The Isfahan Healthy Heart Programme (IHHP) is a five to six year comprehensive integrated community-based programme for cardiovascular diseases (CVD) prevention and control via reducing CVD risk factors and improvement of cardiovascular healthy behaviour in a target population. IHHP started late in 1999 and will be finished in 2005-2006. A primary survey was done to collect baseline data from interventional (Isfahan and Najaf-Abad) and reference (Arak) communities. In a two-stage sampling method, we randomly selected 5 to 10 percent of households from randomly selected clusters. Then individuals aged > or = 19 years were selected for the survey. This way, data from 12,600 individuals (6300 in interventional counties and 6300 in the reference county) was collected and stratified according to living area (urban vs. rural) and different age and sex groups. The samples underwent a 30-minute interview to complete validated questionnaires containing questions on demography, socioeconomic status, smoking behaviour, physical activity, nutritional habits and other behaviour regarding CVD. Blood pressure and body mass index (BMI) measurements were done and fasting blood samples were taken for two hours post load plasma glucose (2 hpp), serum (total, HDL and LDL) cholesterol and triglyceride levels. A twelve-lead electrocardiogram was recorded in all persons above 35 years of age. Community-wide surveillance of deaths, hospital discharges, myocardial infarction and stroke registry was carried out in the intervention and control areas. Four to five years of interventions based on different categories such as mass media, community partnerships, health system involvement and policy and legislation have started in the intervention area while Arak will be followed without intervention. Considering the results of the baseline surveys, (assessments needed, the objectives, existing resources and the possibility of national implementation) the interventions were planned. They were set based on specific target groups like school children, women, work-site, health personnel, high-risk persons, and community leaders were actively engaged as decision makers. A series of teams was arranged for planning and implementation of the intervention strategies. Monitoring will be done on small samples to assess the effect of different interventions in the intervention area. While four periodic surveys will be conducted on independent samples to assess health behaviours related to CVD risk factors in the intervention and reference areas, the original pre-intervention subjects aged more than 35 years will be followed in both areas to assess the individual effect of interventions and outcomes like sudden death, fatal and nonfatal MI and stroke. The whole baseline survey will be repeated on the original and an independent sample in both communities at the end of the study.

BackgroundGeneral practitioners (GP) update their knowledge and skills by participating in continuing medical education (CME) programs either in a traditional or an e-Learning format. GPs’ beliefs about electronic format of CME have been studied but without an explicit theoretical framework which makes the findings difficult to interpret. In other health disciplines, researchers used theory of planned behavior (TPB) to predict user’s behavior.MethodsIn this study, an instrument was developed to investigate GPs’ intention to use e-Learning in CME based on TPB. The goodness of fit of TPB was measured using confirmatory factor analysis and the relationship between latent variables was assessed using structural equation modeling.ResultsA total of 148 GPs participated in the study. Most of the items in the questionnaire related well to the TPB theoretical constructs, and the model had good fitness. The perceived behavioral control and attitudinal constructs were included, and the subjective norms construct was excluded from the structural model. The developed questionnaire could explain 66 % of the GPs’ intention variance.ConclusionsThe TPB could be used as a model to construct instruments that investigate GPs’ intention to participate in e-Learning programs in CME. The findings from the study will encourage CME managers and researchers to explore the developed instrument as a mean to explain and improve the GPs’ intentions to use eLearning in CME.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0738-6) contains supplementary material, which is available to authorized users.

IntroductionClinical courses are required of all medical students and means that they must develop the key skill of self-regulation during learning. The ability to self-regulate learning strategies is affected by different factors. This study determined the views of medical students on the factors affecting self-regulated learning (SRL).MethodThis study uses a qualitative approach and the content analysis method. Nineteen medical students in their fourth, fifth, and sixth years of study at Isfahan University of Medical Science participated in semi-structured, in-depth interviews. The students were selected using purposive sampling based on their overall grade point average (GPA).ResultsFive main themes were found to affect SRL. These themes included family with the two subthemes of family supervisory and supportive roles; peers with the two subthemes of facilitating and inhibiting roles; instructors with the two subthemes of personal and educational instructor's characteristics; educational environment with the two subthemes of facilitator and inhibitor roles; and student with the two subthemes of facilitating and inhibiting personal factors.ConclusionThe outcomes of student understanding of the factors affecting self-regulation indicate that facilitating factors should be used on an individual basis to reduce the effect of inhibiting factors to improve self-regulation in students.

