Instructional design, delivery, and evaluation of interactive case-based e-CME contents

Background and purpose: Studies have shown the advantages of e-CME programs. Developing case-based e-CME activities, which is a popular format of e-CME programs, is difficult and time-consuming. In this article, we have discussed our experience in designing instructional system for creating case-based e-CME contents

Methods: We designed the instructional system in five steps [i.e., system analysis, design, development, delivery, and evaluation] to create e-contents. We held several sessions with subject experts to analyze the system. Then, we determined the contents' framework and created a plan for faculty members' development and incentives. In the development phase, we held workshops for faculty members and trained e-learning advisors who were to help faculties create contents. Incentives were legitimized. Then, we delivered programs to the learners who would fill a program evaluation questionnaire after completing the study of each program

Results: A total of 20 e-CME programs were developed and delivered to the learners and a total of 3644 learner-programs were studied. The cases rated the programs as 4.56 [SD=0.65] on a 1-5 Likert-type scale

Conclusions: Results showed that the learners rated this learning activity highly. However, we faced some challenges in developing the contents. In future, designing a comprehensive instructional system would help overcome these barriers

[ relationship between Sidedness, communicative function and educational state in autistic students]

Difficulties in sidedness of autistic students and their defected language and communication function can be in relationship with their educational state. This research was designed to investigate the possible relationship among sidedness, communicative function and educational state in autistic students. This is a described-analytic research and a kind of cross sectional and comparative one. For these purpose 40 autistic students with age average 10 years old and 8 months [SD=2.5] were chosen. Communicative function questionnaire were completed by all subjects parents. We used observation check list to examine handedness, footedness, and dominant eye and ear. Using of T-test, covariance analysis data were analyzed. Data analysis indicated that there is not significant statistically difference between communicative function and educational state [p<0.05], but participants with weak educational state less tend to definite sidedness preference-in hand and foot not in eye and ear [p>0.05]. These findings reveal that stability of sidedness, which obtains with interventions rehabilitation in autistic students, can perform important role in high language skills and appropriate educational state for them

[Attitudes of nursing and midwifery school's faculty toward blended E-learning at Tehran University of Medical Sciences]

Blended E-Learning is an educational method which has been used recently in higher education worldwide. So, it seems that it is crucial for the Iranian academic members to accept it as a new educational method. This study was conducted to investigate attitudes of the faculty of Nursing and Midwifery School at Tehran University of Medical Sciences toward blended E-learning. In this cross-sectional study, all faculty members of Tehran University of Medical Science [n=60] were recruited to the study. Data were gathered using validated and reliable self-designed questionnaires. The collected data were analyzed using SPSS software. The response rate was 93.33% [n=56]. Most of the respondents [85.7%] were female. The mean age was 44.88 [SD=5.6]. The years of teaching ranged from 5-30 years [mean=16.75]. The majority of the respondents [66%] had positive attitude toward blended e-learning; thirty four per cent had completely positive attitude and none of them had negative attitudes. About 41% reported that they were eager to provide their course syllabuses according to this approach and 87.5% said that they were willing to attend the blended e-learning education workshops. There were no significant relationships between demographic variables and the attitudes. There was a significant relationship between willing to attend the workshops and positive attitude toward blended e-learning [P=0.012]. According to the positive attitude of the respondents toward blended e-learning, it is recommended that further studies take place in order to design and implement the approach in formal education in the school of Nursing and Midwifery of Tehran University of Medical Science

[Satisfaction of student and faculty members with implementing blended-e-learning]

Blended-E-Learning system utilizes various methods and advanced technology to improve learning quality. This study aimed at assessing students' and faculty members' satisfaction with blended-e-learning system which was developed within some courses in School of Nursing and Midwifery of Tehran University of medical Science. The study was carried out using a descriptive-comparative method. Volunteer teachers [n=17] in different programmes [BS, MS and PhD] designed their courses appropriate with blended-e-learning system. In total, 22 courses [45 credit points] of bachelor, master and PhD in Nursing as well as bachelor and master in Midwifery were presented through blended-e-learning system in first semester of educational year, 2008-2009. A self-constructed questionnaire of satisfaction was used the collect the data at end of the semester. All statistics were computed through the SPSS software [version 16] using descriptive [frequency, percentages] and non-parametric statistical tests [Wilcoxon test]. A total of 181 students answered the questionnaire [with a response rate of 88.2%]. 67.4% students were highly satisfied with the system while 24.3% were dissatisfied. Students' satisfaction was assessed within four domains of structure and practical issues; learner related issues; curriculum and content related issues and learner support related issues. Among faculty members, 88.2% were well satisfied with teaching in blended-e-learning system. Both students and faculty members preferred blended-e-learning system to conventional method [P<0.0001]. Considering the learning flexibility of blended-e-learning system and provided opportunity in taking advantages of face to face and electronic education, both which resulted learners and teachers' satisfaction, the study recommends blended-e-learning system as an effective method of education to be used in universities of medical sciences in the country. It's suggested to pay specific attention to enhance the interaction and motivation in blended-e-learning education

[Report of the frequency of normal renal vascular variants in 62 patients by use of abdominal CT angiography]

