Background: The education of medical sciences requires a fundamental change to improve clinical decision-making capacities by using new teaching methods. Objectives: The present study aimed to compare the effect of the Flipped classroom (FC) with demonstration education (DE) in the practical skill of nasogastric tube (NGT) insertion. Methods: The present interventional study was conducted in a faculty of nursing for two sequence semesters. Nursing students were selected by census sampling method and then randomly allocated to two groups, FC (19 and 17 participants) and DE (18 and 19 participants). In the DE method group, the NGT insertion was explained to the nursing students in the skill laboratory. Then, in the FC group method, a week ago, the video and the written educational content related to the NGT insertion procedure were provided to the nursing students. In both groups, two sessions were provided for the nursing students to practice the NGT insertion procedure independently on the Moulage. A comparison of the practical skill and satisfaction scores was done one week after intervention in both groups. The descriptive statistics, chi-square, Fisher exact test, and Mann Whitney u test were applied using the SPSS software, version 24. A P-value less than 0.05 was considered statistically significant. Results: The results of the statistical tests showed a non-significant difference between the two groups in terms of age, mean diploma score, gender, marital status, native status, and living in a dormitory. In the first semester, the practical skill score was non-significantly higher in the FC group [FC: 70.00 ± 2.16 vs. DE: 68.94 ±1.62, p=0.105], but in the second semester, it was significant in the FC group [FC: 67.70 ± 5.65) vs. DE: 61.00 ± 7.64, p=0.005]. The nursing students in the FC group had significantly higher satisfaction compared to the DE group in both semesters [FC: 99.44 ±1.61 vs. DE: 93.10 ±4.70, p<0.001 and FC: 94.11 ± 6.18 vs. DE: 86.15 ± 6.31, p=0.001, respectively). Conclusion: This study showed FC method can be used as a satisfactory and effective teaching approach in NGT insertion. So, it is recommended that educational managers consider it because of the high satisfaction of nursing students in clinical teaching.
Background: The educational environment is defined as the academic atmosphere within a university from the perspectives of all its members, and the clinical environment, as an indispensable and vital component of clinical education, plays a crucial role in achieving educational goals.Objectives: The present study aimed to assess the educational environment of operating rooms in teaching hospitals affiliated with Birjand University of Medical Sciences.Methods: This descriptive-analytical cross-sectional study was conducted on 266 undergraduate operating room and anesthesiology students at Birjand University of Medical Sciences in 2023. Sampling was performed in a convenience and purposeful manner from eligible educational departments. The Iranian Measure of Operating Theater Educational Climate (IMOTEC) questionnaire was employed for data collection. Data were analyzed using Mann-Whitney U and Kruskal-Wallis tests in SPSS software at a 95% confidence level.Results: The mean score of the operating room educational climate was assessed as favorable (68.68 ± 19.48). Among the demographic variables, it was reported that age and academic semester had significant relationships with the mean score of the operating room educational climate (P = 0.026).Conclusion: Most operating room and anesthesiology students at Birjand University of Medical Sciences perceived the operating room educational climate as favorable. However, it is advisable for responsible authorities to make decisions that improve the quality of education and minimize educational disparities across centers.
Background: Students' views play an important role in improving the quality of university services. They determine the degree of discrepancy between the status quo and students' expectations, providing the basis for improving educational service quality.Objectives: This study aimed to design and evaluate the psychometric properties of a tool for assessing the quality of educational services in e-learning centers, based on the SERVQUAL model.Methods: In the first step of this descriptive-analytical study, we searched for the instruments and factors affecting service quality in higher education in the literature and compiled them. Then, similar questions were merged, and all questions were rewritten, asking for experts' opinions on e-learning centers. In addition, some questions were added or removed based on expert opinions and the objective. The content validity ratio and content validity index also determine content validity. In addition, a sample of 110 students participated in the study to examine the construct validity and reliability of the instrument.Results: In the first stage, 88 questions were extracted from related studies. After omitting similar questions, 56 questions remained. These questions were modified for the e-learning environment to make them compatible with this system. Out of the 56 items assessed for CVI and CVR, 20 were ultimately approved with a test-retest reliability of 0.769 and an internal consistency of 0.824 to evaluate the quality of educational services in e-learning centers. This tool explained 67.2% of the total variance.Conclusion: The present research showed that the developed tool has acceptable validity and reliability and can be used to assess the quality of educational services in e-learning centers from students' viewpoints.
