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Outdoor learning can relate students with environment, community, society and themselves. It can benefit students of all ages and successful in a variety of settings. Furthermore, it can enrich the curriculum and improve educational attainment. So, the present study has tried to explore experience of PhD candidates in Medical Education through a focus group. Data were collected from PhD students in medical education after participating in an outdoor session through a focus group which is frequently used as a qualitative approach to gain an in-depth understanding of social issues. Data were analyzed through conventional content analysis approach. Fifteen PhD candidates participated in focus group. Most of them aged above 35. The majority of them were working at Education Development Center (EDC), the rest were clinical practitioner, faculty member and people involved with educational activities. As to conventional content analysis of data, two main categories of instructional and inspirational sides of outdoor learning had emerged with three (Different physical space, Environmental distractors, and Innovative teaching method) and four subcategories (Informal communication, Attractive learning environment, inducing reflection, and making a new viewpoint) respectively. It is recommended to include the outdoor learning experience to provide situations for research and practice. It should be noted that curriculum reform might be necessary for planning the Outdoor learning environments and associated teaching learning methods.

Abstract Proper understanding of the optical function of the eye is the foundation of clinical understanding of ophthalmologists. Although teaching principals of optics has always been a part of ophthalmology residency curriculum, it seems that successful strategies other than lecture—based methods are needed to engage students and facilitate the understanding of optical principals. A collaborative team of physicists (optics Ph.D.), ophthalmologists and medical education experts designed an optics lab for ophthalmology residents to help them practically simulate different optical phenomena. The educational course consisted of 4 sessions of 90 min to practice the optical tests using the lab instruments. Each class consisted of 6–9 residents, divided into 3 groups with a fully equipped unit, and two mentors (an optics Ph.D. professor and an ophthalmology professor). A quasi-experimental design with pre-post test was used to evaluate the effectiveness of the training workshop in changing the ophthalmology residents’ optical knowledge and attitude. Thirty-five residents participated in the study. The average score of residents' performance before the workshop was 5.21 (out of 100), which increased significantly to 66.1 after the workshop. Also, the average knowledge of residents, which was measured as self-reported, increased significantly from 28.85 to 71.09. The average score of students' attitudes and interest was increased from 40.49 to 74.81. It seems that training workshops and labs are effective to bring about change in knowledge and attitude of ophthalmology residents toward optics as a new teaching strategy that would be implemented in their curriculum.

Abstract Background It is necessary to improve medical students’ legal cognitive, affective, and psychomotor skills to prevent further legal issues in the medical profession. Choosing the proper teaching and assessment methods is crucial in this matter. This study aimed to investigate the impact of teaching, learning, and assessment of medical law on the cognitive, affective, and psychomotor skills of medical students. Methods A systematic review was conducted in PubMed, Embass, and Web of Science databases, and Google Scholar search engine using MECIR and PRISMA, AMEE Guide 94 for 1980 to 2022.12.30. Nineteen articles met the inclusion criteria. MERSQI checklist was used to assess the quality of the articles, and URSEC (theoretical underpinning of the development, resources required, setting, educational methods employed, and content) used to assess the risk of educational bias. Results Internship courses called Medical Education Humanities and Society (MESH), clinical scenario design, seminars and small group discussions, web-based interactive training, legal training courses, PBL, and mind maps have been used to improve the medico-legal knowledge of medical students. MESH clerkship, simulation of a legal event, medico-legal advocacy program based on interdisciplinary education, group discussion, integration, and court-based learning used to improve student attitudes. Multidisciplinary training, small group discussions after the seminar, mock trial competition, and interdisciplinary education are used to teach psychomotor skills. All studies, except one on knowledge, reported positive effects of legal education on students’ knowledge, attitudes, and legal performance. Written assessments were used for cognitive and affective domains, while performance was assessed by OSCE, simulated court, and evaluation of patient referrals. Conclusion There are few studies to examine the cognitive, affective, and legal psychomotor skills of medical students. The texts have not yet fully explored the high level of affective and psychomotor domains, which is evidence of a gap in this sector. Recognizing that medico-legal problems are prevented through proper education and assessment, it is recommended that this area be considered a research priority and that effective educational policies are adopted.

