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Background: Systematic application of a cervical cancer screening program reduces the socioeconomic burden of the disease. Evaluation of screening programs using performance indicator sets and applying cultural, economic, and social considerations minimize the negative impacts of screening and maximize its benefits. Objectives: The present study aimed at developing and evaluating performance indicators of a cervical cancer screening program based on the guidelines of Iran Ministry of Health and Medical Education to identify shortcomings and improve national programs. Methods: A total of 839 out of 2504 care checklists for middle-aged women in Rasht, Iran, from 2014 to 2018 were studied. Indicators were evaluated based on the guidelines of Iran Ministry of Health and Medical Education on care for middle-aged individuals in 6 areas of screening intensity, screening the program performance, the participation of individuals, compliance of the implementation with guidelines, etc. Results: The eligible women coverage index was 34%. The index of participation in the first run Pap test was 45.53% in 2014. The study findings showed that with the implementation of the plan on participants, the test rate increased by 39.1%. The indices of identification of high-risk individuals based on medical histories, identification of abnormal Pap smears, and participation continuity in the program were 54.84, 33.73%, respectively and 1.32% in 2015, which decreased to < 1% in 2016. The compliance rate with the guidelines was 64.94%, and the performance recording index was 22.40%. Conclusions: Due to the low coverage rate and other performance indicators, especially the low continuity index, the attention of policy-makers and program managers should be drawn to potential shortcomings of screening programs, such as active implementation, in order to promote women’s health status.

Background: A large number of students enrolled in many universities and the low ratio of supervisors to the student have challenged the process of developing education and research. Today, information and communication technology (ICT) tools have changed the learning environments. We assessed the improvement in challenges in the thesis process for Master’s degree virtual students using learning management systems (LMS). Methods: This study is a translational research design focusing on adaptation of educational technology and was conducted in three stages: Preparation, implementation, and assessment in the Shahid Beheshti University of Medical Sciences in 2017. In the preparation stage, we matched LMS with technical support requirements. In the experimental stage, the effectiveness of a web-based system (LMS) for thesis support was assessed in 67, 65, and 51 master students in 2017, 2018, and 2019, respectively, and they were followed two years. In the post- experimental stage, the program was assessed using quality criteria. The data were analyzed by descriptive statistics (mean and standard deviation), analysis of variance (ANOVA), and post-hoc tests. Results: Data of 67 students as the first entry group were collected after two years of implementation of the program and 22 quality criteria were extracted by literature review and validated by focus group discussion. The results of students’ perspective showed that the scores of the quality criteria after using LMS in comparison other alternative methods were at the desirable level (mean score > 7), the social network and email scores were mostly at the moderate level, and the meeting was almost less desirable (mean score < 4). The results of the supervisors’ perspective also showed that the scores of the quality criteria were at the desirable level. The ANOVA result for most criteria was statistically significant at 95% CI. The results indicated the higher scores in all quality criteria after using LMS in comparison with alternative methods from the viewpoints of the supervisors and students (95% CI: 8.76 ± 0.83) and (95% CI: 8.71 ± 0.64), respectively. Conclusions: The results of this study indicated that implementing LMS for thesis support was almost twice more successful in achieving the considered criteria than other alternative methods in terms of both students’ and supervisors’ perspectives. Implementation of LMS in the thesis process, which significantly affects the quality and quantity of research through improvement in feedback quality, saves time, and increases the rate of thesis completion.

An outbreak of pneumonia, caused by a novel coronavirus (COVID-19) was Identified in China in Dec 2019. This virus expanded worldwide, causing global concern. Clinical, laboratory and imaging features of this infection are characterized in some observational studies. We undertook a systematic review and meta-analysis to assess the frequency of clinical, laboratory, and CT features in COVID-19 patients.We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and CT features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included.Overall, the results showed that fever (84.2%, 95%CI 82.6-85.7), cough (62%, 95%CI 60-64), and fatigue (39.4%, 95%CI 37.2-41.6%) were the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently GGO (60%, 95%CI 58-62) and peripheral distribution (64%, 95%CI 60-69).These results demonstrate the clinical, paraclinical, and imaging features of COIVD-19.

