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Background: The quantity and quality of interaction are critical elements of perceived interactions. This study aimed to summarize findings on the quality of interpersonal interactions in E-Learning at higher education and suggestions that inform future measurement efforts. Method: The scoping review proposed by Arksey and O'Malley (2005) was used. This approach consists of 5 steps: 1) identifying the research question,2) identifying relevant studies,3) study selection, 4) charting the data, and 5) reporting the results. PubMed, Scopus, and Web of Science have searched three databases, including manuscripts in English. The search was conducted from 2000 to July 2021. A PCC (population, concept, and context) was used as eligibility criteria and included the most relevant. The present PCC was defined as a population: university students, context: higher education, and Concept: E-learning and Interpersonal Interactions.Results: This review includes twenty-five articles chosen for inclusion. With the thematic analysis, the results of this scoping review are presented in the form of four themes: interaction in the online environment affects learning outcomes, numerous factors affect the interaction of learners in online settings, online interaction and hidden curriculum, and the importance of forming an online learning community.Conclusion: Findings showed that the quality of interpersonal interactions in e-learning seems to be a neglected link in e-learning. Further studies are needed focusing on the quality of interpersonal interactions in e-learning. It is necessary to develop appropriate tools to measure the quality of interpersonal interactions and further evaluate these interactions at the international level.

Background & Objective: The COVID-19 pandemic has impacted medical education worldwide with several opportunities and challenges. This study aims to provide an overview of medical education's opportunities and challenges according to the experience of the COVID-19 pandemic in order to guide future endeavors in conducting the teaching-learning process in post-COVID era support. Material & Methods: In this systematized review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, databases of PubMed, Cochrane, Scopus, Web of Science, and Eric, in addition to Google Scholar as a search engine, were searched to retrieve relevant original peer-reviewed, review, editorial, and commentary articles published from Dec 2019 to the end of Sep 2022. Results: As per the qualitative synthesis, a total of 29 articles were included from the 1534 records that were identified. Reviewing the included articles showed that most of the relevant studies were considered Medical and healthcare students (51.8%) at undergraduate level (72.5%) in University settings (62.1%). As per the qualitative synthesis, a total of 29 articles were included from the 1534 records that were identified. Reviewing the included articles showed that most of the relevant studies were considered Medical and healthcare students (51.8%) at undergraduate level (72.5%) in University settings (62.1%). On the other hand, post-COVID medical education opportunities have been grouped into four main categories, which are teaching and learning processes, psychological impact, accessibility and education equity, and management and administrative affairs. Post-COVID medical education opportunities also consist of four main categories: teaching-learning process, psychological impact, accessibility and education equity, and management and administrative affairs. Conclusion: Changes in teaching and learning processes in medical education caused by the COVID-19 pandemic created opportunities and caused important challenges that should be considered in the post-COVID era. In this regard, blended learning with the integration of technology using a flexible approach could be an effective recommendation.

Abstract Introduction Studies have reported different results of evaluation methods of clinical competency tests. Therefore, this study aimed to design, implement, and evaluate a blended (in-person and virtual) Competency Examination for final-year Nursing Students. Methods This interventional study was conducted in two semesters of 2020–2021 using an educational action research method in the nursing and midwifery faculty. Thirteen faculty members and 84 final-year nursing students were included in the study using a census method. Eight programs and related activities were designed and conducted during the examination process. Students completed the Spielberger Anxiety Inventory before the examination, and both faculty members and students completed the Acceptance and Satisfaction questionnaire. Findings The results of the analysis of focused group discussions and reflections indicated that the virtual CCE was not capable of adequately assessing clinical skills. Therefore, it was decided that the CCE for final-year nursing students would be conducted using a blended method. The activities required for performing the examination were designed and implemented based on action plans. Anxiety and satisfaction were also evaluated as outcomes of the study. There was no statistically significant difference in overt, covert, and overall anxiety scores between the in-person and virtual sections of the examination (p > 0.05). The mean (SD) acceptance and satisfaction scores for students in virtual, in-person, and blended sections were 25.49 (4.73), 27.60 (4.70), and 25.57 (4.97), respectively, out of 30 points, in which there was a significant increase in the in-person section compared to the other sections. (p = 0.008). The mean acceptance and satisfaction scores for faculty members were 30.31 (4.47) in the virtual, 29.86 (3.94) in the in-person, and 30.00 (4.16) out of 33 in the blended, and there was no significant difference between the three sections (p = 0.864). Conclusion Evaluating nursing students’ clinical competency using a blended method was implemented and solved the problem of students’ graduation. Therefore, it is suggested that the blended method be used instead of traditional in-person or entirely virtual exams in epidemics or based on conditions, facilities, and human resources. Also, the use of patient simulation, virtual reality, and the development of necessary virtual and in-person training infrastructure for students is recommended for future research. Furthermore, considering that the acceptance of traditional in-person exams among students is higher, it is necessary to develop virtual teaching strategies.

Abstract 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.

Abstract 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

Background and Aim: Social accountability is defined as identifying social problems and needs, planning for resolving them and evaluating the effect of the plans. Considering the vital role in providing public health, the universities of medical sciences are the most important ones for fulfilling this mission and directing their education, research and service activities toward addressing health concerns of the community. Despite of these attempts, social accountability has not realized completely and satisfying yet. The aim of this study was exploring factors affecting social accountability and community-based medical education in universities of medical sciences from Iran’s educational development authorities’ view point. Materials and Methods: This was a qualitative study performed by Education Development Center of the Ministry of Health and Medical Education in November 2022. Participants were 68 managers of Education Development Centers and 323 managers of Education Development Offices of schools and hospitals of universities of medical sciences in Iran. Participants were assigned to 8 focus groups. Conventional content analysis was used to extract the categories and subcategories. Results: At the first step 541 codes were extracted which were integrated in to 86 ones after defining similarities. These codes then were categorized into 18 sub-categories and 6 categories, namely “Curriculum” including: curriculum revision, approaches, credits and longitudinal themes and new disciplines, “Community-based education” including: educational fields and creating the foundation, “Students” including: students as teacher, educating students and graduates, “Faculty members” including: faculty members’ services, motivation and compensation and administration, “Evaluation” including: student assessment and program evaluation, and “Management” including: management and leadership, organizations, Interdepartmental communication and research. Conclusion: In this study a comprehensive collection of factors affecting SA in universities of medical sciences were identified and categorized. These factors that are compatible with medical education context in Iran can be used by top managers and educational administrators as a framework for short and long-term planning.