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.

Background: Assessment of physicians’ communication skills with patients is essential to ensure effective treatment. Achieving such a goal requires the use of a valid, native, and culturally-based tool. This study aimed to design a physician-patient communication skills assessment tool and evaluate its validity and reliability among the medical students of Guilan University of Medical Sciences, Rasht City, Iran. Methods: In this cross-sectional, descriptive, and analytical study, out of 400 medical students (interns), 300 were selected by a stratified random sampling method. The initial tool with 30 items was evaluated by calculating the item impact index in the target group. Also, its ratio and content validity indexes were assessed by 10 experts’ views and factor analysis. The reliability of the research tool was confirmed by assessing the internal consistency by calculating the Cronbach alpha value. Results: Out of the 30 initial items, after calculating the item impact score index of higher than 1.5, the content validity ratio greater than 0.51, the content validity index higher than 0.79, and exploratory factor analysis,18 items remained and were considered suitable for the physician-patient communication skills assessment tool. Then, these variables were loaded considering the amount of special value greater than 1 under four factors. The reliability of the research tool was confirmed by calculating the Cronbach alpha coefficient of 0.92. The instrument was also confirmed by confirmatory factor analysis regarding its appropriate fitness indices. This study provided a proper and native instrument with 18 valid and reliable items for the assessment of physician-patient communication skills in medical students. Conclusion: The results of this study could be of interest to researchers in evaluating physician-patient communication skills in other medical sciences universities of Iran.

Background: Changing the mental structure of students and identifying creativity inhibitors are essential for academic survival and the pursuit of innovation. This study aimed to identify the inhibitory cognitive factors in medical students. Methods: This study was a directional qualitative content analysis that conducted based on scientific literature review and opinions of experts in a semiformal expert panel by using semi-structured interviews ranging from 20 to 70 minutes from February 2015 to October 2016. Seventeen talented students were interviewed and conversations were recorded with a digital voice recorder at the Exceptional Talent Development Center (ETDC). The extraction and content analysis was continuously done by listening and writing through several times. The students were in various medical disciplines, and most of them were first rank students in scientific performance and they were collaborating with ETDC. Results: The inhibition variables of creativity were classified in the four main subcategories according to the semantic relationship and after compression, these classes of inhibitory factors included: teacher-related inhibitors, teaching and assessment methods related inhibitors, student barriers and inhibitors of the university's educational system. Finally, 10 codes were extracted from the 4th categories, which were mentioned as inhibitory variables of creativity. The teachers' lack of enthusiasm with the new ideas, the lack of creativity in the academic context and the lack of motivation among the students were the main inhibitors of creativity that were extracted from interviewing with talented students. Conclusion: In this study, the most important cognitional inhibitory factors in creativity promotion were the inhibitors related to the teacher’s character and his attitude to creativity, methods of teaching and the university environment. Planning for the removal of these barriers in medical students recommended.

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.

BACKGROUND: Critical thinking is one of the goals of education. It is a criterion for academic accreditation in medical education by concentration on students' soft skills. Due to lack of basic information on critical thinking tendency in undergraduate medical program, this study aimed to determine the trend of tendency toward critical thinking of medical students in two phases: basic science (year 1) and preinternship (year 5) at Tehran University of Medical Sciences. MATERIALS AND METHODS: This longitudinal descriptive–analytic study has been conducted in two phases (2010 and 2015); all 105 medical students were selected by accessible sampling method. Years of entrance to college was the inclusion criterion. The psychometric properties of The California Critical Thinking Dispositions Inventory (CCTDI) were confirmed, and then, the instrument was completed twice by participants. Data were analyzed by SPSS: 16 using student t-test, and paired t-tests. RESULTS: There was a significant difference between genders of students (P < 0.05). Males were more disposed toward critical thinking than females. The significant increase was found between mean of truth-seeking in the second test compared to the first test; instead, the mean of inquisitiveness, analyticity and self-confidence and inquisitiveness was significantly decreased (P < 0.05). However, in other subscales, there were no significant differences between the 1st and the 5th year students (P > 0.05). The total score of the test in the second phase was lower than the first phase, which was not significant. CONCLUSION: According to the findings, there is necessary to consider the critical thinking dispositions in medical students training programs and break down the barriers. Tendency toward critical thinking seems to be as prerequisite of critical thinking skills in undergraduate medical program.

