Introduction: Misalignment between postgraduate student admissions and available educational resources can compromise the quality, efficiency, and equity of training programs. In many settings, including Iran, postgraduate admission capacity at medical universities is often determined without a standardized, transparent, and evidence-based mechanism, which may result in over-enrollment, under-enrollment, and inefficient resource allocation. As demand for postgraduate education continues to grow and the determinants of educational capacity become increasingly complex, there is a critical need for systematic approaches that incorporate multiple criteria and constraints. This study aimed to develop and validate an evidence-informed model for determining postgraduate student admission capacity at Tehran University of Medical Sciences. Methods: This study was conducted in three sequential phases from 2024 to 2025. In the first phase, criteria and constraints affecting postgraduate admission capacity were identified through a comprehensive review of the literature and grey literature, along with semi-structured interviews with 22 key informants, including leaders, faculty members, and policymakers. Relevant documents in English and Persian were retrieved from four English and two Persian databases, as well as Google Scholar, through March 2024, and screened in two stages: title/abstract review and full-text assessment. Data extracted from eligible sources were analyzed using conventional content analysis. In the second phase, the identified criteria were prioritized and weighted using expert input, and a linear programming model was developed to optimize admission capacity while adhering to predefined constraints. The preliminary model was then evaluated and refined through a Delphi process involving 13 experts to ensure validity, feasibility, and policy relevance. In the third phase, the finalized model was applied in a selected faculty at Tehran University of Medical Sciences. Required data for prioritized criteria were collected from institutional sources, and the model outputs were assessed and validated through expert panel discussion. Results: In the first phase, 51 criteria and 32 constraints influencing postgraduate admission capacity were identified across domains, including human resources, infrastructure, educational processes, and regulatory requirements. In the second phase, 20 key criteria were prioritized and incorporated into a linear programming model designed to maximize admission capacity while maintaining educational quality standards. These criteria included annual intake limits for master’s and doctoral students; classroom and laboratory space; per capita standards; educational support and welfare facilities; faculty composition by academic rank; admission capacity per faculty member; availability of training environments; and departmental ranking based on national scient metric indicators. The Delphi process confirmed the relevance, clarity, and applicability of the proposed model. In the third phase, applying the model to faculty-level data yielded estimated admission capacities of 30 master’s students and 15 doctoral students across 10 academic departments. Experts considered these outputs realistic and aligned with institutional resources and priorities. Conclusion: The proposed model provides a structured, evidence-informed framework for determining postgraduate admission capacity, accounting for educational quality and resource availability. By integrating quantitative optimization techniques with expert-informed criteria, the model offers a scalable alternative to ad hoc decision-making. Its wider adoption could support more rational, equitable, and accountable policymaking and improve alignment between educational capacity and system needs in medical universities.
Introduction: The education of nurses at the doctoral level plays a pivotal role in advancing the nursing profession and improving the healthcare system. To enhance the quality of education at this level, comparing and analyzing educational systems is of particular importance. Accordingly, the present study was designed and conducted with the aim of a comparative analysis of the PhD in Nursing program in Iran with those of the Emory University School of Nursing (USA) and Khyber University (Pakistan). Methods: This descriptive-comparative study was done in the academic year 2025 by seeking relevant online resources with Persian and English keywords "PhD in Nursing", "Nursing Education", and "curriculum", through an overview of the history and components of nursing doctoral curricula in three academic systems including Iran (approved in 2016), Emory University (USA, approved in 2025), and Khyber University (Pakistan, approved in 2021). The four-stage Beredy model was used for comparative comparison. Results: Despite similarities in mission, vision, objectives, educational structure, admission criteria, and evaluation methods, the Iranian and Pakistani programs focus on responding to the needs of the healthcare system. In contrast, Emory University adopts a research-oriented, knowledge-producing, innovative, and international approach. The Iranian curriculum places less emphasis on research and innovation compared to the other two programs. Conclusion: Based on the findings of this study, a fundamental revision of the Iranian PhD in Nursing curriculum is evident. Updating the mission, vision, and program structure, as well as aligning the curriculum with the set objectives, is of great importance for improving educational quality, strengthening the research approach, and responding to the evolving needs of the healthcare system. Furthermore, moving toward specialization in Iranian PhD nursing education requires revising and designing a curriculum tailored to the expected specialized roles and competencies.