BACKGROUND: In team-based learning (TBL), students actively participate in the learning process and are responsible for their learning through preclass studying and team work with other classmates. Evaluation of the TBL method by students provides information for its better implementation. Due to extensive use of TBL method in medical curriculum at medical universities, we aimed to develop a questionnaire for its evaluation from the viewpoints of students. MATERIALS AND METHODS: This mixed-method cross-sectional study with a Qual-Quan design was conducted on 168 medical students in the basic sciences stage of their studies. We evaluated students’ satisfaction with this teaching method and its effectiveness by semistructural in-depth individual interviews until data saturation (12 interviews). We performed content analysis of the interviews and designed the questionnaire. Psychometric characteristics of the questionnaire were assessed in terms of content validity, test-retest reliability, internal consistency, and construct validity through explanatory factor analysis. RESULTS: The final tool was a 25-item questionnaire (reliability = 0.87 and α = 0.93) with five components of “learning enhancement,” “satisfaction,” “technical aspects,” “teacher’s capabilities,” and “appropriate testing.” Explanatory factor analysis showed that 64.68% of total variances were explained by these five components. CONCLUSION: In addition to academic performance outcomes, a successful instructional strategy should generate positive experiences for the learner. This study has created an assessment tool to be part of an evaluation process of the effectiveness of TBL in a given curriculum for medical students.

BackgroundOnline Interaction is a critical characteristic of distance learning, and effective online communication models empower students.PurposeThis research aimed to explain students' experiences on the quality of interpersonal interactions in e-learning.MethodThis 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.ResultsThe 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.ConclusionsThe 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.ImplicationsThe 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.

BACKGROUND: In recent years, educational development centers (EDCs) have evolved among universities from a marginal to a strategic aspect. The present study aimed to achieve an applicable task description at two levels of basic and quality improvement for EDCs and educational development offices (EDOs). MATERIALS AND METHODS: This research used the triangulation method. Initially, the current condition of EDCs across the country was evaluated with an electronic questionnaire in 2019. In the second phase, the modified Delphi method was used in two rounds with purposive sampling and a researcher-made questionnaire. The research participants were from all of the country. In the RAND technique, an electronic questionnaire was sent to 14 experts in medical education. After the analysis, the results were discussed, and the questions were answered again. We determined frequency and used content analysis. RESULTS: The task descriptions containing basic and quality improvement have been developed in three main sections: Organizational communication of EDCs and EDOs for policymaking; organizational structures, organizational charts, and the budget of EDCs and EDOs; and developmental roles of EDCs and EDOs (curriculum policies, curriculum development, blended learning, community-oriented), faculty development, evaluation (student assessment, faculty evaluation, program evaluation, accreditation), research (educational research, educational scholarship, innovative educational designs, events), and students (student committee, talented students). CONCLUSION: The task description guidelines have been prepared with 68 articles in basic and quality improvement and three main sections, including organizational communication of the EDCs and EDOs, organizational structures, the budget of the EDCs and EDOs, and their development roles.

There is a need for institutions to evaluate their e-Learning educational atmosphere to improve students’ learning experiences. The E-Learning Educational Atmosphere Measure (EEAM) is a comprehensive tool focusing on the students’ perception of the e-Learning environment. To be able to verbally interpret the results of the measure for better comprehension and more effective and consistent usage, it is essential to establish clear cut-off scores. We aimed to determine the optimal cut-off points for the EEAM scores by plotting them as the ROC curves versus a single global rating question. The findings showed that while the range of the possible EEAM scores was 40 to 200, cut-off points of equal or below 127, between 127 to 152, and equal or above 152 indicated students’ perception of the e-Learning atmosphere as “poor to weak”, “moderate”, and “good to excellent” respectively. The Area Under the Curve for scores that reflected the “poor to weak” state was 0.875 (p-value=0.000) with a sensitivity of 84.8% and a specificity of 70.0%. This area was 0.947 (p-value=0.000) for the “good to excellent” state with a sensitivity of 100% and a specificity of 82.1%. Our findings are useful in studying, evaluating, and monitoring the e-Learning educational atmosphere of institutions or comparing the results of multiple settings.

Background: Professionalism means understanding a profession and introducing it to the society through professional behaviors. In particular in clinical settings, constructive feedback is provided in education to create professional behaviors.Objectives: This study aimed to investigate giving feedback on professionalism in clinical education.Methods: A narrative review was conducted in PubMed and Google Scholar on the publications over the last 10 years. Eight hundred twenty-six articles were found in the first step, among which 30 were handed over to the expert panel. Fifteen of 30 articles were finally selected.Results: The data of the studies were in four categories: feedback techniques, feedback in. curriculum, the scope of feedback, and feedback outcome. Feedback on professionalism was mostly presented through online services, portfolio, video-based systems, by a preceptor or peers, longitudinally in internship courses, and Multi Source Feedback (360 degree). In a study, feedback on professionalism was considered formally in the curriculum. Educational experts give both formative and summative feedback (most of which were formative). Based on the literature, feedback can enhance learning professionalism, curriculum reforms, system support, student comfort, evaluations, and efficacy of professionalism.Conclusion: Multi-Source feedback assessment was the most used tool for giving feedback in professionalism, and the most popular form was informal-formative feedback. Since professionalism is a multidimensional concept related to personal communication, multi-source tools have been the most commonly used in the literature.