Background and Aim: World Health Organization (WHO) has prioritized cultural competence to provide high-quality healthcare and patient-centered services. Therefore, it is necessary to develop them for all organizational levels. The present study aimed to determine the validity and reliability of the Persian version of OHCC (Ontario Healthy Communities Coalition) organizational cultural competence (2005) instrument in Tehran University of Medical Sciences (TUMS). Material and Methods: In order to confirm reliability, 143 staff members (nurses and physicians) in different administrative positions working in Imam Khomeini educational Hospital, completed the questionnaire. Modified HSR toolkit for translating and adapting instrument, was used for contextualizing the questionnaire: first, two medical education experts who were proficient in English translated it. Then, the content validity of Persian version was confirmed using Lawshe method (CVR and CVI = 0.79); its internal consistency was calculated by Cronbachchr('39')s alpha coefficient (0.91). It was backward translated to compare with the original copy and was sent to experts for their approval. Construct validity was calculated by LISREL software and the result showed that the questions were fit to the domains. The KMO, calculated for this instrument, was 0.75 and α was less than 0.05. Results: Content validity was confirmed by deleting two items from the original 22-item questionnaire. Cronbachchr('39')s alpha was calculated as 0.95 following the removal of two items. Conclusion: The organizational cultural competence instrument was confirmed to be valid and reliable with 20 items in Iranian context.

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

Abstract Background One of the most frequently used assessment tools that measure the trainees’ performance in workplace is the mini-Clinical Evaluation Exercise (mini-CEX), in which an expert observes and rates the actual performance of trainees. Several primary studies have evaluated the effectiveness of mini-CEX by assessing its educational and psychometric properties. The objective of this BEME review is to explore, analyze, and synthesize the evidence considering the utility of the mini-CEX for assessing undergraduate and postgraduate medical trainees. Methods Studies reporting on mini-CEX performed in undergraduate and postgraduate medical education and providing some empirical data for mini-CEX in relation to one or more of the validity, reliability, educational impact, acceptability, and cost of mini-CEX will be included in the review. No restrictions on study design or publication date or language will be handled. To ensure comprehensiveness of our search, we will use different approaches and methods. In addition to electronic search in bibliographic databases, we will conduct forward and backward searching. We will also contact leading authors in the field of mini-CEX and will search for the gray literature. Data extractions will be done independently by two coders based on a form. If there is any discordance, a third author will resolve it. The quality assessment will be also done independently by two team members, based on critical appraisal checklists. In attempting to answer our original research questions, we will use meta-analysis or meta-synthesis. Discussion The findings of this study can be transferred to the medical education stakeholders such as administrators of medical schools, residency program directors, and faculty members. We also hope that publication of this review will encourage stakeholders who have already adopted the mini-CEX to evaluate and report its different characteristics. Lastly, we expect that we can identify gap of knowledge in this field and suggest areas for future research.