Background: Climate change is among the most critical global issues, threatening economies, ecosystems, and human health. It has increased the frequency of heat waves, floods, and droughts, impacting food security, agriculture, and disease patterns. Despite its importance, many medical schools have not sufficiently incorporated climate change into their curricula, leaving future physicians underprepared to address its health impacts. Objectives: This study assesses medical and non-medical students' awareness, attitudes, and behaviours toward climate change. It emphasizes integrating climate change topics into medical education to prepare students to address health-related challenges and become responsible healthcare professionals. Methods: In this cross-sectional analytical study, 375 medical and non-medical university students from Kerman province (2023) were enrolled. Data were collected using a validated five-part questionnaire based on Alina Kote's tool, assessing attitudes, awareness, personal concerns, reinforcing, and adaptive behaviours. Convenience sampling was utilized, and ANOVA was conducted to compare the mean scores between the groups. Reliability was confirmed (Cronbach's a = 0.89). Results: The participants included 41.3% males and 58.7% females. Medical students had significantly higher scores in attitudes (p < 0.001), personal concerns (p < 0.001), and adaptive behaviours (p = 0.011), but lower scores in awareness (p < 0.001) and reinforcing behaviours (p = 0.014) compared to non-medical students. Gender showed no significant influence on the outcomes. Graduate students scored higher in reinforcing and adaptive behaviours than undergraduates (p = 0.014 and p = 0.011, respectively). Conclusion: The study found that gender does not affect students' attitudes, knowledge, or adaptive behaviors toward climate change. The results highlight the importance of integrating climate change topics into curricula for all disciplines. Educational interventions tailored to each university are recommended to increase students' awareness and ability to engage in climate adaptation and mitigation. Additionally, students can play a key role in raising public awareness and influencing policy changes at the community level.
Background: Academic bullying is a global and growing phenomenon in educational settings. Yet, there is a lack of consensus concerning the definitions of academic bullying which challenges researchers. The purpose of this analysis, therefore, was to conceptualize the concept of academic bullying, including its definitions, defining characteristics, antecedents, consequences, and empirical referents. Objectives: The purpose of this analysis, therefore, was to conceptualize the concept of academic bullying, including its definitions, defining characteristics, antecedents, consequences, and empirical referents. Methods: Walker and Avant’s method of concept analysis was employed to identify the antecedents, attributes, and consequences of academic bullying. A review of existing literature on academic bullying was conducted using the electronic databases of PubMed, Scopus, Web of Science, Science Direct, and ProQuest, searched with the phrase of “academic bullying” in the titles of documents without a time limit. The search included all document types (article, review, editorial, letter, note, book, book chapter and dissertation) related to academic bullying published in English. Results: In reviewing the studies, 37 documents were identified to provide information for this concept analysis. Based on the analysis undertaken, a working definition and defining attributes were formulated, along with a discussion of various model cases, antecedents, consequences, and empirical referents regarding academic bullying. Conclusion: Educational leaders can prevent or reduce faculty bullying by raising awareness, offering training, and establishing guidelines. The identification of academic bullying attributes contributes to the body of knowledge of academic bullying, reduces the ambiguity of this concept, and provides a working definition of academic bullying. Defining attributes, antecedents, and consequences can be further tested and used to develop potential interventions. Future research is needed to advance our understanding of this concept and explore interventions that could diminish its negative consequences.