Student support services, especially for students who study virtually, increase satisfaction, attract new students, complete the course, and improve overall student performance. Given the importance of student support in e-learning and the fact that student support models should be specific to the culture and economic conditions and technology of their context, the present study set to design a native model of student support in e-learning for post-graduate students. To conduct the research, first a systematic search was performed to extract the existing models of student support. Through forming an expert panel and rating the models, more compatible models with the context of Iran were selected. The interview questions were then extracted from the concepts of the models who scored the most in the expert panel session. In relation to the examples of student support, interviews were conducted with 22 university teachers, education officials, and post-graduate students studying in educational branches leading to a virtual degree of medical sciences. Using content analysis of codes, sub-categories and the resulting categories were extracted from the interviews. Finally, in the expert panel session, using the (analytic hierarchy process) AHP, the categories were prioritized and the model was designed. After analyzing the content of the interviews, four main categories, namely teaching and learning, interactions and communications, empowerment, and structural support were extracted and the final model of student support was designed using the opinions of e-learning instructors. Despite relatively similar similarities between the native model of student support for e-learning students and the existing models, this model, which is designed based on the needs of students and faculty and e-learning officials, places more emphasis on teaching, learning, interactions, and communications.

Abstract Background Medical students should effectively manage conflicts in teamwork and communication with other team members. This study aimed to develop and validate a tool to evaluate attitude of medical students and physicians toward conflict management. Method A multi-step process was employed to develop and validate a Conflict Management Attitude Questionnaire (CMAQ) based on the steps recommended in AMEE Guide No. 87. First, the initial items were obtained from the literature review and focus group. After cognitive interviews with the medical students and revision of the questionnaire, content validity was performed by experts. The construct validity and reliability of the questionnaire were assessed using exploratory Factor Analysis (EFA) and Cronbach’s alpha coefficient, respectively. Results This multi-step process resulted in a 12-item, five-point Likert-type questionnaire with satisfactory construct validity. Exploratory factor analysis revealed three factors, comprising the four items from the "perceived interactions in conflict management" subscale loading on the first factor, and five items from the "perceived value of learning conflict management" subscale loading on the second factor, along with three items from the "perceived application of conflict management" subscale loading on the third factor. All subscales described 56.48% of the variance. Validation results showed that Content Validity Index (CVI) and Content Validity Ratio (CVR) were greater than 0.75. Cronbach's alpha coefficient was 0.791. Conclusion This study showed that CMAQ has valid evidence for assessing the attitude of medical students toward conflict management with favorable psychometric properties and strong evidence of construct validity. However, due to the lack of evidence on any specific questionnaire to evaluate the attitude towards conflict management, future studies should conduct a confirmatory investigation regarding other aspects of medical students' attitudes toward conflict management.

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.

Student engagement has an important role in academic achievement in all learning contexts, including e-learning environments. The extent of monitoring and promoting student engagement in e-learning affects the quality of education and is a determining factor for ensuring student’s success. Log data of students’ activities recorded in a learning management system (LMS) can be used to measure their level of engagement in the online teaching–learning process. No previous studies have been found stating a consistent and systematically raised list of LMS-based student engagement indicators, so this systematized review aimed to fulfill this gap. The authors performed an advanced search in the PubMed, Ovid, Google Scholar, Scopus, Web of Science, ProQuest, Emerald, and ERIC databases to retrieve relevant original peer-reviewed articles published until the end of June 2021. Reviewing the 32 included articles resulted in 27 indicators that were categorized into three themes and six categories as follows: (a) log-in and usage (referring to LMS, access to course material), (b) student performance (assignments, assessments), and (c) communication (messaging, forum participation). Among the categories, access to course material and messaging were the most and the least mentioned, respectively.

Abstract Background Although the use of mobile devices can facilitate the learning process, there may be barriers to using them for learning purposes. This study aimed to identify and investigate the barriers and facilitators of using mobile devices as an educational device from the perspective of nursing students. Methods This qualitative descriptive study was conducted in 2020 on undergraduate nursing students of the Nursing and Midwifery Faculty, Tehran University of Medical Sciences. A total of 22 undergraduate nursing students were selected by purposive sampling with maximum variability. Inclusion criteria were Undergraduate nursing education, having mobile devices, and willingness to participate in research. Data were collected through semi-structured individual interviews for 45–75 min in the proposed environment of students until the data were saturated. Data analysis was performed manually using the framework analysis method with the steps: familiarization, identifying a thematic framework, indexing, Charting and Synthesis, Mapping, and Interpretation. Trustworthiness was determined by methods of Credibility, Dependability, Conformability, and Transferability. Results The majority of participants (45.45%) were 21 years old, 63.63% were women, and 36.36% studied in the 8th semester. Findings from the analysis of interviews showed that barriers to the use of mobile devices were classified into 4 main categories (barriers related to mobile devices, barriers related to Internet access, barriers related to information literacy, cultural-environmental barriers) and 15 subcategories, and facilitating the use of mobile devices was divided into 2 main categories (easy to use mobile devices and easy access to information) and 6 subcategories. Conclusion The results of this study help educational managers and curriculum planners to adapt to technological change, to focus on the many benefits of mobile devices as an educational tool, and to plan to overcome barriers to mobile device use, and use mobile devices to teach theoretical topics and clinical nursing skills effectively.

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, andcommunity 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 behaviorchange, 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.

Abstract 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.

