A new practical approach using TeamSTEPPS strategies and tools: - an educational design.

BACKGROUND: Teamwork has played a critical role in ensuring patients' safety and preventing human errors in surgery. With advancements in educational technologies, including virtual reality, it is necessary to develop new teaching methods for interpersonal teamwork based on local needs assessments in countries with indigenous cultures. This study aimed to design and develop a new method of teaching teamwork in cesarean section surgery using virtual reality; we further evaluated the effects of this method on healthcare professionals' knowledge and attitudes about teamwork. METHODS: This study was designed using the ADDIE instructional design model. The TeamSTEPPS Learning Benchmarks questionnaire was used to assess the educational needs of 85 participants who were members of the cesarean section surgery team. A specialized panel analyzed the extracted needs, and the scenario was compiled during the design stage. Finally, four virtual reality contents were created using 360-video H.265 format, which were prepared from specified scenarios in the development of the educational program. The TeamSTEPPS Learning Benchmarks questionnaire was used to measure knowledge, and the T-TAQ was used to measure the participants' attitudes. RESULTS: Six micro- skills were identified as training needs, including briefing, debriefing, cross-monitoring, I'M SAFE checklist, call-out and check-back, and two-challenge rule. Intervention results showed that the virtual reality content improved teamwork competencies in an interprofessional team performing cesarean section surgery. A significant increase was observed in the mean score of knowledge and attitude after the intervention. CONCLUSION: Through addressing the need for teamwork training, utilizing the TeamSTEPPS strategy, and incorporating new educational technologies like virtual reality, the collaboration among surgical team members can be enhanced.

Testing adaptation and psychometric properties of survey instrument for students' perspectives on e-professionalism and social media in Iranian students: Corona crisis and medical education.

BACKGROUND: The use of social networks in the field of education has also accelerated and has become a powerful source of learning for transformation and empowerment in various fields. This study aimed to test the adaptation and psychometric properties of an instrument for students' prospective on e-professionalism in the use of social media in Iranian medical science students. MATERIALS AND METHODS: In this questionnaire, with the aim of psychometric properties of the perception toward social media in Iranian students, this survey instrument developed by (Ness et al.) in five fields in 2nd-year pharmacology students in Purdue University The fields include accountability, hiring decisions, profile editing, professionalism, and privacy settings. In this study, first, a cultural adaptation was done by an expert panel. Then, psychometric properties of an instrument by content validity and construct validity using explanatory factor analysis were performed. Reliability was assessed by test-retest and internal consistency of items. The reliability of the survey instrument with three factors was 0.82 using the test-retest, and the internal consistency was good (r = 0.94). RESULTS: The result of psychometric properties using the principal component method extracted three factors (accountability, hiring decision, and professionalism) to assessment of students' attitude to professionalism using social media in Iranian students. CONCLUSION: The adapted and psychometric properties of the instrument developed by Ness et al., 2013, with three dimensions and ten items proved to be a valid, reliable instrument for use for assessing perspectives on e-professionalism and social media in Iranian medical students. This questioner may be suitable for Iranian researches in medical education.

Effectiveness of ethics case based on blended learning approaches on medical students' learning: A quasi-experimental study.

BACKGROUND: The use of active teaching methods in ethics education, instead of being merely teacher centred, can lead students to problem-solving in a practical way. Therefore, this study was conducted with the aim of comprehensive medical ethics education based on educational approaches and the effect of this approach on students' learning and moral reasoning skills. MATERIALS AND METHODS: This quasi-experimental intervention study was performed on seventy physiopathology medical students who had taken the medical ethics course. The students' educational program included teaching theoretical concept of medical ethics, discussing ethical cases and clinical reasoning in class, and then discussing in forum environment and individual assignments in the learning management system (LMS) system and completing the portfolio. Student evaluation was associated students' knowledge, attitu de, and moral reasoning skills and learning. A comprehensive program including forum participation, individual assignments in LMS, theory and objective structured clinical examination (OSCE) tests, and portfolio completion was used to evaluation of students. The students' learning was compared to students of the previous year, which was conducted through a traditional teacher-centered method. Data analysis was conducted using IBM® SPSS® Statistics 21 at two levels of descriptive statistics and analytic statistics. RESULTS: The results showed that there was a significant difference between the mean learning of students compared with traditional class (P < 0.05). Furthermore, comparison of students' practical scores through the OSCE test showed its impact on changing students' knowledge, attitude, and performance in moral reasoning. CONCLUSION: According to research findings, it seems that the mentioned model is one of the important and new issues as a suitable method of teaching medical ethics. Furthermore, it can be suitable model in other medical courses. The more research in multicentral may be need to assess other effects on students' learning indicators.