Introduction: Pharmacology and drug therapy constitute a vital and highly valued component of the nursing profession. Their effective and accurate management is not only an integral part of nurses' clinical role but also one of their direct responsibilities. Fulfilling this responsibility requires specialized knowledge, skills, and competencies. Therefore, empowering nursing students in this domain is essential for ensuring future patient safety. However, several studies have indicated that most nursing students lack the necessary proficiency in this area, and insufficient attention has been paid to the teaching and learning of pharmacology within nursing education. The present study was therefore conducted to assess the current state of pharmacology education and nursing students' level of satisfaction with it in the clinical setting. Methods: This descriptive-analytical study was conducted at Islamic Azad University, Qom branch during the first semester of the 2025–2026 academic year. A convenience sampling method was employed, and a total of 215 nursing students from the third to seventh semesters participated in the study. Data were collected using two researcher-developed instruments: a questionnaire assessing the status of pharmacology education, and a questionnaire measuring satisfaction with pharmacology education. Descriptive statistics, including frequency, relative frequency, mean, and standard deviation, were calculated for the demographic and main variables. Given the non-normal distribution of the data, non-parametric analytical tests were applied: the Kruskal–Wallis test was used to examine significant differences in the overall mean scores of each variable across academic semesters; the Spearman correlation coefficient was used to assess the relationship between the overall mean scores and age; and the Mann–Whitney U test was employed to determine significant differences in the overall mean scores based on gender and student work experience. A significance level of P < 0.05 was considered statistically significant. Results: Of the 215 participating students, 64.7% were female, and the mean age of the participants was 22.20 ± 2.54 years. The mean score for the status of pharmacology education was 2.82 ± 0.54, and the mean score for satisfaction with pharmacology education was 3.06 ± 0.77, both of which fell within the average range. Regarding the specific components of pharmacology education, most students rated the recognition of drug side effects as undesirable, while drug calculation skills were rated at an average level. In terms of satisfaction, the lowest levels were reported in relation to instructors' performance in the following areas: creating motivation to learn pharmacology and clinical drug therapy, transferring knowledge, and introducing appropriate learning resources and methods. Interestingly, students expressed greater satisfaction with their own performance compared to that of their instructors; however, both remained at an average level overall. The Kruskal–Wallis test revealed a statistically significant difference in the status of pharmacology education across academic semesters (p < 0.05). However, no significant difference was found between satisfaction scores and academic semester. Additionally, the Mann–Whitney U test showed a significant difference in satisfaction scores based on gender (p < 0.05), and the Spearman correlation coefficient indicated a significant relationship between the status of pharmacology education and age (p < 0.05). Conclusion: The moderate levels of pharmacology education status and student satisfaction observed in this study may reflect inadequate exposure to effective instructional approaches during clinical internships. However, identifying the root causes of these educational inefficiencies, reinforcing existing strengths, and addressing students' learning gaps could represent meaningful steps toward improving the overall quality of pharmacology instruction. To this end, the integration of a dedicated clinical pharmacology course into the nursing curriculum is strongly recommended. Additionally, greater emphasis should be placed on the careful selection of qualified instructors and the continuous refinement of teaching methodologies to ensure that pharmacology education is both impactful and clinically applicable.