Emergency Severity Index version4 is the standard triage method in Iran. Effectiveness of training by lecture or e-Learning was investigated. But its effect on nurse performance in triage unit was not studied. The aim of this research is to study the impact of triage training by lecture, multimedia, and pamphlet on triage nurse performance and comparison of them. 21 triage nurses from three general hospitals in Kermanshah in three groups of 5, 6, and 10 persons were included. In each hospital only one method of training was introduced. Pre training variances of percentages of performance accuracy in three groups were homogeneous and pre training triage accuracy was similar in these groups. Post training performance was statistically improved in lecture group and multimedia group but in pamphlet group this improvement was not seen. According to study results multimedia training can be suggested as a good substitute for traditional lectures to improve triage nurse performance. Multimedia training offers the learner freedom to study in their preferred time and place and is more compatible to nurse shift work.

Obtaining metacognitive skills is crucial for enhancing self-regulation. So, this quasi-experimental study aimed to assess the effect of teaching metacognition through peer-conducted flipped classroom on high school students' self-regulation. 107 students filled out Self-Regulation Questionnaire as the pre-test. Both control and intervention groups received a package of four-session multimedia e-content about metacognition during four weeks. Each week, the students in the intervention group participated in a face-to-face session during which peers handled the instruction, while participants in the control group had teacher conducted sessions. Finally, the same questionnaire was answered as the post-test. The results showed a significant increase from pre to post-test scores in the intervention group, in contrast to the control one with no significant increase. Between groups comparison of post-test scores resulted in a significant higher score in the intervention group. So, the findings showed the positive effect of teaching metacognition through this method on students’ self-regulation.

Universities assess their academic learning environment to improve students’ learning. Students’ experience in e-learning environment is different from face-to-face educational environment. So, in this study a specific valid and reliable instrument was devised for assessing perception of e-students from educational environment, that is, educational atmosphere. Firstly, we devised the primary instrument based on factors constituting educational atmosphere. Then Instrument’s content and construct validity were assessed. Also, Cronbach’s alpha and test–retest were used for studying the internal consistency and reliability of the instrument respectively. The final instrument named ‘e-learning educational atmosphere measure’ (EEAM) consisted of 40 items covering six factors, including programme effectiveness, teaching quality, ethics and professionalism, learner support, safety and convenience, and awareness of the rules, which accounted for 68.53% of variances. Content validity ratio was more than 0.51 and content validity index score of all questions was above 0.81. Test–retest reliability was 0.85 (p = 0.001) and Cronbach’s alpha was 0.943. Assessing educational atmosphere in e-learning settings by EEAM could provide managers and investors with useful information to settle an effective education system by prioritising the necessary changes.

مقدمه: احیا قلبی پیشرفته و برخورد با ایست قلبی از موضوعات مهمی است که دستیاران طب اورژانس باید با آن آشنایی کامل داشته باشند. هدف از انجام این طرح مقایسه دو روش آموزش حضوری و استفاده از سرویس های پیام رسان (که قابلیت به اشتراک گذاری صوت و تصویر را دارند مانند واتساپ) است. روش مطالعه: در این مطالعه دستیاران طب اورژانس برای آموزش احیای قلبی ریوی، به صورت تصادفی به دو گروه تقسیم شدند. گروه کنترل آموزش حضوری به صورت طرح سناریو انجام شد و در گروه دوم آموزش احیا به صورت طرح سناریو در گروه پیام رسان نرم افزار واتساپ، به صورت غیر حضوری انجام شد. پیش آزمون و پس آزمون از هر دو گروه انجام شد. نمرات آزمون ها مورد محاسبه وآنالیز آماری قرار گرفت. یافته ها: بررسی مقایسه فراوانی جنسی، مقایسه میانگین سال دستیاری، مقایسه فراوانی گذراندن دوره CPR، و میانگین سنی دو گروه مورد بررسی اختلاف معنی داری را نشان نمی دهد. همچنین میانگین درصد نمره آزمون CPR در بین دو گروه مورد بررسی قبل و پس از آموزش اختلاف معنی داری را نشان نداد. اما میانگین درصد نمره آزمون CPR در گروه مداخله قبل و پس از آموزش اختلاف معنی داری را نشان داد. میانگین درصد نمره آزمون CPR در گروه کنترل قبل و پس از آموزش اختلاف معنی دارد. همچنین در صورتی که پس آزمون را به عنوان متغیر وابسته و دو گروه را به عنوان متغیر مستقل و پیش آزمون را به عنوان کوواریانس وارد فرمول ANCOVA کنیم بین دو گروه در پس آزمون اختلاف معنی دار مشاهده می شود. (P-value= 0.002) نتیجه گیری: آموزش مبتنی بر سناریو در مورد احیا بالغین به روش بحث گروهی با نرم افزار پیام رسان بر روی دستیاران موثرتر است. برای مطالعات آتی بررسی با حجم نمونه بزرگتر و در مدت زمان طولانی تر پیشنهاد می شود.

Background and Aim: Studentschr('39') academic achievement is one of the important indicators in evaluating the educational system. Emotional intelligence is one of the success factors in educational environments that can predict success in different aspects of life.The purpose of this study was to determine the relationship between emotional intelligence and academic achievement in students of Anesthesiology and Operating Room of Tehran University of Medical Sciences. Materials and Methods: This cross-sectional study was performed on 140 people of anesthesiology students and operating room of Tehran University of Medical Sciences in 2018. The samples were selected by available method. The instrument consisted of two demographic questionnaires and the Bradbury and Graveschr('39') standard questionnaire for emotional intelligence. In order to measure academic achievement, the average score of the whole course of the students was used. Data were analyzed by SPSS software and P