E-professionalism in medical sciences: A Hybrid Concept Analysis.

BACKGROUND: Professionalism is one of the most important and vital concepts in the medical sciences. With the rapid growth of e-learning in the medical sciences in the past few years, the concept of virtual professionalism has emerged. This study was conducted as a hybrid concept analysis on describing e-professionalism in medical sciences. MATERIALS AND METHODS: This is a qualitative study with a hybrid concept analysis approach, consisting of theoretical stage, field research, and analysis. In the theoretical stage, the concepts of e-professionalism in medical sciences were identified through a review of the literature. During the fieldwork stage, in-depth interviews were conducted with five medical students who were intentionally selected. Finally, after analyzing the literature and the qualitative interviews, a theoretical description of e-professionalism concept in the field of medical sciences was extracted. RESULTS: the themes (3 numbers) and the subthemes (4 numbers) were extracted from 62 codes. These themes include information and communion technology and educational strategies professionalism in medical education. CONCLUSIONS: For describing professionalism, it is necessary to consider education and culture, role models, by emphasizing on the acceptance of professional responsibility, developing and improving social media policies, determining the scope of communication and interaction between individuals, and identifying the boundary between local laws and customs.

Development and validation of a questionnaire for professionalism in cyber users in medical sciences in Iran.

BACKGROUND: Considering the importance of virtual professionalism and professional ethics in medical sciences, and the necessity to pay attention to this issue and its impact on medical professionalism, this study aimed to build a professional culture questionnaire in a virtual environment for students of medical sciences in Iran. MATERIALS AND METHODS: This is an exploratory, sequential, mixed-methods research which was conducted in three sections. In the first section, the concept of e-professionalism in medical sciences was analyzed using the hybrid concept analysis in the theoretical work, field work, and final analysis stages in order to extract information related to the concept. In the second section, an item of the questionnaire was designed based on the concept, reviewed texts, and related questionnaires, in the third section, psychometric properties of a questionnaires were evaluated. RESULTS: Totally, 39 items were included in the initial pool, which reduced to 33 items in the final questionnaire after reviewing the psychometric properties. Factor analyses led to extraction of five factors including appraisal of e-professionalism compliance with the laws and regulations governing cyberspace, individual professionalism, knowledge management, respect for professionalism in interpersonal and group rules, and complying with ethics in the use of cyberspace. The internal consistency of questionnaire was also confirmed by Cronbach's alpha coefficient of 0.78, also all factor correlations absed stability were significant (P < 0.05). CONCLUSION: An exploratory sequential study in this study led to the extraction of five factors and development of a 33-item questionnaire in e-professionalism. As results and analysis of the psychometric properties and validation of each item, this questionnaire is valid and reliable for the assessment of levels of e-professionalism in medical sciences in Iran.

Psychiatry gamification from blended learning models and efficacy of this program on students.

BACKGROUND: New gamification technology with a detailed understanding of the goals and prospects, and with the help of game elements and techniques, leads to promotion of motivation and participation, and ultimately behavior change. Therefore, this study aimed to evaluate the implementation of a mental gamification from blended learning based on the flex model and efficacy of this program on students. METHODS: In this study, with the design of mental illness lessons for undergraduate and executive groups, using flex model, two parts of technical and educational design were used. In the technical section, three parts on dynamics, mechanisms, and elements of gaming were considered. Intervention was studied on different groups of medical students including medical, health, and laboratory sciences. Effect of this educational program and its impact on their students' learning, motivation, and satisfaction was studied using quantitative and qualitative analyses. RESULTS: The results of the students' prospective about the efficacy of the method showed that the mean scores of most of the items were higher than the average. This implies that students' attitude toward using gamification was positive. In the other part, the qualitative results of the study were analyzed and the students' analysis of their advantages and disadvantages and their perceptions on the impact of the intervention was examined. CONCLUSION: Based on the flex model, mental gamification based on blended learning is effective in shaping the students' satisfaction.