Introduction: Medical education integrates theoretical instruction with clinical training, the latter representing a core component of medical sciences curricula. Clinical training, however, exposes students to a wide range of stressors that can adversely affect their learning, professional development, and overall well-being. Accurately identifying these stressors is essential for informing interventions that reduce stress, improve educational outcomes, support the development of competent healthcare professionals, and ultimately enhance the quality of healthcare services. Although several instruments have been developed to assess stressors in clinical education, many have important methodological and psychometric limitations. Therefore, this study endeavored to revise and evaluate the psychometric properties of the Clinical Education Stressors Questionnaire among medical sciences students. Methods: This methodological study was conducted in 2025 at Bushehr University of Medical Sciences. Following Waltz’s (2010) framework for instrument development, the present study focused on the fourth phase, namely the evaluation of the validity and reliability of the Clinical Education Stressors Questionnaire developed by Yazdankhahfard et al. The original questionnaire comprised 60 items across five dimensions: interpersonal communication, clinical experiences, educational environment, unpleasant feelings, and humiliating experiences. Face validity was assessed both qualitatively and quantitatively by ten students representative of the target population, including students of medicine, nursing, midwifery, operating room technology, and anesthesia. Content validity was evaluated qualitatively and quantitatively by a panel of ten experts in medical education and faculty members from nursing and midwifery with extensive experience in clinical teaching. To assess internal consistency reliability, the questionnaire was administered to a separate sample of 30 students representative of the population, and Cronbach’s alpha coefficients were calculated for each dimension and for the overall scale. Results: During the psychometric evaluation, 13 items were removed from the initial version of the Clinical Education Stressors Questionnaire: two during qualitative content validity assessment, one based on the content validity index, eight based on the content validity ratio, and two following reliability assessment. As a result, the final instrument comprised 47 items across five dimensions: interpersonal communication (14 items), clinical experiences (16 items), educational environment (5 items), unpleasant feelings (7 items), and humiliating experiences (5 items). All retained items achieved an impact score greater than 1.5. The scale also demonstrated acceptable content validity, with a content validity ratio of 0.82 and a content validity index of 0.92. Internal consistency was acceptable overall (Cronbach’s α = 0.82). The Cronbach’s alpha coefficients for the five dimensions were 0.87 for interpersonal communication, 0.86 for clinical experiences, 0.59 for educational environment, 0.76 for unpleasant feelings, and 0.91 for humiliating experiences. Conclusion: The revised questionnaire demonstrated satisfactory psychometric properties and addresses the limited availability of specialized instruments for assessing stressors in clinical education. It therefore provides a useful tool for identifying factors that contribute to stress during clinical training and for informing strategies to improve the clinical learning environment. Future research should examine the construct validity of the questionnaire to further establish the validity of its underlying dimensions. In addition, because the instrument was developed based on the perspectives of faculty members and students at Bushehr University of Medical Sciences, further validation across different universities and student populations is warranted to examine its generalizability and broader applicability.
Introduction: Classroom silence is regarded as a form of negative classroom behavior. Academic self-efficacy and fear of negative evaluation are among the influential factors associated with negative silence. This study endeavored to investigate the mediating role of fear of negative evaluation in the relationship between academic self-efficacy and negative silence among students of Ahvaz Jundishapur University of Medical Sciences. Methods: This analytical–correlational study employed structural equation modeling. From a temporal perspective, it was a cross‑sectional survey, and in terms of data collection, it was survey‑based. The population consisted of 6403 students of during the academic years 2024–2025. The sample size was determined as 362 students using the Morgan table, and participants were selected through simple random sampling. Data were collected using standardized questionnaires. Data analysis was conducted at both descriptive and inferential levels. At the descriptive level, indices such as mean and standard deviation were examined, and at the inferential level, Pearson correlation coefficients and structural equation modeling were applied to evaluate the relationships among variables. Results: The results of structural equation modeling indicated that academic self‑efficacy had a significant effect on reducing negative silence (β = −0.76, p < 0.001). Besides, academic self‑efficacy indirectly reduced negative silence through decreasing fear of negative evaluation (β= −0.51, p < 0.001). The positive and significant effect of fear of negative evaluation on negative silence (β= 0.89, p < 0.001) indicates the partial and significant mediating role of this variable in the relationship between academic self‑efficacy and negative silence. Conclusion: The findings indicate that students with higher levels of academic self‑efficacy experience lower fear of negative evaluation, and this process indirectly leads to a reduction in negative silence.