Introduction: In the test-enhanced spaced learning, educationalcontents are presented in small packages of well-developedtest questions with a defined frequency to the learners. It is notclear that applying this educational style might have a positiveimpact on the summative assessment. Therefore, in this studywe assessed the effect of the test-enhanced spaced learning onthe otolaryngology board and annual examinations of residencytraining.Methods: In a quasi-experimental study with consecutivesampling, all forty-four residents of otolaryngology in four levelsof training in 2016 at Tehran University of Medical Sciences(TUMS) received daily-standardized multiple-choice questionswith a twice-repeated frequency of 10 days. Individual feedbackaccording to one’s response to each test was provided. The resultsof national board and annual exam were compared with the sameresults of all residents of other universities and previous yearTUMS’ residents for whom spaced learning were not applied andthey were considered as the control groups. The board exam hadtwo parts, multiple-choice questions, and computer-based clinicalexamination. The annual exam format was multiple-choicequestions. The total score for each one was 150. Student’s t-testand Mann-Whitney U test were used for comparative analyses. Results: The mean of the board exam results showed statisticallysignificant improvement compared to other medical schools(113.6±10.7 vs. 102.9±13.4 in multiple-choice questions,p=0.048, 118.7±12.5 vs. 54.1±60.0 in the computer-based clinicalexamination, pprevious year did not show any significant difference.Conclusion: Spaced learning with testing effect may be useful inthe clinical education setting to improve the learning outcomes.

Background: Nowadays, several studies have been performed on the factors affecting the effectiveness of virtual education. One of the characteristics of learners is their different learning styles.Objectives: The purpose of this study was to investigate the relationship between learning style and the level of satisfaction and usage of e-learning facilities in medical students.Methods: This cross-sectional and retrospective (ex post facto) study was performed among medical, public health, and operating room students of Shahrekord University of Medical Sciences in 2017. We redesigned their courses to be delivered in the blended method, so that teachers used a Learning Management System (LMS) in addition to traditional teaching. Information about learning styles was collected using Kolb’s questionnaire, satisfaction level evaluated with a researcher made questionnaire and use of e-learning was examined by checking system loggings. Data were analyzed using one-way ANOVA, Tukey’s post hoc, Welch’s ANOVA and X2 tests in SPSS software.Results: Students’ satisfaction with e-content in diverging learning style was higher (P = 0.032), but there was no significant relationship between learning style and demographic characteristics and total average mark. Also, there was no significant difference in the amount of using e-learning facilities between different learning style groups (P = 0.256).Conclusion: It seems that using virtual learning facilities and considering the type of learning style in students can increase their satisfaction.

In a flipped classroom, class’ lecture is delivered as a video to students before the class is held, and the actual time of the class is spent on problem solving and discussions. As there is a need for further clarification of the way of using this method, in this study, we assessed the effect of the sequence of flipped and lecture-based classes on medical students’ learning and satisfaction in Emergency Medicine theoretical course. For this purpose, 59 medical students participated in this quasi-experimental study who were divided into two flipped-first and lecture-first groups. Eight topics were selected to be taught. Firstly, students took a pre-test covering these topics’ objectives. Afterward, in the lecture-first group, 4 topics were taught through lecturing while the next 4 topics were taught through flipped classroom method. Then the teaching method was shifted for the flipped-first group. Finally, students’ answered the satisfaction survey and post-test questions. Indeed, not only the final score of the flipped-based topics in both groups was significantly higher than lecture-based ones (P-value = 0.022), but also the post-test score of all topics were significantly higher in the flipped-first group (P-value = 0.032). In addition, the satisfaction score for the flipped-based topics was higher than the lecture-based one (P-value = 0.011). As a conclusion, flipped classroom approach could increase medical students’ learning as well as their satisfaction and it is recommended that flipped classes be applied from the beginning of the course to be more effective.

Background: Studies on the efficacy of adaptive e-learning in dentistry are limited. This study aimed to compare the efficacy of linear and adaptive electronic continuing medical education (CME) courses about dental bleaching. Methods: This quasi-experimental study using a post-test control group design evaluated the efficacy of an electronic CME course on dental bleaching offered to 60 dentists who were non-randomly allocated in two linear and adaptive groups (n=30). One training session was held for participants of both the intervention and the control groups. At the end of the course, the learners participated in a post-test and completed a satisfaction questionnaire. SPSS 23 was used to analyze the results. An independent t test was used to assess the effect of type of intervention on the outcome of education, and Pearson’s chi-square test was applied to assess the effect of the intervention on participants’ satisfaction. Results: The mean post-test scores of participants were 6.33±1.47 for the linear group and 6.40±2.31 for the adaptive group. The mean satisfaction scores of participants were 4.02±0.53 for the linear group and 4.15±0.42 for the adaptive group. According to an independent t-test, the two groups were not significantly different in terms of post-test score (P=0.7) or level of satisfaction (P=0.2). Conclusion: The adaptive approach has considerable advantages and comparable efficacy to the linear method in terms of post-test score and self-reported knowledge and satisfaction of participants. Thus, this method of education may be as effective as the linear method for instruction in dental bleaching. The use of an adaptive approach is therefore recommended in educational curricula.

Introduction : E-learning is used in the worldwide in higher education to improve the quality of the learning experience by students; at the same time using this approach requires behavioral changes in the faculty members. One of the steps in the implementation and monitoring of e-learning, is audience analysis using techniques such as knowledge, attitude and practices (KAP). This study investigates the knowledge, attitude and faculty members’ performance of Tehran University of Medical Sciences (TUMS) on e-learning. Methods: This descriptive, cross-sectional study was conducted in 2014-15 through a research-made questionnaire. Face validity was determined by expert opinion, Cronbach’s alpha was measured to assess the reliability and its construct validity was investigated through exploratory factor analysis. . The questionnaire was e-mailed to all TUMS faculty members . 218 faculty members responded to the questionnaire. Results: The reliability score of the questionnaire was assessed using Cronbach alphs, and it was 0.79. Exploratory factor analysis of the attitude part of the questionnaire produced a single factor that explained 53% of the variance. The results showed the positive attitude of faculty members regarding e-learning, although their knowledge and practice scores was less than half of the total score. There wass not found any meaningful differences between knowledge, attitude and performance of the participants based on sex, rank and work experience. ANOVA test showed that the difference of scores among schools was statistically significant ( = 0.000; = 0.003 and = 0.000, respectively). Conclusion: The findings of this study showed the state of knowledge, attitude and faculty members’ performance of TUMS on e-learning. Over the past years, TUMS has established suitable e-learning infrastructure such as educational websites and virtual programs as well as training workshop for faculty members. The results of this study can help the revision and improvement of the faculties’ educational programs.