Reflection on the future of medical care: Challenges of social accountability from the viewpoints of care providers and patients.

INTRODUCTION: Clearly, there are some challenges and difficulties in fulfilling social accountability which should be identified and dealt with in order to reach the ultimate goal. The main objective of this study was to identify the challenges associated with social accountability. METHODS: In this qualitative study, focus groups and in-depth semi-structured interview were used to obtain the opinions and experiences of 35 people with 4 focus groups of students, faculty members, patients and their companions in Jahrom University of Medical Sciences. Purpose-based sampling was performed. The participants asked "What is social accountability?" And then it continued with the more specific question, i.e. "What factors increase or decrease social accountability?" After identifying the categories and sub-categories, conventional content analysis was used to analyze the data. RESULTS: Overall, 97 codes were extracted from the text and five main categories were revealed: notification, sense of responsibility, practical education, and professional status and ethics. CONCLUSION: Since there are numerous challenges in the field of social accountability, it is essential that we understand the challenges and barriers and take effective steps to implement reforms.

The effect of web quest and team-based learning on students' self-regulation.

INTRODUCTION: In this study, the authors aimed to examine the effects of cooperative learning methods using Web Quest and team-based learning on students' self-direction, self-regulation, and academic achievement. METHOD: This is a comparative study of students taking a course in mental health and psychiatric disorders. In two consecutive years, a group of students were trained using the WebQuest approach as a teaching strategy (n = 38), while the other group was taught using team-based learning (n=39). Data gathering was based on Guglielmino's self-directed learning readiness scale (SDLRS) and Buford's self-regulation questionnaire. The data were analyzed by descriptive test using M (IQR), Wilcoxon signed-rank test, and the Mann-Whitney U-test in SPSS software, version 13. p<0.05 was considered as the significance level. RESULTS: The results of the Mann-Whitney U test showed that the participants' self- directed (self-management) and self-regulated learning differed between the two groups (p=0.04 and p=0.01, respectively). Wilcoxon test revealed that self-directed learning indices (self-control and self-management) were differed between the two strategies before and after the intervention. However, the scores related to learning (students' final scores) were higher in the WebQuest approach than in team-based learning. CONCLUSION: By employing modern educational approaches, students are not only more successful in their studies but also acquire the necessary professional skills for future performance. Further research to compare the effects of new methods of teaching is required.

Attitudes About Sexual Activity Among Postmenopausal Women in Different Ethnic Groups: A Cross-sectional Study in Jahrom, Iran.

BACKGROUND: Sexual function is affected by personal and interpersonal factors, familial and social traditions, culture, religion, menopause, and aging. So, ethnicity is a determining factor in sexual function. The present study aimed to investigate the prevalence of sexual dysfunction and attitudes towards sexuality in postmenopausal women among three different ethnic groups in Iran. METHODS: This cross-sectional study was conducted on 746 postmenopausal women between 50 and 89 years who referred to Honoree clinic, Jahrom in 2013. Among the study participants, 42.4% were Arab, 33.5% were Persian, and 24.1% were Lor. Data were collected about women's socio-demographic characteristics, attitudes regarding sexuality and sexual function. The descriptive statistics were used for demographic variables. Moreover, ANOVA, post hoc (LSD) was used. Besides, p<0.05 was considered statistically significant. RESULTS: The participants' mean age was 60.10±6.89 years and the total mean score of Female Sexual Function Index (FSFI) was 19.31±8.5. In addition, 81.5% of the women had sexual dysfunction (FSFI <26.55) and only 147 women (18.5%) had normal sexual function (FSFI >26.55). Sexual dysfunction was 75.3% in Arabs, 83.2% in Persians, and 86.1% in Lors. Besides, the most prevalent sexual dysfunction was dyspareunia in Arabs and arousal disorder in Persians and Lors. CONCLUSION: The results of this study showed that sexual dysfunction is considerable among postmenopausal women. The most prevalent sexual dysfunction was dyspareunia in Arabs and arousal disorder in Persians and Lors.

