Introduction Since the onset of the COVID-19 pandemic, many higher education and health centers have faced challenges. Educational leaders have tried to manage the new situation, but the human infrastructure was not ready for such an event. This study aims to explain the challenges and opportunities of the COVID-19 pandemic for medical education. Method This qualitative study used conventional content analysis to collect data from face-to-face and semi-structured interviews. The interviews continued until data saturation was reached. The participants were 12 students and 14 faculty members at Shiraz University of Medical Sciences. To ensure data rigor, we used member checks, peer checks and an external observer. Results Three main categories and 15 subcategories were extracted. The findings showed that four subcategories, e.g. perception on feasibility of e-learning, standardizing of e-learning, dedicated teaching, and networking and interdisciplinary collaborations, affected the development of medical e-learning. The main opportunities from the COVID-19 pandemic for medical education were classified into five subcategories: attitudes to e-learning and adaptability, preventing students’ separation from the educational environment, documentation and monitoring education, take control of own learning, and increasing perceived usefulness. The main challenges were divided into four subcategories, e.g. noncompliance with virtual classroom etiquette, inadequate interactions, time limitations, and infrastructure defects and problems. Finally, participants believed that methods of evaluation in e-learning were more suitable for diagnosis and formative evaluations. Generally, two subcategories were extracted, e.g. formative and summative. Conclusion Medical schools have necessarily moved towards e-learning to compensate for the interruption in classroom education, such that traditional classes have been replaced with e-learning. These rapid, extensive changes in teaching and learning approaches have consequences for medical schools.

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 aquasi 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 reliablequestionnaires: 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.

Background: Hospitals are one of the most important health facilities in every society. Therefore, these facilities should be located in a rational manner. The present study aims to 1) select optimal locations for establishing new hospitals in Shiraz and 2) assess the location of the existing hospitals in Shiraz using the geographical information system (GIS). Methods: At first, the hospital location allocation criteria were identified through reviewing the literature. Then, the criteria were entered into a questionnaire, which was completed by experts based on analytic hierarchy process (AHP). Afterwards, spatial raster layers of all the criteria were created in the Arc GIS 10.3 software. Then, in order to select optimal locations for hospitals, weights of the criteria were calculated based on AHP in Arc GIS and the weights were exerted on the relevant spatial created layers. Combination of the layers was presented on a map. After evaluating the 33 existing hospitals' locations based on the map, the areas located in standard hospital service areas (1500 m) were erased from the map in order to exclude the served areas. Results: The results revealed that 'proximity to the main roads' was the most important criterion amongst the whole applied criteria for selecting hospital location. This study also presented 15 land parcels, located in northern part of the city, as the best lands for constructing new hospitals. Besides, according the applied criteria in this study, none of the 33 existing hospitals were located in the appropriate locations. Conclusions: Considering the obtained pattern of the existing hospitals' locations, in most of the cases, the existing location is not good and the future hospitals must be located in more appropriate locations. The results of this study can be useful for health policymakers to select the most suitable locations for constructing new hospitals in future.

Introduction Mental health problems as a consequence of cancer lower the quality of life of cancer patients. Despite increasing studies of breast cancer‐focused mobile health applications (m‐Health apps), there is less research on breast cancer patients' quality of life or well‐being. The purpose of this study is to develop and evaluate the usability and quality of an educational m‐Health app aimed at improving the resilience of breast cancer in women. Methods This study was conducted in four phases. It included extracting the requirements of the app through the nominal group technique. Based on these results, an m‐Health app was developed and evaluated in terms of usability and quality by two scales, System Usability Scale and Mobile App Rating Scale questionnaires, respectively. Finally, the role of patients' age and educational backgrounds in the use of the app was assessed. The relationship between learnability and usability of the app was measured by the T‐Test. Results The app was developed with three user interfaces. Its usability developed from the patient's point of view scored a remarkable score of 83.20 with a 95% confidence interval. This value was too indicative of high satisfaction with the usefulness and the possibility of recommending it to other cancer survivors. The results of the quality evaluation from an expert's point of view showed that this app had good functionality. Evaluation of the role of demographic information in the use of the app showed that it can be used for all age groups with different levels of education. The app did not differ significantly between learnability and usability. Conclusion The development of m‐Health apps, based on usability principles that are suitable for all age groups with different levels of education, is welcomed by cancer patients.

BackgroundAlthough self-care can control and prevent complications in hypertensive patients, self-care adherence is relatively low among these patients. Community-based telehealth services through mhealth can be an effective solution.ObjectiveThis study aimed to evaluate the effect and acceptance of an mhealth application as a community-based telehealth intervention on self-care behavior adherence.MethodThis clinical trial included sixty hypertensive patients and their matched controls from two heart clinics affiliated to Shiraz University of Medical Sciences (SUMS). Self-care behaviors were assessed using Hill-Bone questionnaire before and after the intervention. Acceptability was evaluated in the intervention group at the end of the study period. The data were analyzed via SPSS 18 software using descriptive and inferential statistics.ResultThe results showed a significant difference between the intervention and control groups regarding the mean score of self-care behaviors (4.13 ± 0.23 versus 3.18 ± 0.27, p < .001). Additionally, a significant difference was observed between the two groups concerning the mean scores of the two subscales of self-care behaviors, including “medication taking” and “proper diet”. However, no significant difference was observed between the two groups regarding the mean score of “appointment keeping” (p = .075). Overall, the intervention group participants were satisfied (4.27 ± 0.34) with this approach for managing hypertension.ConclusionCommunity-based telehealth services through mhealth had the potential to improve self-care behaviors in hypertensive patients and seemed to be accepted by the patients in the intervention group.

Background: Clinical reasoning plays an important role in the accurate diagnosis and treatment of diseases. Script Concordance test (SCT) is one of the tools that assess clinical reasoning skill. This study was conducted to determine the reliability and concurrent and predictive validity of SCT in assessing final lessons and gynecology exams of undergraduate midwifery students. Methods: At first, 20 clinical scenarios followed by 3 questions were designed by 2 experienced midwives. Then, after examining the content validity, 15 scenarios were selected. The test was used for 55 midwifery students. The correlation of SCT results with grade point average (GPA) was measured. To evaluate the concurrent validity of SCT, the correlation between SCT scores and the final exam of the gynecology course was measured. To measure predictive validity, the correlation of SCT scores with comprehensive exams of midwifery was calculated. Data were analyzed using SPSS software. Descriptive statistics, Pearson correlation, and coefficient Cronbach's alpha were used for analysis. The test’s item difficulty level (IDL) and item discriminative index (IDI) were determined using Whitney and Sabers’ method. Results: The internal reliability of the test (calculated using Cronbach’s alpha coefficient) was 0.74. All questions were positively correlated with the total score. The highest correlation coefficient was related to GPA and comprehensive test with the score of 0.91. The correlation coefficient between SCT and the final test (concurrent validity) was 0.654, and the correlation coefficient between SCT and comprehensive test (predictive validity) was 0.721. The range of item discriminative index and item difficulty level in this exam was 0.39-0.59 and 0.32-0.66, respectively. Conclusion: SCT shows a relatively high internal validity and can predict the success rate of students in the comprehensive exams of midwifery. Also, it showed a high concurrent validity in the final test of gynecology course. This test could be a good alternative for formative and summative tests of clinical courses.

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