Background: In today’s digital era, challenges related to privacy, security, and transparency in the management of sensitive medical data continue to impede progress in healthcare innovation. Blockchain technology, with its decentralized and tamper-resistant architecture, presents a promising avenue to address these issues. However, a comprehensive meta-synthesis examining blockchain applications across medical education, research, and healthcare delivery remains lacking. Objectives: The purpose of this study is to investigate and identify the applications of blockchain technology within the domains of medical education, medical research, and healthcare. Methods: The current study utilized a meta-synthesis methodology to analyze 49 peer-reviewed articles published between 2008 and 2025. Sources were identified through systematic searches of reputable academic databases and selected based on defined inclusion and exclusion criteria aligned with PRISMA guidelines. Relevant data were extracted, coded, categorized, and synthesized into overarching thematic domains. Results: Findings revealed that blockchain enhances medical education by improving the issuance and verification of academic credentials, enabling adaptive learning, supporting competency-based assessments, and promoting interactive, learner-centered environments. In the domain of medical research, blockchain contributes to secure data sharing, improved research ethics, enhanced transparency, and more effective inter-institutional collaboration. In healthcare delivery, the technology enables secure and interoperable health record management, pharmaceutical supply chain monitoring, privacy-preserving telemedicine, and intelligent clinical decision-making. Overall, these applications were categorized into six thematic categories for education, eight for research, and nine for healthcare. Conclusion: Blockchain technology, by offering a secure, transparent, and decentralized infrastructure, holds significant potential to transform medical education, research, and healthcare delivery. The findings of this meta-synthesis provide a conceptual framework for the optimal integration of blockchain within the healthcare system and illuminate pathways for future research aimed at advancing the practical applications of this technology.
Background: Traditional classroom lecture has been the backbone of medical education for a long time. Though effective, it has inherent problems of active student engagement and facilitation of learning for better outcomes. In contrast, innovative small-group learning methods like the Fish bowl technique promote active participation and foster learning. Objectives: The study aims to analyze the combined utility of the Fish bowl technique along with lecture and to compare students’ perceptions of its effectiveness. Methods: A quasi-experimental crossover study was conducted among second-phase medical undergraduate students in the Department of Pathology. The students were primed about the topic via a didactic lecture which was followed by a pre-test. The study consisted of 138 students, who were divided into six groups across 2 days/week (three batches/day), each group consisted of 23 students, and a Fish bowl discussion was conducted. At the end of the session, a post-test was done and feedback was taken from students. Results: There was statistical improvement in post-test scores of the Fish bowl technique, a gain of 16.81% as compared to the pre-test score. Lecture followed by Fish bowl sessions stimulated more interest (75.36%), increased active participation (86.23%), and improved satisfaction of learning (73.91%) amongst students as compared to lecture only. The retention of the study subject, coverage of important concepts, and meaningful discussion was better with lecture along with Fish bowl discussion. Conclusion: The combination of traditional and Fish bowl technique proved to be a positive learning experience for students. Fish bowl is an effective student-centric method that piques curiosity, promotes active participation, and fosters critical thinking.
Background: Despite the numerous advantages of internationalization, universities and higher education institutions (HEIs) often encounter challenges when implementing internationalization activities. Part of the problem concerns the vague definition of internationalization and its performance indicators.Objectives: The present research aims to identify indicators for internationalization in universities and (HEIs) by conducting a comprehensive literature review to help universities better understand and implement internationalization activities and processes.Methods: This study is a systematic literature review, informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in which six bibliographic databases, including Web of Science, Educational Resources Information Center (ERIC), ScienceDirect, and Wiley Online Library for English literature and Scientific Information Database (SID) and MagIran for the Persian literature were searched in 2023. Approved articles underwent synthesis, and findings were analyzed using qualitative content analysis.Results: A total of 2086 articles were identified, out of which 37 were selected for content analysis. The content analysis and final synthesis revealed six overarching themes consisting of 12 subthemes, 38 groups, 11 subgroups, and 466 codes. The main themes included education (with three subthemes of internationalization at a distance, quality assurance and continuous improvement of internationalization, and internationalization of education, teaching, and learning outcomes), international aspects (with two subthemes of international public relations and communication, and international cooperation and networking), research (with two subthemes of internationalization of research, and commercialization of ideas and innovations), students (with two subthemes of student welfare/support services, and cultural/social services), management and human resources (with two subthemes of management, and human resources), and healthcare (with one subtheme of healthcare and treatment).Conclusion: The results necessitate consideration of several indicators, rendering internationalization a multifaceted challenge that requires inter-sectoral cooperation at both internal and external university levels. The results hold significance for international relations managers and education policymakers in facilitating the planning and implementation of internationalization activities.