A Study of Couple Burnout in Infertile Couples.

INTRODUCTION: Infertility is a major crisis that can cause psychological problems and emotionally distressing experiences, and eventually affect a couples' relationship. The objective of this study is to investigate couple burnout in infertile couples who were undergoing treatmentat the Infertility Clinic of Yazd, Iran. METHOD: The present study is a cross-sectional descriptive one on 98 infertile couples referringto the Infertility Centerof Yazd, Iran, who were chosen on a simple random sampling basis. The measuring tools consisted of the Couple Burnout Measure (CBM) and a demographic questionnaire. The collected data were analyzed using SPSS 16 and the statistical tests of ANOVA and t-test.P-values less than 0.05 were considered as significant. RESULTS: The results show that infertile women experience higher levels of couple burnout than their husbands (p<0.001). Also, a comparison of the scales of couple burnout--psychological burnout (p<0.01), somatic burnout (p<0.01), and emotional burnout (p<0.001)--between wives and husbands show that women are at greater risk. CONCLUSION: Infertile couples' emotional, mental, and sexual problems need to be addressed as part of the infertility treatment programs, and psychotherapists should be included in the medical team.

Factors affecting professional ethics in nursing practice in Iran: a qualitative study.

BACKGROUND: Professional ethics refers to the use of logical and consistent communication, knowledge, clinical skills, emotions and values in nursing practice. This study aimed to explore and describe factors that affect professional ethics in nursing practice in Iran. METHODS: This qualitative study was conducted using conventional content analysis approach. Thirty nurses with at least 5 years of experience participated in the study; they were selected using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. RESULTS: After encoding and classifying the data, five major categories were identified: individual character and responsibility, communication challenges, organizational preconditions, support systems, educational and cultural development. CONCLUSIONS: Awareness of professional ethics and its contributing factors could help nurses and healthcare professionals provide better services for patients. At the same time, such understanding would be valuable for educational administrators for effective planning and management.

The effects of case-based team learning on students' learning, self regulation and self direction.

INTRODUCTION: The application of the best approaches to teach adults in medical education is important in the process of training learners to become and remain effective health care providers. This research aims at designing and integrating two approaches, namely team teaching and case study and tries to examine the consequences of these approaches on learning, self regulation and self direction of nursing students. MATERIAL & METHODS: This is a quasi experimental study of 40 students who were taking a course on mental health. The lessons were designed by using two educational techniques: short case based study and team based learning. Data gathering was based on two valid and reliable questionnaires: Self-Directed Readiness Scale (SDLRS) and the self-regulating questionnaire. Open ended questions were also designed for the evaluation of students' with points of view on educational methods. RESULTS: The Results showed an increase in the students' self directed learning based on their performance on the post-test. The results showed that the students' self-directed learning increased after the intervention. The mean difference before and after intervention self management was statistically significant (p=0.0001). Also, self-regulated learning increased with the mean difference after intervention (p=0.001). Other results suggested that case based team learning can have significant effects on increasing students' learning (p=0.003). CONCLUSION: This article may be of value to medical educators who wish to replace traditional learning with informal learning (student-centered-active learning), so as to enhance not only the students' knowledge, but also the advancement of long- life learning skills.

Integrated method of teaching in Web Quest activity and its impact on undergraduate students' cognition and learning behaviors: a future trend in medical education.

INTRODUCTION: Web Quest is one of the new ways of teaching and learning that is based on research, and includes the principles of learning and cognitive activities, such as collaborative learning, social and cognitive learning, and active learning, and increases motivation. The aim of this study is to evaluate the Web Quest influence on students' learning behaviors. MATERIALS & METHODS: In this quasi-experimental study, which was performed on undergraduates taking a psychiatric course at Jahrom University of Medical Sciences, simple sampling was used to select the cases to be studied; the students entered the study through census and were trained according to Web Quest methodology. The procedure was to present the course as a case study and team work. Each topic included discussing concepts and then patient's treatment and the communicative principles for two weeks. Active participation of the students in response to the scenario and introduced problem was equal to preparing scientific videos about the disease and collecting the latest medical treatment for the disease from the Internet.Three questionnaires, including the self-directed learning Questionnaire, teamwork evaluation Questionnaire (value of team), and Buffard self-regulated Questionnaire, were the data gathering tools. RESULTS: The results showed that the average of self-regulated learning and self-directed learning (SDL) increased after the educational intervention. However, the increase was not significant. On the other hand, problem solving (P=0.001) and the value of teamwork (P=0.002), apart from increasing the average, had significant statistical values. CONCLUSIONS: In view of Web Quest's positive impacts on students' learning behaviors, problem solving and teamwork, the effective use of active learning and teaching practices and use of technology in medical education are recommended.