Objective: The objective of this study is to describe the process of training valid simulated patients (SPs) for assessing communication and counseling skills of pharmacy students' performance. Methods: This is a cross-sectional and correlational study. Psychometric properties of checklist and SPs' portrayals and their filling of the checklist regarding assessing pharmacy students were assessed. Five SPs who were working in the simulated patient's pool were volunteered to take part in the project, which one of the SPs failed. Three scenarios, along with corresponding checklists, were developed based on the usual medications of different diseases consisting of asthma, respiratory infections, and osteoporosis. The SPs' role-play performance was video-recorded and rated independently by two experts according to an observational rating scale to assess validity. The role-play was repeated after 1 week with the same scenario and the same doctor, to assess test-retest reliability. The inter-rater agreement between SPs and experts was determined by calculating the intraclass correlation coefficient and kappa coefficient. Findings: The four eligible SPs were all women, with an average age of 37 years. The correlation between mean scores of raters and mean scores of SPs was 0.91 and 0.85, respectively. The Pearson's correlation between mean scores of raters with SPs was 0.75. The checklists' reliability, Cronbach's alpha, was calculated to be 0.72. The measured weighted Cohen's kappa for the ratings of by each SP, and the gold standard was between 0.53 and 0.57, indicating a moderate agreement. The inter-rater reliability kappa coefficient between raters was 0.75 (P = 0.01). Conclusion: The authors have demonstrated the technique of using standardized patients to evaluate communication and counseling skills of pharmacy students. The findings indicated that trained SPs can be used as an effective tool to assess pharmacy students' communication and counseling skills.

Background: Soft skills are the key indicators of success and quality of performance in various professions, including the dental profession. The skills are the main tools for enhancing the quality of technical work in Dentistry. Hence, the aim of this study was to identify and prioritize the soft skills in dental profession. Materials and Methods: The study employed a mixed methods research. In the qualitative phase, the dental skills were identified using a semi-structured interview with faculty members and dental students. In the quantitative phase, the soft skills were prioritized with Analytical Hierarchical Process (AHP). The data analysis was using Expert Choice software. Results: The results showed that the dental profession to improve the quality of performance needs to 29 soft skills in six categories. In professional ethics, work ethics (with weight of 0.212) and responsibility (0.188); in artistic skills, handicrafts (0.616); in cognitive skills, decision-making ability (0.290) and spatial thinking (0.249); in communication skills, verbal/nonverbal communication and listening (0.266), and patience (0.240); in individual characteristics, stress management (0.381) and self-esteem (0.260); and finally, in management skills, time management (0.481) are among the most important soft skills in dental profession. Conclusion: Identify and prioritize the soft skills can help to improve the quality of performance the dental profession. Therefore, it is recommended to integrate these skills into the dentistry curriculum. Moreover, by increasing the number of studies the essential backgrounds for developing soft skills in dentistry education will be provided.

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 and Aim: InterProfessional Education (IPE) and collaboration is an inseparable part of professional team work to render efficient patient care. In addition, the readiness of medical students to take part in InterProfessional (IP) activities and considering IPE in undergraduate medical curriculum positively affects the IPE. This descriptive cross-sectional study aims to adapt the RIPLS for these contexts. Materials and Methods: Permission to translate the questionnaire was secured from its developers (Parsell and Bligh). The questionnaire was translated to Persian and its face and content validity was confirmed by an expert panel (N=10). The adapted version was distributed among a random group of senior medical students of Tehran University of Medical Sciences (N=40). Finally, Test- retest was performed and Cronbach’s alpha coefficient was applied to assess reliability and internal consistency of the instrument. The Cronbach’s alpha’s cut-off point was 0.7 in this study. Results: Experts confirmed face and content validity of the questionnaire, and it was internally consistent. The Cronbach’s alpha was 0.92. The intra-class correlation (ICC) was above 0.7 in each subscale. Conclusion: This study indicates that Farsi version of RIPLS questionnaire is valid and reliable and it can be used to assess interprofessional readiness in Iranian contexts.

Introduction: Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners. Methods: Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general. Results: The participants’ experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers’ use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME. Conclusion: Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME.