In most individuals, each kidney is supplied by a single renal artery and a vein, however multiple renal arteries and veins is not uncommon. In comparison to conventional angiography computed tomographic [CT] angiography is a new and less aggressive measure used for detection of normal renal vascular anatomy and diagnosis of vascular variants. To evaluate the frequency of normal vascular variants in 62 patients [124 Kidneys], underwent abdominal CT Angiography [Aortography]. During a period of one year, abdominal CT angiography was performed in 62 patients, 48 male and 14 female between 7-74 years of age [Mean 25.68 years]. The angiographic images were studied after being reconstituted by use of a computer. There was no complication and all patients tolerated the procedure without any reaction and/or discomfort. One forth of the patients felt some warmness during contrast injection. In 98 [79%] kidneys only one renal artery, in 20 kidneys [16.1%] two arteries, in 4 kidneys three arteries, and in two kidneys four arteries were detected. In 109 kidneys [88%] only one vein and in 15 kidneys [12%] two renal veins were detected and circum-aortic renal vein or renal collar was found only in one case. In this study the frequency of multiple renal vascular variants was less common than those of other studies. By use of spiral CT angiography and reconstitution of images by a computer, renal arteries and veins can be investigated in a short time avoiding invasive sequela or any complication for the patients

Wandering spleen presenting as an asymptomatic pelvic mass: a case report

Ectopic spleen is a rare entity. It is more common in children than in adults and it is about 15 times more common in females. Here we report a patient with an ectopic spleen who was referred for sonographic evaluation of an asymptomatic pelvic mass by a gynecologist. At sonography, a big homogenous mass located at the RLQ of the abdomen and the right pelvic cavity was detected. Further investigation by color Doppler sonography showed that the mass is an ectopic spleen and the main spleen could not be detected at its normal location. In the abdominopelvic CT scan, the spleen was located at the RLQ, no splenic tissue was found in the left hypochondrium, and this region was occupied by the left colon and stomach. Ectopic spleen, though very rare, should be considered in the differential diagnosis of asymptomatic pelvic masses

Primary hydatid cyst of the breast: a case report

Cystic hydatid disease is caused by the parasite Echinococcus granulosus. The breast is a rare primary site of hydatid disease that accounts for only 0.27% of all cases. The cyst is usually asymptomatic and should be included under differential diagnosis of a breast lump, especially in endemic areas of this disease. Herein, we described the biopsy-proven case of a 46-year-old woman with primary hydatid disease of left breast

[Extra-cranial carotid artery disease in patients with chest pain]

The usual course of coronary artery disease [CAD] can be complicated when it is accompained with cerebral accidents. Objective of this article is to evaluate the frequency of cerebral vascular involvement in these patients, and to study the correlation between the severity and extent of the disease in coronary and carotid arteries. After performing a coronary angiography in 107 patients complaining of chest pain [63 Male/44 Female, average age of 56.62 and SD=12.23 years], carotid arteries were studied by gray scale, color and spectral Doppler ultrasound scanning for intima-media thickness, atherosclerotic plaque and lumen stenosis in their cervical course. There was single coronary artery stensosis [SVD] in 21 cases [19.6%], two-vessel stenosis [2VD] in 14 [13.1%] and left main stem [LMS] or three-vessel involvement [3VD] in 37 cases [34.6%]. There was concomitant carotid involvement in 54 of these patients, 46 of them [43%] having less than 60% and 8 patients having equal or more than 60% carotid stenosis. 66.7% of patients with CAD showed evidences of carotid artery disease as well, but in patients without CAD there was sonographic evidences of carotid artery disease in only 17.1%. [P=0.000]. Carotid artery disease was detected in 52.4% of patients with SVD and in 78.6% of patients with 2VD and in 70.3% of patients with 3VD. In patients with normal coronary angiography there was only 5.7% carotid involvement. In this study we found a strong correlation between the presence and the extent of CAD and carotid artery disease in our patients. Our study confirms a relatively high frequency of carotid artery disase in patients suffering from CAD and a great correlation between the sever coronary artery disease and significant carotid disease. According to these results, carotid sonography can be recommended as a method of evaluation before reconstruction of coronary artery in patients suffering from widespread coronary involvement

Sonographic evaluation of the relationship between rheumatoid arthritis and renal stones

Considering the different renal manifestations of rheumatoid arthritis [RA], we carried out this study to investigate the prevalence of renal stones in patients with RA compared to general population. From January 2000 to March 2001, 74 patients with RA and 58 healthy individuals as the control group were evaluated for kidney stones with sonography. All patients were diagnosed on the basis of 1987 criteria of American College of Rheumatology [ACR].1 In the group of patients with RA, 6 out of 74 subjects [8.1%] had renal stones. The prevalence of renal stones in the control group was 8.6% [5 out of 58 persons]. The difference in the incidence of renal stones in the two groups was not statistically significant. The size of renal stones in the two groups was not significantly different. We did not find any relationship between the duration of RA or its various symptoms and the incidence of renal stones. Although RA involves kidneys and in previous studies it was mentioned that the incidence of renal stones in the patients with RA is higher than general population, we did not find any significant statistical correlation between RA and the incidence of renal stones in our study