Introduction: Interprofessional Education (IPE) is recognized as a key strategy for preparing healthcare students to engage in collaborative work and deliver patient-centered care. Self-efficacy, functioning as a critical psychological variable, plays a major role in an individual's performance and their ability to adapt to new educational challenges. Despite its importance, studies specifically investigating the role of general self-efficacy in the context of shared learning remain limited. General self-efficacy can serve as the psychological foundation for interprofessional interactions. Accordingly, this study endeavored to determine the relationship between readiness for interprofessional learning and general self-efficacy among undergraduate nursing students at Urmia University of Medical Sciences. Methods: This descriptive-correlational, cross-sectional study was conducted in the academic year 2025. The statistical population comprised all undergraduate nursing students at the Faculty of Nursing and Midwifery. A total of 215 students were recruited using a census sampling method. Data were collected using a three-part self-administered instrument. The first section was a demographic information questionnaire. The second section utilized the Readiness for Interprofessional Learning Scale, a standard tool designed to assess students' attitudes toward collaborative education. The third section employed Sherer’s General Self-Efficacy Scale to evaluate the students' overall self-efficacy beliefs. To analyze the data, both descriptive statistics and inferential tests were utilized, including Pearson and Spearman correlation coefficients, independent t-test, Analysis of Variance (ANOVA), Mann-Whitney U, and Kruskal-Wallis tests, with the significance level set at p < 0.05. Results: The mean (standard deviation) of the total score for readiness for interprofessional learning was calculated at 73.61 (9.96) out of a maximum possible score of 95. The mean score for general self-efficacy was 64.01 (10.84) out of a maximum of 85. The Spearman correlation test revealed a positive and statistically significant relationship between readiness for interprofessional learning and general self-efficacy (r = 0.453, p < 0.001). Besides, the findings indicated significant differences based on academic year and employment history; second-year students and individuals without a history of clinical employment had significantly higher readiness and self-efficacy scores compared to fourth-year students and those with clinical employment experience (p < 0.05). Additionally, a weak, yet statistically significant, inverse relationship was observed between the students' age and their readiness for interprofessional learning (r = -0.152, p = 0.026). Conclusion: The findings demonstrate a direct correlation between general self-efficacy beliefs and students' willingness to engage in interprofessional learning. However, the observation of lower levels of these indicators during the final years of study and among students with prior clinical work experience serves as a critical warning for the educational system. It highlights that mere presence in clinical settings, devoid of structured and guided interprofessional education, is ineffective in fostering teamwork competencies. Therefore, the design and implementation of continuous educational interventions, such as clinical simulations, along with providing targeted support for final-year students, appear essential to enhance interprofessional skills and adequately prepare them for future collaborative practice.
Introduction: Ambulatory education is a core component of training general practitioners to manage common health problems. Although numerous studies in Iran have examined the current status and challenges of ambulatory education, few have specifically addressed its efficient implementation. Given the lack of direct evidence, this study endeavored to identify the prerequisites for efficient implementation of clinical ambulatory education by studying the perspectives of medical interns at Bushehr University of Medical Sciences. Methods: In this descriptive cross-sectional study, all eligible medical interns in Bushehr University of Medical Sciences (n = 150) who had completed at least one month of internship were surveyed using a researcher-developed questionnaire. A total of 13 clinical and medical education faculty members reviewed the questionnaire’s content validity, and its reliability was confirmed via test–retest (r = 0.8, p < 0.001). Results: More than 99% of the medical interns considered active participation in all stages of the patient visit to be essential while over 70% regarded the necessity of conducting this process under faculty supervision. Interns favored small group sessions (fewer than six students) (91.4%), a four-week outpatient training duration (67.6%), and integration with the corresponding clinical rotation (71.9%). The need for feedback-based teaching (98.6-100%) was strongly emphasized. Conclusion: Medical interns believe outpatient training plays a pivotal role in clinical preparedness. Active engagement and appropriate infrastructure are essential components effective outpatient education. These findings highlight the need to revise current educational strategies to better align with learners’ needs and healthcare realities.
Introduction: Nursing education in Iran is mainly based on teacher-centered methods; however, innovative approaches such as games can play an important role in education by enhancing students’ active participation and critical thinking. This narrative review endeavored to synthesize evidence and examine the applications, benefits, and outcomes of using games in nursing education in Iran. Methods: Accordingly, articles were searched using keywords including “game”, “gamification”, “game-based”, “game-based learning”, “serious games”, and “nursing education”. Articles published in Persian and English with full texts available between 2000 and 2025 academic years were retrieved from reputable databases including PubMed, Scopus, Web of Science, Cochrane, Magiran, SID, IranMedex, and Google Scholar. The quality of the articles was assessed using the JBI tool. Out of 1,218 articles, 16 relevant cases on the application of games in nursing education in Iran were included. Data were analyzed through comprehensive review, qualitative synthesis, and final conclusion. Results: This review included 11 quasi-experimental studies, 1 short report, and 4 clinical trials. Findings indicated that game-based approaches, including gamification and game-based learning, were effective in improving nursing students’ self-efficacy, knowledge, clinical decision-making, learning, recall, motivation, and clinical thinking. However, games had limited effects on improving students' attitudes. Conclusion: Games, as an innovative educational approach in nursing, provide diverse affordances across different levels of learning. To better utilize this method for enhancing the learning process and promoting nursing students’ clinical skills, it seems indispensable to develop appropriate educational policies, improve technological infrastructure, and allocate sufficient financial resources.