INTRODUCTION: Assessment interprofessional collaboration (IPC), in community health-care setting usually has been neglected due to the lack of standard tools and assessors. In the present study, the IPC checklist extracted from CANMEDS collaborator toolkit for teaching and assessing the collaborator role is contextualized in Iranian community healthcare. MATERIALS AND METHODS: According to CANMEDS Toolkit, an instrument extracted for IPC assessment. Using Chavez' toolkit, face and content validity were studied through two rounds of Delphi by 12 experts of TUMS. Qualitative content validity including content validity index (CVI), and content validity ratio (CVR) were assessed following watching a standard video about IPC by them. Construct validity was studied by confirmatory factor analysis through LISREL software. To check reliability, Cronbach's alpha was calculated, and the other 12 experts completed checklists in test–retest process with a 2-week interval. RESULTS: Face and qualitative content validity were confirmed using the Delphi method. CVI and CVR were calculated as 0.61 and 0.86. In factor analysis, x2/df and RMSEA were calculated as 1.363 and 0.036; CFI, IFI, GFI, and AGFI were >0.7, and hence, the construct validity was confirmed. Cronbach's alpha was 0.953 for internal consistency. Test–retest was also calculated as 0.918 indicated to confirm reliability. CONCLUSION: CANMEDS framework as an assessment tool for evaluating IPC in community health setting is not only valid and reliable in the Iranian context but also it is easy to use for respondents resulted from the rational number of items in community.

End-of-life care and protection of the patient in the near-death moments are part of a patient’s rights and the duties of the medical staff. As the beginning and end of human life are most sensitive moments, there are various religious rules associated with them. The ethical issues regarding practicing medical procedures on nearly dead patients are of particular complexity and are consistent with invaluable and profoundly religious recommendations. In addition, the purpose of medical training is to provide physicians with the knowledge and skills necessary to practice appropriately and within legal and ethical frameworks. Therefore, respecting patients’ cultural and religious beliefs is an ethically accepted principle in the health systems of different countries and is the basis of respect for human dignity. The present study used a qualitative content analysis to explain how to practice medical procedures on a dying or nearly dead patient in accordance with Islamic jurisprudential rules. It was finally concluded that according to the Islamic jurisprudential rules of “authority”, “no harm”, “necessity”, and “public interest”, procedures performed on a dying patient could be used for training purposes under certain circumstances. Nevertheless, such activities should only be done with the patient’s permission and provided they cause no unnecessary harassment, and they may take place in the absence of alternative methods.

Part one of the present study presented practical Islamic jurisprudential rules and investigated their application to performing medical procedures on nearly dead patients. It was contended that a dying patient could be used in medical education in cases where there is no alternative method, provided the patient voluntarily consents and is not offended. Part two of the present study addresses the issue by referring to the opinions of Islamic jurisprudents to find an appropriate solution to a challenging question in medicine, namely, whether clinical training of medical students on the dying person is permissible. For this purpose, istiftas (petitions or requests for a fatwa) were sent to prominent contemporary Shiite jurisprudents to solicit their opinions on the use of dying patients for medical education. After exploring the existing views, it was finally concluded that the majority of the jurisprudents allowed the practice in cases of “necessity” and provided that the principles of “no harm” and “consent” were strictly observed. All these terms are found in jurisprudential rules, and we reached the conclusion that Shiite jurisprudents considered this type of training permissible under certain circumstances and in accordance with jurisprudential rules.

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.