Increasing and decreasing factors of hope in infertile women with failure in infertility treatment: A phenomenology study.

BACKGROUND: Assisted reproductive technology (ART) provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. OBJECTIVE: The purpose of this study was to explore the lived experience of infertile women from increasing and decreasing factors of hope in infertile women with failure in infertility treatment. MATERIALS AND METHODS: Using a qualitative research design (Phenomenology study), 23 subjects were selected who had experienced infertility failure visited by gynecologist (Rasekh Infertility center) in 2012. The data were collected through semi structured interviews and analyzed using interpretive research strategies of phenomenology by Collizi's seven-stage method. RESULTS: Totally 96 codes were identified. The data arranged in two categories. The factors decreasing and increasing hope in infertility treatments. Totally 5 themes and 20 sub themes were extracted. The increasing factors which emerged from the data contain "spiritual source", "family interaction and support" and "information through the media", and decreasing factors contain "nature of treatments" and "negatively oriented mind".

A holistic approach to psychological sexual problems in women with diabetic husbands.

BACKGROUND: One of negative and influential factor to chronic diseases is creation of sexual problems in the couple's sexual relationship. Sexual health is one of the most important factor in Sexual and marital satisfaction. OBJECTIVE: This study aims to compare the relationship between couple burnout, sexual assertiveness, and sexual dysfunctional beliefs in women with diabetic and non-diabetic husbands. MATERIALS AND METHODS: This cross sectional descriptive study was a causal comparative one. The research plan was derived from the master's dissertation for family counseling in Shahid Beheshti University which was done during 2011-2012 in Tehran, Iran. Totally 200 participants were included in this study; 100 participants were women with diabetic husbands and the others were women with non-diabetic husbands. These participants were selected by purposeful sampling method. Data were collected using personality traits and demographic characteristics' questionnaire, couple burnout Measure, Hulbert index of sexual assertiveness and sexual dysfunctional beliefs Questionnaire. RESULTS: RESULTS of the multi-variable analysis of variance indicated that there was a significant difference between couple burnout, sexual assertiveness, and sexual dysfunctional beliefs in women with diabetic and non-diabetic husbands. Women with non-diabetic husbands had a higher mean score in sexual assertiveness factor compared to women with diabetic husbands, whereas in couple burnout and sexual dysfunctional beliefs factors, women with diabetic husbands had a higher mean score. CONCLUSION: It seems that one of the most important factors which influences and increases couple burnout, increases wrong sexual beliefs regarding sexual function, and decreases sexual assertiveness in women is their husbands' sexual dysfunction. In fact, women whose husbands suffer from chronic diseases such as diabetes (which results in sexual dysfunction) have lower sexual assertiveness and higher couple burnout and sexual dysfunctional beliefs compared with other women. This article is extracted from student thesis. (Edalat Asadi).

Menopause and crisis? Fake or real: comprehensive search to the depth of crisis experienced: a mixed-method study.

INTRODUCTION: Menopause is beyond the lack of menstruation and fertility decline in estrogen. Menopause is associated with at least three types of crisis: Biological, psychological and social. The aim of this study was to investigate psychiatric problems related to menopausal stress and experiences about psychological conditions related to menopause as a developmental crisis. MATERIALS AND METHODS: This mixed-method study (by triangulation approach) was done on 300 women in menopause age (44-54 years) by consensus sampling. Data gathering was from questionnaire conclude psychosomatic listed and hypochondria's criterion that has been specified by DSMIV. The severity of the disorder was also collected by self-reported question. In the qualitative part, as a phenomenology study, data were gathered with Purposive sampling by a deep semi-structured interview. Data analysis was from content analysis). RESULTS: Results showed that most of the disorders from psychosomatic listed experienced by women conclude: sexual problems 101(33.7%), hypertension 39(13%), and constipation 30(10%); 2.9% had experienced hypochondrias disorder. In the qualitative part, 5 themes were driven from the results of this study which described the structures of psychological experiences of the menopause as follows: change in emotion and mood, change in attitude, change in self-concept and change in interpersonal relationships. CONCLUSION: Menopause is a physiological process in women's life, but due to many symptoms and complications, it requires culturally appropriate education, appropriate coping with problems and mental health promotion in this sexual crisis.

