrieval errors, and eight communication errors. Also, based on the levels presented in the risk matrix in terms of severity of consequences, the highest percentage (36.34%) belonged to the borderline category. The majority of identified errors were action errors, which can be reduced by providing appropriate instructions and training nurses, compiling reports and building error recording systems, improving management controls, and promoting a safety culture. [ABSTRACT FROM AUTHOR]