Introduction:Moral sensitivity is a combination of one's awareness of dimensions such as being responsible and attention to ethical issues that are necessary for ethical action. Enhancing experience alone does not increase moral sensitivity; instead it should be accompanied by learning and knowledge development. On the other hand, considering the impact of the educational environment and the hidden curriculum on the development of professional features of medical students, we aimed to compare the ethical sensitivity of nurses working at teaching hospitals and nursing students. Method and Materials:In this cross-sectional study, 82 senior nursing students in undergraduate level and 123 nurses working in teaching hospitals were involved after obtaining informed consent. To collect data, Luetzen's moral sensitivity questionnaire was used. Data were analyzed using SPSS 16 software. Results:123 nurses with mean age of (35.02±6.44) and 82 nursing students with mean age of (20.88±0.80) completed the questionnaire. The mean score of moral sensitivity of nursing students and professional nurses was 61.74 ± 9.74 and 62.41 ± 8.77, respectively, and there was no significant difference between them (P=0.416). The mean score of moral sensitivity with demographic characteristics was not significantly correlated. Conclusion:Most nurses and students were at moderate moral sensitivity. Considering the interplay of nurses' ethical approaches to quality of care services and their role modeling of students, strengthening this issue through retraining nurses and quality supervision on nurses' professional practices and emphasizing this issue in nursing students' education should be considered.
Introduction: Quality improvement and performance evaluation have become today’s mainstream medical issues, whereas in many areas of medical care, the quality of care services is less than desirable. Objective: To determine a conceptual model for practice-based learning and improvement (PBLI) competency in medicine. Methods: This study was conducted using Walker and Avant’s theoretical synthesis method. Articles related to the concept of PBLI were searched using the keywords of practice-based learning and improvement, quality improvement, core competency, medical education, practice-based learning in English, separately and combined in google, google scholar, and Pubmed databases. After identifying the theoretical blocks and variables of each block and communicating them, a visual model of PBLI was presented. After a focused search for each block, a total of 229 full papers were studied and the PBLI model was developed in six conceptual blocks. Results: The visual model that presented in this study shows the relation among six theoretical blocks of PBLI including: Block of approach to PBLI, PBLI process triggers block, gap bridging solutions, PBLI infrastructure block, PBLI sub-competencies block, PBLI academic development block. Conclusions: Nowadays, PBLI is one of the inevitable qualities of medicine that ensures the quality of medical practice, which, in addition to individual requirements, requires a series of technical, strategic, structural, and cultural infrastructures. By utilizing this capability, a physician will be able to discover the knowledge, skills, and performance gaps, and will be able to cope up with their appropriate approaches, thereby improving the quality of their medicine and the care provided and the patient’s safety. It can provide satisfaction and trust in society. The model presented in this paper makes it easy to understand the relationships between the various components of this competency.
Background and Objective: Diabetes is one of the most common diseases caused by metabolic disorders. This disease is not definitive, but it can be controlled. Successful diabetes control depends largely on patient self-care because more than 95 percent of diabetes care is done by the patient himself. The purpose of this study was to determine the effect Blended training on comparison with inperson training on self-care behaviors in type 2 diabetes patients. Materials and Methods: This study was a quasi-experimental study with two groups of blended training and in-person training in which 60 patients with type 2 diabetes were randomly divided into blended training and in-person groups. Data were collected by standard questionnaires of SDSCA (Diabetes Self-Care Behavior Inventory). For the blended training group, blended training programs were implemented and the in-person training group received the training in person at the health center. The results were analyzed by SPSS 16 software. Results: Before the intervention, the mean and standard deviation of self-care score in the in-person training group was 3.3 ± 0.74 and three months after the intervention was 3.87 ± 0.99, In the blended training group before the intervention, the mean and standard deviation of self-care was 3.56 ± 0.64 and three months after the intervention was 4.6 ± 0.85, this difference was statistically significant in both groups. But this increase was in favor of blended training. Conclusion: The results of this study showed that the use of blended training method is more effective in increasing the self-care of patients with type 2 diabetes than the in-person training. Therefore, the use of this method in controlling and reducing the complications of the disease is recommended in patients with type 2 diabetes.
Background: Analysis and review of dissertations over a period of time is one of the methods of viewing documents so that by formulating newer topics, a platform will develop for scientific advancement in the fields related to various academic majors. Objectives: The purpose of this study was to review master's dissertations of medical education graduates in the virtual school of medical education and management of shahid Beheshti University of Medical Science in the years 2011 to 2016. Methods: In this study, 144 master's dissertations of medical education students graduated in 2011 - 2016 from the virtual school of medical education and management of Shahid Beheshti University of Medical Science were evaluated. Using an information checklist, relevant data were extracted from the dissertations. The topics of these dissertations were categorized into nine general categories. Also, we also reviewed the journals in which the articles extracted from the dissertations were published. Results: Overall, 74 MSc. dissertations in medical education (2011 to 2016) in the Virtual Faculty of Medical Education and Management of Shahid Beheshti University of Medical Sciences were evaluated, and the relevant journals in which the extracted articles were published were also reviewed. Conclusions: The results of this study showed that the tendency of students for conducting descriptive studies and using questionnaires was significantly higher, ignoring other research methods. This issue needs to be evaluated, and authorities should determine relevant causes to help planning and to create more diversity in the types of studies in this field. Also, due to the non-allocation of dissertations to some subject areas, such as reviewing and analyzing processes, there is a need to prioritize this topic when selecting future dissertations’ subjects and appropriately direct students to achieve the desired situation.
Objective: Breaking bad news to the patient is challenging, especially for the physicians and the residents, due to the lack of structured and practical training. This study aimed to design and evaluate a novel virtual instructional design for improving obstetrics and gynecology (Ob/Gyn) residents breaking bad news skills. Materials and methods: Virtual instructional design was performed based on the ADDIE model (Analysis, Design, Development, Implementation and Evaluation) from September 2020 to July 2021 at the Department of Ob/Gyn, a referral hospital affiliated with Tehran University of Medical Sciences, Tehran. Iran. The five steps of ADDIE virtual instructional design were applied sequentially. Results: Totally 33 of the Ob/Gyn residents included in the study that 77% needed specific training. The awareness of the performance of the residents in seven areas including interview context, strategy, planning, professionalism, empathy, knowledge, and receiving information needed to be trained for breaking bad news. The content of the virtual training package was designed based on the prior assessment needs in four multimedia lectures of professors, one short educational video, a 65-page file that combines text and images in 4 parts. The pre-test and post-test mean scores (SD) were 9.45 (2.0) and 10.67 (1.7), respectively (p-value≤0.001) in the cognitive and attitudinal domain. In the final step, the final corrections were made in the virtual training package. Interestingly, the satisfaction of residents' attitudes was 96.5%. Conclusion: Most Ob/Gyn residents do not have the necessary perception and skills to deliver bad news to the patients. Designing an appropriate virtual training package for improving communication skills is associated with satisfaction. Thus, the efficacy of the training program should be implemented for all Ob/Gyn residents.
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