Introduction: Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students. Methods: This is a mixed methods study performed in 2 steps. First, the researchers defined “clinical learning” in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14. Results: To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55%) was defined by the first 3 factors while the rest of the total variance percentage (59.45%) was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93) confirmed the high internal consistency of the questionnaire. Conclusion: Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it involves 41 expressions and properties such as instrument design based on perception and experiences of the nursing students about effective factors on clinical learning, definition of facilitator and preventive factors of the clinical learning, simple scoring, suitable validity and reliability, and applicability in different occasions.

Background: There is a global interest for deploying faculty members′ activities evaluation systems, however implementing a fair and reliable system is a challenging issue. In this study, the authors devised a model for evaluation of faculty members′ activities with regard to their viewpoints and meta-evaluation standards. Materials and Methods: The reliability of the current faculty members′ activities metrics system was investigated in Medical School of Tehran University of Medical Sciences in 2014. Then authors conducted semi-structured interviews regarding meta-evaluation standards and designed a questionnaire based on interviews′ results which were delivered to faculty members. Finally, they extracted the components of the model regarding interviews′ content analysis and questionnaire′s factor analysis and finalized them in a focus group session with experts. Results: Reliability of the current system was 0.99 (P < 0.05). The final model had six dimensions (mission alignment, accuracy, explicit, satisfaction, appropriateness, and constructiveness) derived from factor analysis of the questionnaire and nine factors (consensus, self-reporting, web-based system, evaluation period, minimum expectancies, analysis intervals, verifiers, flexibility, and decision making) obtained via qualitative content analysis of the interviews. Conclusion: In this study, the authors presented a model for faculty members′ activities evaluation based on meta-evaluation of the existing system. The model covered conceptual and executive aspects. Faculty members′ viewpoints were the core component of this model, so it would be acceptable in a medical school to use the model for evaluating their activities.

Background Because of the developments and advancements in information technology (IT), unparalleled opportunities have been provided in electronic arenas; among them, electronic learning (e-learning) systems have brought attention to the facilitation of education. Since educational environment is a factor influencing the success of educational programs, the current study aims at evaluating the factors that create the educational atmosphere in cyberspace. Methods The current study employed a qualitative content analysis approach and a targeted sampling method. A total of 11 students and 13 faculty members were recruited by a semi-structured interview in 2015. The interviews were continued separately for both students and lecturers up to the saturation of sample size. After the interview data were qualitatively analyzed. Results After the data analysis, 685 codes were extracted out of the qualitative data, which were reevaluated in several stages and classified into 38 subcategories. Then, 13 categories and 6 domains (The status of virtual education, learner support, teaching skills, evaluation, professionalism and professional ethics, and self-efficacy) were created. Conclusions Since the educational environment is an inseparable part of a curriculum, the factors creating an educational atmosphere in cyberspace are critically important and necessary for the qualitative and quantitative evaluations of the curriculum and prediction of educational outcomes.

Partnership is one of the mechanisms of scientific development, and scientific collaboration or co-authorship is considered a key element in the progress of science. This study is a survey with a scientometric approach focusing on the field of e-learning products over 10 years. In an Advanced Search of the Web of Science, the following search formula was used: TS=("m-learning" OR "mlearning" OR "mobile learning" OR "online learning" OR "virtual learning" OR "distance learning" OR "electronic learning"). The study was limited to 2005-2014, and the document type was limited to paper. A total of 4292 documents were found, to which 12362 authors contributed. The articles were evaluated individually and their information was entered into Microsoft Office Excel 2007 for analysis using the collaborative coefficient formula. In the Computers and Education journal, articles with two authors are the most frequent. The United States, with the highest production of articles in the field of e-learning, tends to produce articles with two authors. In 2014, the most productive year, articles with three authors were more frequent. The highest collaborative coefficient is in 2005 and 2014. Our findings show that despite the need for research activities as a team, the authors in the field of e-learning tend to publish their papers alone or in a team of two.

Introduction: Information and communication technology has changed the traditional role of teachers and learners. It’s important to detect factors influencing e-teachers’ role to improve their performance more than ever. So in this study we identified and prioritized factors influencing e-teacher’s effective performance. Methods: In this descriptive study, 15 e-learning experts from Tehran University of Medical Sciences were selected through purposeful sampling. Having focus group sessions held, their viewpoints about main factors affecting e-teacher’s performance were collected. In order to collect the views toward the significance of each criterion, a questionnaire was developed regarding the main criterion and its subordinates in which there was a comparison table for each criterion. Then Fuzzy Analytic Hierarchy Process decision making was used for prioritizing and weighting factors (ie., criteria). Results: Totally 5 factors influencing e-teachers’ performance were extracted. The factor of professional knowledge had the highest weight (0.28) was recognized as the most important factor. This factor did not have any subordinate. Technology with the lowest weight (0.137) was identified as the least important factors affecting e-teacher’s performance. Factors (and their most important subordinates with the highest coefficients) were as follows: skillfulness in e-teacher role playing (mastery in pedagogy), technology (mastery in information technology), management (management of virtual classroom), and personality factor (interest in virtual training). Conclusion: In order to select an e-teacher and develop his capabilities, it must be considered that IT expertise is of the least importance and teachers who encompass factors such as professional knowledge and are able to act as an effective teacher, are also able to act as a successful e-teacher.