Background & Objective: Today using new educational strategies and methods is of great importance Using a study guide is one of these new methods of teaching and learning The aim of the present study was to evaluate the perception of lecturers and students of the School of Dentistry Tehran University of Medical Sciences Iran toward the use of a study guide Methods: In this quasiexperimental study 25 students of the School of Dentistry of Tehran University of Medical Sciences who had chosen the community dentistry course were randomly selected A study guide was given to students before their briefing session and 2 sessions in the school A questionnaire was designed in order to collect data on the perception of students toward the study guide and was used after the completion of the course The validity and reliability of the questionnaire were verified The questionnaire was also filled out by a professor of the Department of Oral Health Data was analyzed by SPSS software Results: The survey of the students and lecturers perception of the study guide showed that 765% and 86% respectively chose agree and completely agree with the use of the study guide options Conclusion: Using the study guide was rated as a suitable method thus it can be used to help students in the efficient use of training time

Introduction: Educational environment is an important determinant of students’ behavior and its elements are associated with academic achievement and course satisfaction. The aim of this study was to determine students’ expectations of the ideal educational environment. Methods: This was a qualitative study with content analysis approach. Using a theoretical sampling method, we selected eight students from Health School of Hormozgan University of Medical Sciences, studying health education, public health, environmental health, occupational health and medical entomology. To collect data, semi-structured interviews were used and continued until reaching data saturation. Qualitative content analysis was used to analyze the data. Results: Students' expectations of the ideal educational environment emerged in four main themes including school atmosphere, teaching, human aspects (with three subthemes including teachers, students, and school staff) and nonhuman aspects (with two subthemes including educational equipment and physical environment). Conclusion: Educational environment is a multidimensional issue and to achieve an ideal educational environment, educational planners should meet the students' expectations of the school atmosphere, teaching, teachers, students, school staff, educational equipment and physical environment.

Background & Objective: Educational environment is an important determinant in success of a curriculum The quality of educational environment is one of the elements of effective learning The aim of this study was designing a valid and reliable tool for assessing academic educational environment in schools of health Methods: Using a theoretical sampling method eight students and three faculty members of School of Health Hormozgan University of Medical Sciences (Iran) were interviewed and 81 items related to educational environment were extracted These items were classified in six domains including school atmosphere teaching faculty members students educational equipments and facilities and physical environment Expert panels and assessing item impact were used to determine face validity and content validity ratio and index were used to determine content validity of the tool To determine its construct validity 250 students in completed the questionnaires and confirmatory factor analysis was applied Reliability of the tool was determined by Cronbachs Alpha and intracluster correlation coefficient Results: Due to expert panel and calculating item impact and content validity ratio and index the tool items decreased from 81 to 56 The results of confirmatory factor analysis showed that all of factor loadings were significant in level of 005 Cronbachs Alpha for total items was 094 and for six domains ranged from 065 to 085 Moreover intracluster correlation coefficient for total items was 094 Conclusion: The designed tool has good validity and reliability and can be used as a suitable tool for assessing academic educational environment in schools of health

Background and Aim: Learning styles are among efficient factors in the teaching-learning process. The aim of the present study was to assess healthcare management students’ learning styles at Tehran University of Medical Sciences (TUMS). Materials and Methods: This descriptive cross-sectional study was conducted on healthcare management students selected randomly through stratified sampling (response rate = 85%). The data collection tool used in this study was Kolb learning style questionnaire (Cronbach Alpha was 0.7-0.9). The data were analyzed through descriptive and analytical tests (χ2 and t-test). Results: Most postgraduate students preferred the Accommodate Style (55.6% of PhD students and 64% of MCs students). The majority of undergraduate students, however, preferred the Convergent Style (45.67%). Conclusion: As to these students’ dominant learning styles, the results of the study emphasized the use of “teaching methods based on Role Playing and Simulation” among postgraduate students and “Problem-Based Learning” among undergraduate students.