Background: Universities were compelled to transition from in-person instruction to online instruction following the COVID-19 pandemic. Nevertheless, this transition has presented a plethora of obstacles, necessitating the development of innovative solutions to guarantee that all students have access to effective and inclusive learning experiences. Objectives: We conducted a review investigating the innovative E-learning methods in health sciences education. Methods: This study was designed as systematic review. We searched PubMed, Scopus, Eric, Google Scholar, and Iran Scientific Database from start of the pandemic to September 2021. Papers meeting our inclusion criteria were reviewed for data extraction. Screening of articles, data extraction, and risk of bias assessment was done in double-blind groups. Our primary objective was to provide a comprehensive overview of emerging e-learning methods and to assess their effectiveness using eleven commonly used metrics that are used to quantify the efficacy of online learning. As a secondary outcome, we employed Kirkpatrick’s four levels of learning to assess the quality of online learning. Results: Six Thousand Four Hundred Ninety Two papers were identified, thirty records were included, the majority of studies reported (n= 25) a transition of previous methods to online formats. Five studies described innovative methods. The included studies were classified as moderate to high risk of bias. In the study of success factors, the most ignored area was 'usage of suitable assignments' (37.5%), while 'optimal quality of media' emerged as the most consistently used component (67%). All studies assessed Kirkpatrick’s level 1, 76% had assessed level 2. None described Kirkpatrick levels 3 or 4. Conclusion: E-learning can be alternatively utilized for health education. Future E-learning research should incorporate randomized designs and adhere to principles of Kirkpatrick model, with a particular focus on levels 3 and 4, to develop more effective evidence-based systems.
Background: Undergraduate health professionals frequently lack awareness of research and demonstrate limited participation due to insufficient opportunities, inadequate training, and the perception that research is irrelevant to clinical practice. However, their involvement is crucial for advancing medical knowledge. Objectives: This study aimed to assess undergraduate healthcare students' perceptions and participation in research, identify perceived barriers, and collect their recommendations for improving engagement. Methods: This cross-sectional study was conducted at Lahore Medical & Dental College with 1514 medical, dental, and allied health science participants. Data were collected using a five-section questionnaire covering demographics, perceptions, participation, limitations, and recommendations. SPSS version 22.0 was used for reliability, descriptive, and inferential statistical analysis. Results: Among 1514 students, 76.5% acknowledged the importance of research. However, 77.8% had neither attended a research course/module nor participated in a project, and 44.9% had never planned a research question. The primary barrier was the lack of perceived relevance, with 32.3% unaware of the research. For improvement, 60.3% recommended establishing a research support center, and 56.6% emphasized the need for qualified, research-oriented mentors. Conclusion: The findings highlight the need to enhance research engagement among undergraduate healthcare professionals. Limited awareness, supervision, and funding contribute to poor participation. Universities should integrate research modules into the curriculum, conduct workshops, and provide necessary resources to promote student involvement.
Background: Effective learning and strong critical thinking are vital for health sciences students navigating an evolving field. This underscores the importance of understanding how their learning approaches relate to their critical thinking tendencies in health sciences education. However, variations in these skills among students and the challenges in applying knowledge in professional settings highlight the need for focused investigation within specific educational contexts. Objectives: This study evaluated the learning approaches and critical thinking dispositions of medical students at Sirjan University of Medical Sciences to inform educational enhancement. Methods: This descriptive-analytical study examined critical thinking dispositions and learning approaches among 310 students. Data were collected via questionnaires. Independent samples t-tests and Pearson correlations were used for data analysis. Results: The mean score for critical thinking disposition indicated a moderate tendency toward critical thinking. Creativity was related to gender (p < 0.001), as was the strategic learning approach (p < 0.001). Deep and strategic learning approaches showed significant positive correlations with critical thinking disposition (p < 0.001). The surface approach showed a weak negative correlation with critical thinking disposition (p < 0.001). Conclusion: Transforming teaching and evaluation approaches may enhance the effectiveness of the deep learning approach. Active and innovative teaching strategies can increase students' motivation and critical thinking skills.