Background Nowadays, there is an ongoing development in virtual social networks and their application for patients' support, diagnosis, self-care, and education. On the other hand, applying short messages as the easiest, simplest, and cheapest way of presenting information would be helpful in this regard. Thus, in this study the effect of social network and sending short messages was assessed on negative thinking status of women. Methods This was an experimental study with pretest-posttest design performed in 2015. Out of 1165 women in Mohajeran city, 75 were randomly assigned into three groups of social network, short message, and control. The participants received a compact disc containing e-content about reducing negative thoughts. They filled out the Crandell cognition inventory (CCI) before and immediately after the intervention and also one month later for assessing their negative thoughts. A Telegram group was established for the social network group while follow-up short messages were sent for the other intervention group. SPSS V.21 was used for data analysis by paired t test, one way analysis of variance, analysis of covariance and repeated measures tests. Validity (in terms of content and structure) of the questionnaire was confirmed by comments from experts and professors and Bartlett test (KMO = 0.846, p and lt; 0.001); the reliability was confirmed by Cronbach’s alpha coefficient (0.69) and test-retest coefficient (0.928). Results There were significant differences between pretest and posttest scores in social network, short message, and control groups (P value 0.45, 0.001 and lt; 0.001 and lt; respectively). There were also significant differences between pretest and follow-up scores in the abovementioned groups (P value 0.003, 0.012, 0.001 respectively). There was no significant difference in the follow-up scores between three groups (P = 0.917). Conclusions The results showed that multimedia e-content merely would reduce participants’negative thoughts. Therefore, providing multimedia e-content could be beneficial in improving the effectiveness of public health education.

Background & Aim:Lack of adherence to prescribed medication is a main concern in medicine especially in chronic diseases. The aim of present study was to determine the effect of supportive text message on the adherence to treatment of depression. Methods & Materials: This quasi-experimental study was conducted on sixty eligible patients with diagnosis of depression who referred to a psychiatry clinic in Shahrekord. The patients were allocated to supportive text message and control groups. The patients in both groups were treated with the same antidepressants; however, the patients in supportive text message group additionally received daily text messages for six weeks. The adherence to medication was assessed by a researcher-made questionnaire and the severity of depression was assessed by Beck depression inventory. Results: Immediately after intervention, average score of depression showed a significant improvement in both groups (P

Delphi as a consensus development technique enables anonymous, systematic refinement of expert opinion with the aim of arriving at a combined or consensual position. In this study, we determined the criteria and their weights for Iranian Medical Schools' ranking through a Delphi process. An expert committee devised 13 proposed criteria with 32 indicators with their weights, which were arranged hierarchically in the form of a tree diagram. We used the Delphi technique to reach a consensus on these criteria and weights among the deans of 38 public Iranian medical schools. For this purpose, we devised and sent a questionnaire to schools and asked them to suggest or correct the criteria and their weights. We repeated this process in two rounds till all the schools reached an acceptable consensus on them. All schools reached a consensus on the set of 13 criteria and 30 indicators and their weights in three main contexts of education, research and facilities, and equipment which were used for Medical Schools’ ranking. Using Delphi technique for devising the criteria and their weights in evaluation processes such as ranking makes their results more acceptable among universities.

Introduction: Designing e-learning systems based on the principles and prerequisites of teaching and learning theories requires a comprehensive and systematic approach to instructional design procedure. An experience of instructional design, implementation and evaluation of an e-learning system is represented in this study. Methods: In the present action research study, five steps of systematic instructional design, including analysis, design, development, implementation and evaluation, were performed in Tehran University of Medical Sciences for developing an e-learning system. The principles and prerequisites of teaching and learning procedure were identified. Then the supportive learning management system was designed and related regulations which were approved in associated university councils were developed. Faculty development workshops were held for e-teachers. This procedure was completed during 2007-2009. Results: Master degree program on medical education was chosen as the first discipline and 25 students enrolled in two academic years. The application of system as a supportive pedagogical instrument began by 44 faculty members who used the system for 450 students. Students' and teachers' evaluation of system showed their high satisfaction (88%). None of the students dismissed the course. Conclusion: A systematic instructional design before launching e-learning systems or purchasing softwares may guarantee its success. University's used the evaluation results for further revisions and updates of the system.

Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.

Objective(s): After two decades of expansion of medical universities and increasing the number of students as one of the most attainable solutions for the problem of substandard status of Iranian community health, recently, quality-based policies in medical education have taken priority over most of the national health plans. In this study, we stratified educational services of schools providing a two-year degree course in health sciences in Iran to determine their differences. Methods: To measure the educational performance of the course nationwide, a benchmarking tool, consisting of 47 indicators, was devised. Their weights were defined through consensus developing methods. Each school was asked to introduce a representative who would complete a questionnaire, which was designed to collect schools’ information. In the next step, all the divisions were visited by one of the projectchr('39')s members and the school’s representative. Then, data retrieval was performed and verified at the project’s office. Results: Schools providing the course were stratified based on their individual scores. Furthermore, all schools were also ranked in each indicator. Among schools providing the course School of Health Sciences of Iran University of Medical Sciences gained the first rank, with the score of 86.53 out of 100. Conclusion: This study defines the educational strengths and weaknesses of health sciences programs in Iran that could be used as a measure for authorities to devise practical strategies for qualitative and quantitative improvement.