Background and Aim: Collaboration within and between healthcare teams facilitates effective healthcare provision. Fundamental strategies in effective healthcare services focus on collaboration and teamwork. This study was an attempt to assess reliability and validity of Team STEPPS Teamwork Attitudes Questionnaire (T-TAQ) in Iranian context. Materials and Methods: This cross-sectional survey was conducted in Iran in 2012. Delphi method was applied and the questionnaire was submitted to 11 experts in 2 rounds to determine its face and content validity. Besides, it was translated and back translated to determine external validity. To estimate the reliability of the instrument, test-retest method was used. A sample of 67 medical and nursing senior students was stratified from Tehran University of Medical Sciences (TUMS). T-TAQ is a questionnaire having 30 questions in 5 themes. The obtained data were analyzed by SPSS13. Results: The content, face and external validity of the tool were approved by Iranian experts. Meanwhile, applying Cronbach's alpha, total reliability was estimated to be 0.80; moreover, the ICC turned out to be 0.8. Conclusion : Since the validity and reliability of this instrument are confirmed in an Iranian context, it can be used to measure attitude regarding teamwork in this context.

BACKGROUND AND OBJECTIVE: Applying the Best Evidence Medical Education (BEME) in real educational arena is a necessity in medical education. As to the literature, there are enough evidence; however, their application by educators and policymakers has been still failed. Therefore, this study conducted to explore the experience of educators about applying BEME in Iranian context. MATERIALS AND METHODS: Qualitative approach using content analysis method was utilized for exploring 25 participants involved with medical education in different levels, introduced the study using purposeful sampling. Data were collected through a semi-structured interview by which they answered to researcher's questions in around 45 min about how they apply evidence in their educational setting. To make more clarification, probing questions were used. Interviews were recorded and transcribed and then analyzed by coding paradigm immediately. RESULTS: Three categories were emerged as: applying different levels of evidence, substitution of evidence-based medicine for BEME, and variation of understanding BEME. The first category includes subcategories of using personal experience, textbooks, and filtered papers. The second contains lack of knowledge about BEME elements, time and motivation as well as no priority for applying available medical education evidence; and third, using different terminology and having some problems in applying process, based on individual understanding and using papers with or without modification. DISCUSSION: For effective evidence application, it is necessary to operationalize BEME terminology and overcome any ambiguity surrounded it. It is also important to suggest educators to apply the appraised evidence as well as teach them how they search and appraise evidence independently. Certainly, in the first steps, supervision and providing a proper context for BEME applications are crucial.

Distance learning is expanding and replacing the traditional academic medical settings. Managing trauma patients seems to be a prerequisite skill for medical students. This study has been done to evaluate the efficiency of distance learning on performing the initial assessment and management in trauma patients, compared with the traditional learning among senior medical students. One hundred and twenty senior medical students enrolled in this single-blind quasi-experimental study and were equally divided into the experimental (distance learning) and control group (traditional learning). All participants did a written MCQ before the study. The control group attended a workshop with a 50-minute lecture on initial management of trauma patients and a case simulation scenario followed by a hands-on session. On the other hand, the experimental group was given a DVD with a similar 50-minute lecture and a case simulation scenario, and they also attended a hands-on session to practice the skills. Both groups were evaluated by a trauma station in an objective structured clinical examination (OSCE) after a month. The performance in the experimental group was statistically better (P=0.001) in OSCE. Distance learning seems to be an appropriate adjunct to traditional learning.

Introduction: One of the most appropriate methods for needs assessment is to assess learners' needs and arrange the educational programs based on their viewpoints. The aim of this study was to determine the topics and content of Continuing Medical Education (CME) programs in five selected subjects by medical education experts and target group, based on the real needs of General Practitioners (GPs) in order to revise CME national programs. Methods: In this cross-sectional applied study, 700 GPs covered by Medical Sciences Universities in Tehran province were studied. A questionnaire consisting of two parts of demographic features and 80 scientific questions regarding their knowledge in five domains of clinical pharmacology, skin diseases, toxicology, emergencies, and forensic medicine was used. The questionnaires were delivered to physicians' offices by trained personnel using a list or by direct referral to offices and then gathered. Three topics in each subject and 15 standard educational contents in total were developed for the target group. Results: There was almost a complete relationship between the opinion of experts and target group in forensic medicine. Some of the first five priorities of the two groups overlapped in skin diseases, forensic medicine, and emergencies. No common viewpoints were observed between experts and target group in pharmacology. In toxicology, there was no common viewpoint in the first three selections of the two groups. Conclusion: Real educational needs of GPs in receiving new information in order to promote their competencies and knowledge were different from those considered by experts. It is recommended to design the educational content for the target groups in the health care field based on their real deficiencies in knowledge and practice and by assessing their views and knowledge.