Introduction: Internships play a crucial role in developing students' professional skills, and improving assessment methods enhances the quality of education. This study endeavored to reform and enhance the assessment methods used in public health students’ internships. Methods: This applied qualitative research, with a developmental approach, was conducted between 2022 and 2024 In so doing, focus group discussions, brainstorming, and expert consensus were used. The procedure included three phases: first, internship courses were categorized and weighted. Then, the expected skills of graduates were identified and compiled into a logbook. Finally, evaluation criteria were defined across six domains and weighted accordingly. Results: Sixteen internship units were identified as follows: vaccination, health system structure and management, health education, reproductive health, maternal health, child health, mental health, nutritional health, first aid, school health, oral and dental health, communicable disease control, non-communicable disease control, elderly health, environmental health, and planning, monitoring, and evaluation. The number of identified skills recorded in the logbook was 178. Six domains were defined for assessment, which included: assessment through the logbook, case report, guideline conference, written exam, professional ethics, and assessment by the health center supervisor. Conclusion: By categorizing and weighting the curriculum components, clearly defining the expected skills, designing a structured logbook, and establishing assessment criteria, a framework for assessing student performance was developed. The identification of required skills based on authentic environments, along with the development of a comprehensive assessment system, has enabled an objective measurement of student competencies and can provide a framework for improving internship evaluation in public health students. It is recommended that structured and continuous feedback from both students and instructors be integrated into the program to facilitate continuous quality improvement and sustain alignment with evolving healthcare demands.
Introduction: Universities are recognized as the most important educational institutions for training specialized nursing personnel. Nursing education plays a significant role in promoting the professional competencies of nurses. Comparing the differences and similarities of various educational systems provides the opportunity to improve and enhance the quality of the curriculum. Methods: This study is a descriptive comparative study that was conducted in 1403 to compare the bachelor's degree nursing program of Iran and Bangladesh. The implementation stages were carried out according to the Bard's model, which includes four stages: description, interpretation, juxtaposition, and comparison. Results: The results of this study were presented for each component in the form of; comparison of goals, student admission requirements, course duration and structure, the number of course units by category, general courses, basic and specialized courses, internships and practical training, and the evaluation conditions of learners in the nursing education program of Iran and Bangladesh. Conclusion: A comparison of undergraduate nursing programs in Iran and Bangladesh reveals that, although there are similarities, differences exist in course integration and semester structure. Considering the nursing workforce shortage in Iran and the cultural proximity between the two countries, utilizing Bangladeshi nurses could be an effective solution. Moreover, the educational commonalities provide a valuable opportunity for collaboration.
Introduction: The Direct Observation of Practical Skills (DOPS) is a novel clinical evaluation method. This study aimed to investigate the effect of the DOPS test on the clinical skills of infectious disease residents. Methods: This before-after clinical trial was conducted with 18 infectious disease residents at Labbafinejad Hospital, from March 2021 to April 2023. Participants were enrolled using the census method. In the first phase, the residents demonstrated seven infectious disease-specific skills. An observer evaluated these skills using a translated version of the DOPS assessment form based on a Likert scale ranging from "lower than expected" to "higher than expected." The observer then provided feedback on the residents' strengths and weaknesses, along with strategies for improvement. In the second phase, all the steps mentioned above were repeated one month later. Additionally, these steps were repeated one month after the second phase. Finally, the residents' skill levels were compared before and after the intervention using the Friedman test with SPSS software version 23. Results: In comparing the first and third phases of the overall assessment of residents' skills, the percentage of cases within or above the expected level significantly increased from 5.6% to 100% (χ2=32.000, P<0.001). Also, the percentage of cases at or above the expected level of ten DOPS items in the third phase had a significant increase compared to the first phase: proper understanding of the anatomy (+94.4%, P<0.001), obtaining informed consent (+78.8%, P<0.001), preparation method before the skill (+88.9%, P<0.001), anesthesia (+66.7%, P<0.001), ability to perform the skill (+88.9%, P<0.001), observance of sterile conditions (+66.7%, P<0.001), asking for help if needed (+83.3%, P<0.001), patient management after performing the skill (+100%, P<0.001), communication skills (+88.9%, P<0.001), and professional demeanor (+94.4%, P<0.001). Conclusion: The study's findings indicated that the DOPS method enhanced the clinical skills of infectious disease residents.