Background: Physical, mental, and behavioral signs of exam anxiety show themselves throughout test preparation. This research sought to explore the psychometric characteristics of the Persian version of the Multidimensional Test Anxiety Scale (MTAS) among university students given the absence of a tool to assess the many aspects of test anxiety. Objectives: Given the lack of a reliable and valid Persian-language scale for measuring the dimensions of test anxiety, the present study was conducted with the aim of examining the psychometric properties of the Persian version of the Multidimensional Test Anxiety Scale among university students. Methods: Convenience sampling was used to choose 232 Jundishapur University of Medical Sciences students for this descriptive, psychometric research in 2022.Participants filled out the Rosenberg Self-Esteem Scale, the Frost Multidimensional Perfectionism Scale-Short Form, and the MTAS. Confirmatory factor analysis was part of the MATS's psychometric analysis, which was assessed using LISREL 8.8 and SPSS version 25. Results: Confirmatory factor analysis verified the four-factor structure of the MTAS (Worry, Cognitive Interference, Tension, and Physiological Indicators).The MTAS exhibited an internal consistency of 0.93, while the Worry, Cognitive Interference, Tension, and Physiological Indicators subscales exhibited internal consistency of 0.88, 0.81, 0.89, and 0.83, respectively, as determined by Cronbach's alpha coefficient. The MTAS demonstrated strong divergent and convergent validity. Conclusion: The MTAS has acceptable reliability and validity, as indicated by the results. The results of this investigation have the potential to enhance the cross-cultural literature on the MTAS.
Background: Higher education institutions have maintained a longstanding commitment to the education and development of academically talented students, consistently seeking to identify, attract, empower, and support this population. Objectives: The current research has developed a holistic framework intended to mitigate the available obstacles for academically talented students’ success and facilitate favorable outcomes. Methods: This phenomenological study explored the experiences of 50 talented students, specifically examining the challenges they encountered. Through in-depth interviews, focus groups with experts, and a comprehensive literature review, a practical guide was developed, grounded in Keller's motivational model, to identify and manage challenges and empower gifted learners. Results: The research identified a central theme, "the narrow alley of talented students," and six sub-themes. Through the information and concepts extracted from interviews, expert focus group discussions, and a comprehensive literature review, the study developed a conceptual model comprising four key categories: Attention, relevance, confidence, and satisfaction. This model effectively transformed abstract explanatory concepts into practical guidelines and actionable solutions. Conclusion: The proposed strategies within this study offer remarkably beneficial. Overlooking the unique needs of these individuals can culminate in decreased motivation and misallocation of financial resources. The findings of this research can be leveraged by students, professors, and educational administrators to empower these invaluable assets to the academic system.
Background: The Faculty of Medicine at Kasetsart University, as a new medical school, faces the challenge of attracting high-caliber students. This study examines the motivations of rural high school students to pursue medical education at this institution. Objectives: To explore the key factors influencing rural high school students’ decisions to study at the new medical school. Methods: A descriptive study was conducted with 120 high school students from Sakon Nakhon province and surrounding areas in Thailand. Participants completed a structured questionnaire during the Open House event. The questionnaire assessed motivations related to academic interests, career goals, and perceptions of the medical school. Descriptive and inferential statistics were used to analyze the data. Results: Participants were primarily aged 17 (32.5%) and 18 (40.0%), with a near-equal gender distribution (47.5% male, 52.5% female). The most important motivations for choosing this new medical school in the top three rankings were passing the medical professional licensing examination (23.33%), followed by the quality of teaching facilities (40%) and educational support technology (35%). Scholarships, welfare services, and employment opportunities were also significant motivators. Other factors, such as curriculum content, counseling processes, and research opportunities, ranked lower in importance. While there were no significant differences in the proportions of males and females ranking specific motivations as their top choice. Conclusion: The findings suggest that rural high school students prioritize academic success, modern learning facilities, and support systems when selecting this new medical school.