Barriers to infertility treatment: an integrated study.

BACKGROUND: Infertility is one of the most important events in life. Despite the negative impact of infertility, a significant number of women struggling to conceive do not consult a physician and do not fallow up infertility treatment. This integrated study aimed to investigate a large amount of factors which influenced discontinuation of infertility treatment. METHODS: This integrated study (qualitative - quantitative study) was done on infertile women who had referred to infertility center in Jahrom University of medical sciences using purposive sampling. In the first study, data were collected from a valid questionnaire with 22 questions in a 5-point likert scale about barriers to infertility treatments and in the second study, as a phenomenology approach, data collection was done using deep unstructured interviews and focused groups were aimed to identify deep individual experiences about it. RESULTS: major barriers to infertility treatments included the probability of treatment failure (52.5%), couple's age and possibility of high risk pregnancy (51.5%), Painfulness of some treatment methods such as laparoscopy (50.5%). Qualitative results led to the identification of three main themes: Nature of treatment, negative thinking, social and cultural factors. CONCLUSION: As a result, we suggest family education and enrichment of cultural context in the field of infertility; infertile people would be willing to pursue infertility treatments.

Therapeutic vaccines: hope therapy and its effects on psychiatric symptoms among infertile women.

Infertility is a life crisis which leads to serious psychological problems. The present study aims to investigate the effects of hope therapy as a psychological intervention on psychological distresses among infertile women. The present study was an experimental one. The study population included infertile women referring to gynecology clinics. Women who lived in Jahrom and could take part in psychotherapy sessions, had no chronic physical or mental disorders, suffered from primary infertility, had infertility unknown causes and had no history of miscarriage and stillbirth were selected through convenience sampling method and were divided into control and intervention groups (n=61). Women in the intervention group participated in eight 2-hour sessions for a period of 2 months. Study results revealed that there was a significant difference between the two groups after the intervention. Besides, there was a significant difference between the two groups through paired T-test (p<0.05). Furthermore, results of ANCOVA showed that after eliminating demographic variables, the intervention was effective in the total mean difference of the study groups. It means that the difference between the two groups was resulted from intervention.Hope therapy as a positive psychological approach can improve infertile women's general health and subsequently improve family's health. Therefore, in addition to assisted reproductive techniques, hope therapy is recommended to be presented to infertile people in order to improve the quality of their life and help them adapt with their problems.

Blood glucose levels, insulin concentrations, and insulin resistance in healthy women and women with premenstrual syndrome: a comparative study.

OBJECTIVE: To compare the blood glucose levels, insulin concentrations, and insulin resistance during the two phases of the menstrual cycle between healthy women and patients with premenstrual syndrome (PMS). METHODS: From January of 2011 to the August of 2012, a descriptive cross-sectional study was performed among students in the School of Medicine of Jahrom University of Medical Sciences. We included 30 students with the most severe symptoms of PMS and 30 age frequency-matched healthy controls. We analyzed the serum concentrations of glucose, insulin, and insulin resistance by using the glucose oxidase method, radioimmunometric assay, and homeostasis model assessment of insulin resistance equation, respectively. RESULTS: No significant differences between the demographic data of the control and PMS groups were observed. The mean concentrations of glucose of the two study groups were significantly different during the follicular and luteal phases (p=0.011 vs. p<0.0001, respectively). The amounts of homeostasis model assessment of insulin resistance of the two study groups were significantly different in the luteal phase (p=0.0005). CONCLUSION: The level of blood glucose and insulin resistance was lower during the two phases of the menstrual cycle of the PMS group than that of the controls.