Introduction: Recognizing the strengths and weaknesses of schools through comparison of their educational services status, is one of the effective ways in determining their present situations. In other words, educational ranking of institutions and introducing the best models, is the requisite for short-term and long-term plannings regarding qualitative and quantitative improvement of schools. The aim of this study was to develop a tool for studying the qualitative and quantitative status of educational services in nursing schools and ranking them through this tool. Methods: In a survey study, a set of criteria for investigating educational services was developed based on a tree diagram model. Then, the weignt of these criteria was determined through consensus making method. A representative from each school was introduced to complete the questionnaire. Through visiting the schools, the data was completed and revised. Subsequently, the score of every individual school was estimated for each criterion. A computer software was exploited to perform the final analysis. Results: In order to investigate the educational services provided in nursing education, a set of more than 60 criteria and indicators in three subsets of input, process, and output were designed and their weights were also determined. The first rank belonged to nursing discipline in School of Nursing and Midwifery of Isfahan University of Medical Sciences with the score of 65.15 out of 100 School of Nursing and Midwifery of Tehran University of Medical Sciences with the score of 62.59 out of 100 owned the secon rank and the third rank belonged to School of Nursing and Midwifery of Iran University of Medical Sciences with the score of 59.76 out of 100. Conclusion: Having this project carried out, the strengths and weaknesses of educational services provided in nursing field were defined, and presented to administrators and educational managers as a practical model for qualitative and quantitative improvements.

Background: Assessing the statue of educational services in schools of Paramedical Sciences can help authorities to plan for further promotion through identifying schools strengths and weaknesses Objective: To design criteria and indices for educational ranking of associate programs of Paramedical Sciences including Laboratory Sciences Operating Room Nursing Technology of Radiology Anesthesiology Nuclear Medicine Technology of Radiotherapy and Medical Emergencies in Iran Methods: In an expert committee criteria used in worldwide rankings and medical education standards were reviewed Then a set of criteria and indices which were compatible to Iran educational system was devised and their weights were defined through consensus developing methods Each school was asked to introduce a representative to collect schools information and schools were visited to verify the gathered data Then schools scores for each criterion were calculated Results: A set of 42 criteria sorted as a tree diagram was devised Main branches of this tree included input branch consisting of National Entrance Examination (Weight: 2%) faculty members (weight: 18%) and facilities and equipment (weight: 20%) process branch consisting of administrations (weight: 405%) and support and counseling systems (weight: 45%) and output branch consisting of students output (weight: 9%) and faculty members output (weight: 6%) Conclusion: This study provided the educational strengths and weaknesses of Paramedical Sciences programs in Iran The results can be used in devising practical strategies for qualitative and quantitative improvement

Objective: After two decades of nomber expansion of universities of medical sciences and increasing the number of students as one of the most attainable solutions for the problem of substandard status of Iranian community health, recently, the quality-based policies in medical education have taken priority over most of the national health plans. The goal is determine differences in the field of education between schools providing rehabilitation sciences programs in Iran by stratifying their educational services. Materials & Methods: To measure the educational performance of rehabilitation sciences programs nationwide, a benchmarking tool, consisting of aboute 50 indicators, was devised. Their values were defined through consensus developing methods. Each school was asked to introduce a representative who would complete a questionnaire, which was designed to collect schools’ information. In the next step, all the divisions were visited by one of the project’s members and the school’s representative. Then, data retrieval was performed and verified at the project’s office. Finally, a special computer software was exploited to perform the final analysis. Results: Schools providing rehabilitation sciences programs were stratified based on their individual scores. Furthermore, all schools were also ranked in each indicator. Among schools providing bachelor’s rehabilitation sciences programs, University of Social Welfare and Rehabilitation Sciences gained the first rank, with the score of 73.41 out of 100 Iran Rehabilitation School was the second with the score of 70.91 and Tehran Rehabilitation School gained the third rank with the score of 68.91. Conclusion: This study defines the educational strengths and weaknesses of rehabilitation sciences programs in Iran that could be used as a measure for authorities to devise practical strategies for qualitative and quantitative improvement.

There is now clear evidence that the atherosclerotic process begins in childhood. A major and important cause of atherosclerosis and coronary heart disease (CHD) is elevated cholesterol level. In order to clarify the sigificance of elevated Total Cholesterol (TC) in children who live in Tehran, we measured the lipid profiles including TC Triglyceride (TG), and High density Lipoproteein Cholesterol (HD –C) of 1000 twelve- year-old children. Low-density lipoprotein Cholesterol (LDL-C) value was calculated by using friedwald formula. The mean level of TC in all cases reached 170±39 mg/dl. The mean level of LDL-C, HDL-C and TG were 101±38 mg/dl, 48±12mg/dl, and 105±52 mg/dl, respectively. Tc level in 16.4% of the cases was above 200 mg/dl and 16% had LDL-C levels more than 130mg/dl. Mean LDL-C level in the boys was 6.2 mg/dl (with 95% confidence interval of 1.3 to 11.1) more than girls. Also mean HDL-C level in the girls was 4.1 mg/dl (with 95% confidence interval of 2.5 to 5.7) more than that of boys (P-value in both=0.000). TC and HDL-C levels in the northern parts of Tehran were significantly higher than the southern parts. Mean LDL-C and TG levels didn’t show any differences. Regarding the normal range of TC (

Iran universities of medical sciences have experienced a period of expansion in past decades. Now previous concerns are alleviated, and the former quantity-based policy has given a way to a more quality-seeking attitude. In this study, we developed a planning model for expansion and stagnation of higher education in Iranian universities of medical sciences based on workforce requirements of the country and capabilities of the universities. The plan provided an objectively documented base for the authorities to decide on developmental limits of universities. We devised guidelines for justifying existing programs within universities, assigning new undergraduate and postgraduate programs to universities, voluntary request of universities to cancel a program, and their request to offer new programs for the first time in the country, based on three factors: university educational status, each university-program educational status and the nation's need for each discipline. Related councils of the Ministry of Health and Medical Education legitimately approved the plan and guidelines. In this article, we introduced the methodology of developing the plan, described it and its related guidelines and discussed challenges and limitations we encountered in design and application phases.