Background: Among core competencies introduced by the Accreditation council for graduate medical education (ACGME), practice-based learning and improvement (PBLI) monitors the improvement and quality of physicians’ performance during their professional practice. Understanding and knowledge of the viewpoints of medical professionals, planners, and graduates about the concept of PBLI and investigating its current status are required for proposing appropriate policies and plans in this area. Methods: This qualitative study was performed through thematic content analysis. In-depth semi-structured interviews were conducted to gather data in Tehran, Iran from June 2016 to January 2017. Purposeful sampling was applied, and the participants included experts, planners, and medical graduates. While considering the trustworthiness criteria during the study, interviews were performed, transcribed, and coded. We used ATLAS.ti version 6 for coding and categorization. Results: The study sample consisted of 11 participants, including 4 executive officials, 4 experts of medical education, and 3 general practitioners (4 females and 7 males). The average age of the participants was 48 ± 8.47 years. The analyses introduced 9 categories, 56 subcategories, and 224 initial codes. The main categories included: PBLI attributes, components of PBLI, shortcomings of the academic educational system, shortcomings of the health system, strategies for academic education reform, strategies for health system reform, activators of PBLI, solutions for gaps in PBLI, and need for PBLI. Conclusions: PBLI is a professional necessity for all physicians. Feasibly, excellence in clinical care can be achieved with this competency. Implementation of PBLI requires a competency-based curriculum, academic education, and a proper infrastructure for its implementation in clinical service delivery environments. Health system stewardship plays a great role in overcoming the challenges and developing coordinated national systems.

BACKGROUND: In Iran, community health workers (CHWs) are native and are only employed in the health-care system. Therefore, the training and empowerment of these staff are essential. The present study was aimed to develop cooperative learning techniques in CHWs to improve both cognitive and noncognitive aspects such as accountability and other social skills in learners. METHODOLOGY: This study employed a quasi-experimental pre- and post-test design with a control group that was conducted in Kangavar City, Iran, in 2019. Forty-four CHWs were selected using a two-stage cluster sampling, of whom 22 were randomly assigned to the experimental group where the jigsaw technique was applied and the rest to the control group where the lecture method was applied. The aim was to identify job performance and motivation among the CHWs after instruction and compare the two groups. Pre- and posttests were applied to the groups before and after an in-service training course using valid questionnaires. Data analysis was performed on both descriptive and inferential statistics such as mean and standard deviation, paired t-test, and covariance analysis with the confidence level of 95%. RESULTS: The findings showed that the intervention significantly increased the mean score of motivation and performance in the experimental group. Covariance analysis with the removal of the pretest effect was also statistically significant (P = 0.01). Moreover, the MANCOVA test showed the jigsaw technique effect considering motivation and performance with a confidence level of 95%. CONCLUSION: Given the well-known effect of cooperative learning techniques and since CHWs have multi roles and tasks, it is necessary to use such techniques so that they can be accountable for developing health indicators in local areas.

Context: Given the importance of learning from both cognitive and non-cognitive aspects of development in medical science education, the selection of appropriate educational strategies is a key structural issue. The jigsaw method is used in cooperative learning to improve cognitive and non-cognitive skills. Objectives: The present study aimed to investigate the status of the jigsaw method as a cooperative learning technique. Methods: This was a review and meta-analysis, in which relevant studies were identified through electronic database searching using specific keywords. The inclusion criteria for the meta-analysis were experimental and quasi-experimental studies. The intervention involved the comparison of the jigsaw method to other methods, and various cognitive and non-cognitive outcomes were assessed. The meta-analysis to determine the summary estimation using comprehensive meta-analysis software was performed using the fixed model method. The heterogeneity of the studies was evaluated based on the I2 index. Results: From the extracted studies (n = 682) with various stages of investigation in the target databases and exclusion of the repetitive cases, 10 articles were selected based on the inclusion criteria, and seven articles with common outcomes were selected for the meta-analysis. The summary estimate of 1.29 (95% CI: 1.07 - 1.51) was calculated, and many outcomes were individually interpreted. Conclusions: The national literature review indicated that the jigsaw method is rarely used in medical education. Considering the impact of this approach on cognitive and non-cognitive skills, the necessary cooperative learning approaches should be developed in the medical education system.