Introduction: Flourishing is a key indicator of psychological well-being and optimal functioning among medical students, playing a crucial role in enhancing the quality of education and professional performance. This study aimed to examine the predictive role of meaning in life, grit, and self-control in the flourishing of medical students. Methods: This cross-sectional correlational study was conducted among students at Kashan University of Medical Sciences in the academic year 2024. A total of 291 students were selected using proportional stratified random sampling. Participants completed the Flourishing Scale, the Meaning in Life Questionnaire, the Grit Scale, the Self-Control Scale, and demographic questions. Data were analyzed using multiple regression analysis by SPSS-24. Results: The results of the simultaneous regression analysis indicated that meaning in life (β = .30, p < .001), grit (β = .25, p< .001), and self-control (β = .19, p < .001) were significant positive predictors of students' flourishing. Collectively, these variables accounted for 29.1% of the variance in flourishing. Conclusion: Enhancing students’ sense of meaning in life, as well as fostering grit and self-control, can facilitate their flourishing and psychological well-being. Policymakers in medical education, academic counselors, and socio-cultural administrators can play a significant role in strengthening these factors to foster success among medical students.
Introduction: Since the development of self-directed learning skills is an important goal of medical education, and academic motivation is considered a key prerequisite for the effective development of this skill, it seems necessary to examine the relationship between these two variables. Therefore, this study aimed to determine the relationship between academic motivation and the level of readiness for self-directed learning in nursing students. Methods: This research is a descriptive-analytical cross-sectional study that was conducted on 200 nursing students of Bushehr University of Medical Sciences in 1403 who were enrolled in the study by the census method. To collect data, were used a demographic form and the Vallrand Academic Motivation and Self-Directed Learning questionnaires of Cheng et al. Finally, the data were analyzed using descriptive statistics, Mann-Whitney and Kruskal-Wallis tests, and Spearman's correlation coefficient. Results: The average academic motivation score in nursing students was reported to be very good (138.56±32.033 out of 196) and the average self-directed learning readiness score was relatively good (78.8±11.779 out of 100). The results indicated that academic motivation has a direct and significant relationship with the level of self-directed learning readiness of students (P<0.001). Conclusion: Since there is a positive and significant relationship between academic motivation and the level of readiness for self-directed learning, strengthening academic motivation can lead to improved self-directed learning in nursing students, which is important for success in the nursing profession and lifelong learning.
Introduction: Lifelong learning is a dynamic and continuous process that enables physicians to adapt to rapid advancements in medical sciences and improve the quality of clinical care. Despite existing challenges in defining and interpreting the concept of lifelong learning, this study aimed to identify the components for the development and application of the concept of lifelong learning in the curricula of the general medicine course. Methods: The present study was conducted using a mixed-methods approach (qualitative-quantitative). The participants included 15 experts in medical education, curriculum planning, and faculty members from the Universities of Medical Sciences in Rafsanjan, Kerman, Isfahan and Isfahan payamenoor in the year 2025. They were selected through purposive sampling. Data were collected using closed- and open-ended questionnaires following the Delphi method and analyzed with descriptive statistics including frequency, mean, interquartile range, and agreement ratio, reaching consensus based on a 75% criterion. Results: The findings showed that 17 components reached consensus with agreement of 75% and above. These components included self-directed learning, self-regulated learning, evidence-based medicine, Learning how to learn, attention to and utilization of learning opportunities, curiosity and having an active mind, continuous learning process, engagement in scientific-practical and evolutionary efforts, knowledge translation, readiness to accept and value new ideas, intrinsic dynamism of learning and knowing, promotion of professional skills and accountability, interdisciplinary collaboration, continuous personal and occupational satisfaction, personal growth, having a mindset for success, and self-efficacy. Conclusion: The identified components for the development and application of the concept of lifelong learning encompass a broad scope. These concepts can serve as a foundation for improving curriculum planning and for training physicians with competencies aligned with the needs of society.