Introduction: Evaluating the knowledge and practice of newly graduated midwifery students can reflect to some extent the results of midwifery educational planning. This study was done to assess knowledge and practice of newly graduated midwives in Normal Vaginal Delivery (NVD) in hospitals affiliated to Medical Sciences Universities in Tehran. Methods: In a survey study, all newly graduated midwives (n=30) employed in hospitals affiliated to Med-ical Universities in Tehran and graduated in the past two years were selected through census sampling method. A self-administered questionnaire containing 40 multiple-choice questions for measuring knowledge was completed by midwives. Then the practice of midwives while performing normal vaginal delivery and episiotomy was observed using a 109 item checklist. The data was analyzed by SPSS software using freque-ncy distribution, mean and standard deviation. Pearson Correlation Coefficient was used to measure the correlation between knowledge and practice scores, and age and experience of midwives. Results: Most of the subjects had an average knowledge (90%) and desirable practice in all stages of NVD including first stage (60%), second stage (73.3%) third stage (73.3%) and forth stage (60%). In immediate care of the new born 86.7% and in episiotomy 80% had a desirable practice. Conclusion: This study showed that graduated midwives were competent enough to perform a safe normal vaginal delivery.

Introduction. In the current educational system, considering the economic aspects and rational utilization of manpower is essential. In this respect, identifying educational needs, determining priorities and latest educational methods in Continuing Medical Education (CME) programs can provide the opportunity for optimum use of limited available resources. The aim of this study was to determine the educational priorities, effective educational methods and appropriate type of CME activities for general surgeons with respect to their viewpoints in Tehran University of Medical Sciences in the year 2002. Methods. A cross-sectional survey was carried out. The data collection tool was a self administered questionnaire whose validity was confirmed through content validity and its reliability by test-retest. Using census sampling method, 143 surgeons who had participated in CME Programs and received the final certificate, filled the questionnaires. The data analysis was performed by SPSS-9 software using frequency distribution. Results. The most important educational priority was new methods of surgery (25.4%), and the most preferred educational method was lecture accompanied by question and answer (57.3%). Most surgeons preferred the length of the program to be less than three days (61.5%). Conclusion. The new methods of surgery which was mentioned as the first educational priority, is related to their job requirement. Lecture accompanied with question and answer was determined as their preferred educational method which could be due to insufficient knowledge about other educational methods. Therefore, it is recommended to use other educational methods in future CME programs and perform more composed programs compared to other educational programs.

Among the various methods of clinical teaching, rounds and grand rounds are considered as the gold standards. Clinical round includes some standard components and it plays an effective role in student's learning process. The aim of this study was to evaluate the content of teaching rounds in 40 clinical wards in 4 medical teaching hospitals affiliated to Tehran University of Medical Sciences in Tehran, Iran, and also to assess the learners benefit rate from these programs and determine the factors affecting those. This is a cross sectional, descriptive and analytical study conducted on 318 medical learners in different grades, about the content of clinical rounds. The data collection tool was a questionnaire made by researchers. The validity of the questionnaire according to experts opinions and the reliability with a pilot study conducted on 30 cases were confirmed (α=0.826). Data entered into the SPSS software and for analysis Chi-square, Student's t-test, ANOVA and linear regression analysis tests were used. In this study 20 subjects related to clinical rounds content were assessed. The highest score was related to the subject of diagnosis and the lowest one was related to legal issues. Overall, the mean score of the learner's benefit rate to this method was 3.52 out of five. The level of learner's benefit rate was above the average and the benefit rates according to educational grade, number of the students and faculties were significantly different (P