Background: The primary objective of medical education is to cultivate competent individuals capable of achieving preventive and therapeutic goals and improving community health. To accomplish this, the employment of effective and efficient teaching methods for the precise and systematic organization of educational content is of paramount importance.Objectives: The current research aimed to investigate the impact of implementing an orthopedic surgical technology training course using a vertical integration approach on learning outcomes, clinical skills, and satisfaction as educational outcomes among operating room students.Methods: This semi-experimental study was of pretest-posttest type in which 52 fifth semester undergraduate operating room students were recruited using a convenience sampling method. Based on whether or not they had passed the theoretical credit of surgical technology course, they were assigned to the control (non-integrated) or intervention (integrated) groups. In the intervention group, the theoretical and practical topics of the orthopedic surgical technology course were taught using a vertical integration approach, while in the control group, training was conducted using the routine method. Before and after the training, learning outcomes and clinical skills in both groups of students were assessed and compared using a questionnaire and an observational checklist. The data were analyzed using the paired t-test, Wilcoxon test, and analysis of covariance (ANCOVA) in SPSS software.Results: Based on the paired t-test results, implementing an orthopedic surgical technology training course using a vertical integration approach had a significant impact on learning outcomes and clinical skills in surgical technology (P < 0.001). The independent t-test results revealed that the level of satisfaction in the intervention group was significantly higher (P < 0.001). According to the results of the ANCOVA, the effectiveness of the vertical integration approach intervention on learning outcomes and clinical skills was reported to be significantly higher than the non-integrated group (P < 0.001).Conclusion: Implementing an orthopedic surgical technology training course using a vertical integration approach can be considered an effective educational strategy that, in addition to improving learning outcomes, can culminate in improved clinical skills and satisfaction among students. Therefore, it is recommended that educational managers in the operating room department pay attention to this matter and provide the conditions for implementing integrated training in their centers.
Background: Online learning is a form of virtual learning that is being organized and implemented across universities of medical sciences in developing countries.Objectives: The present study aimed to investigate the effectiveness of online learning from the perspectives of students and faculty members at selected universities of medical sciences in the post-coronavirus (COVID-19) era in Iran.Methods: This descriptive-analytical study was conducted in 2023 at Zanjan University of Medical Sciences, Iran University of Medical Sciences, and Shahed University among faculty members and undergraduate students of nursing, midwifery, anesthesiology, and operating room. A stratified random sampling method and the Online Learning Effectiveness Assessment Questionnaire were employed in this study. Descriptive statistics and inferential statistical tests, such as Chi-square, Fisher’s exact test, and Pearson’s correlation coefficient, were used for data analysis.Results: This study involved 286 students and 61 faculty members. From the perspectives of faculty members, online learning components, including teaching-learning activities, feedback, flexibility, assistance, motivation, and evaluation, demonstrated a desirable effectiveness, while the components of content, page design, and educational materials exhibited a moderate effectiveness. However, workload was deemed to have an undesirable effectiveness. From the students’ perspectives, the components of content, teaching-learning activities, page design, feedback, workload, assistance, motivation, and evaluation were reported to have a desirable effectiveness, whereas educational materials and flexibility were reported to have an undesirable effectiveness.Conclusion: The effectiveness of online learning in the post-COVID-19 era has been reported to be high among both students and faculty members. Given that online learning infrastructure was established compulsorily during the COVID-19 era and this method of instruction has not been abandoned in the post-COVID-19 era, its blended use with in-person instruction can enhance the quality of education among students and faculty members.