Background: Little research has been conducted to investigate role stress experienced by faculty members in medical schools in developing countries. This becomes even more important when the process of reform in medical education has already taken place, such as the case of Iran. The objectives of this study were to investigate and assess the level and source of role-related stress as well as dimensions of conflict among the faculty members of Iranian medical schools. Variables like the length of academic work, academic rank, employment position, and the departments of affiliation were also taken into consideration in order to determine potentially related factors.

Background:Medication errors and adverse drug events of high alert medication are one of the major problems in therapeutic system. The purpose of the present study was to investigate ύthe effect of clinical supervision model on high alert medication safety in intensive care units nurses.Materials and Methods:This was a quasi-experimental study conducted on 32 nurses of intensive care units. The researcher observed the administration of high alert drugs including heparin, warfarin, norepinephrine, dobutamine, and dopamine by nurses and recorded the scores of the work in preventing medication errors, the work in preventing adverse drug events, and medication safety. Then, the researcher performed clinical supervision model and during performance of the model, the researcher reassessed the score of the work in preventing medication errors, The work in preventing adverse drug events and medication safety. Tool of data collection was action plan of high alert medication safety checklists (heparin, warfarin, norepinephrine, dobutamine, and dopamine checklists).Results:The result of the statistical trials showed that before and after applying the clinical supervision model, there was a statistically significant difference between the average scores of medication safety of heparin (15.7 vs 18.73), warfarin (11.08 vs 15.67), norepinephrine (14.60 vs 19.72), dobutamine (13.80 vs 19.30), and dopamine (14.25 vs 19.47).Conclusions:Based on the results of this study, it seems that administration of clinical supervision model in intensive care units can lead to improving the status of safety of high alert medication.

Background Monitoring and management of undergraduate medical education (UME) curricula are crucial contributors to successful medical education. This systematized review explores the different approaches that medical schools have to UME curriculum management or monitoring in order to provide a basis for curriculum managers. Methods PubMed, Science Direct, Scopus, and ERIC were searched with no time limitation using the keywords curriculum , medicine, management, monitoring , and alignment . Advanced search options and Boolean operators ‘AND’ and ‘OR’ were also used to find more relevant records. Results From a total of 673 records, 14 articles along with 7 papers from hand searching and snowballing were included in the review. Documents were categorized into 3 groups of UME curriculum management: developing computerized tools, surveying curriculum stakeholders and reviewing curriculum documents, and introducing managerial structures. Conclusions Different approaches are reported for UME curriculum management/monitoring at different levels. Managerial structures and computerized tools are most frequently used at the college level because of the large number of faculty members who are responsible for the UME curriculum delivery and the large amount of complex curriculum information. Surveys and reviews of curriculum documents are used mostly to manage a part of a UME curriculum or to monitor teaching of a certain subject during all or some of the educational years.

Introduction:Appropriate instructional design plays a crucial role in e-learning success, and analyzing learners is the cornerstone for instructional design process. Students’ readiness for e-learning was assessed in the present study as an example of learner analysis for a distance course in medical education master program.Materials and Methods:A census sample of 23 students applied for distance master program on medical education, completed the “Students’ E-Learning Readiness Scale” developed by Watkins, via email. The reliability and validity of the scale has been confirmed before. Average scores in total and 6 subscales were calculated. The score range was 1-5 and scores above 3 indicated good readiness. Data was interpreted using descriptive and non-parametric tests (Mann-Whitney U and Kruskal-Wallis).Results:Response rate was 100%. The students’ readiness scores in total and all subscales (“technology access”, “online skills and relationships”, “motivation”, “online audio/video”, “readiness for online discussions”, and “importance of e-learning to your success”) were above 3. Comparing different subscales, students’ mean scores in “motivation” and “internet discussion” subscales were less than others, although the difference was not significant. There were no significant gender differences in the readiness scores. Students who were academic staff had significantly higher scores than others in total and in “motivation” and “online skills and relationship” subscales.Conclusion:Good learners’ readiness, observed in the present study, may imply that the instructional designer can rely on e-learning strategies and build the course upon them. However, according to the slightly lower scores in “motivation” and “online discussion” subscales, it is recommended to stress more on strategies that improve these two components. To generalize the results, it is needed to test students’ readiness in more different degree programs.

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