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Background Digital storytelling (DST), which combines traditional storytelling with digital tools, can provide a narrative pedagogy that promotes critical thinking (CT). However, we found no previous study in medical education. Materials and methods The aim of the study was to investigate if DST can promote CT and, if so, which CT skills were improved. Thirty-two students participated in a non-equivalent control group pretest-posttest research study, with 16 in each group. The participants were fifth-year medical students on a hematology rotation. We compared the routine instructional method (control group) with DST (intervention group). The measures of CT used for the pre- and post-test in both groups was the Health Science Reasoning Test (HRST) and knowledge test. We also evaluated the satisfaction of the students in DST group. We used Paired and independent t-tests for comparing the mean scores. To eliminate the confounding effect of pre-test on the results of the intervention, the ANCOVA test was used. Results There was no significant difference in the overall CT pretest scores (P-value = 0.51) between the control and intervention groupsbut the difference was significant for the post-test scores (P-value = 0.03). Although post-test scores showed a significant increase (P-value = 0.002) compared to pre-test scores in the intervention group, no significant increase was observed in the control group (P-value = 0.26). Most students considered that DST improved their CT, deep learning, communication skills and team-working. Conclusions The study demonstrated that DST promoted CT. We recommend the use of DST to promote CT in clinical education placements., Highlights • Critical thinking (CT) is a vital ability for medical students. • Digital storytelling (DST) is a narrative approach to promote CT. • DST promote CT as well as analysis skill in clinical setting. • For medical students who deal with everyday patient's stories, DST is a powerful teaching and learning method in clinical education.

Integration of simulated practice with art-based teaching strategy can be effective for learning communication skills. This pilot study outlines the effect of integrating simulation with art-based teaching strategies on the attitudes of oncology fellows toward learning communication skills. The study was conducted in Iran using a quasi-experimental method. The participants were the oncology fellows of Tehran University of Medical Sciences (n = 19). The intervention was 1-day workshop, followed by integrating simulation with different types of art-based teaching methods. The Communication Skills Attitude Scale (CSAS) was used to assess the effectiveness of the developed model. Our finding indicated that the mean values of oncology fellows' attitude scores in all domains of CSAS including importance in medical context (53.26 ± 2.13vs 41.00 ± 5.01, p = 0.001), excuse (25.84 ± 3.01vs14.36 ± 2.62, p = 0.001), learning (23.26 ± 1.40vs8.89 ± 2.25, p = 0.001), overconfidence (13.10 ± 1.44 vs 5.57 ± 1.38, p = 0.001), and overall (115.47 (5.51) vs 69.84(6.51) p = 0.001) increased significantly after the intervention as compared with before it. Findings support the hypothesis that using integrated training methods may help oncology fellows to appreciate the importance of communication skills learning. The implications of this hypothesis are that the inclusion of integrating simulation with art-based teaching strategies in the medical curriculum can improve the attitude of oncology fellows during their education.

The task of breaking bad news (BBN) may be improved by incorporating simulation with art-based teaching methods. The aim of the present study was to assess the effect of an integrating simulation with art-based teaching strategies, on fellows’ performance regarding BBN, in Iran. The study was carried out using quasi-experimental methods, interrupted time series. The participants were selected from medical oncology fellows at two teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran. Participants were trained through workshop, followed by engaging participants with different types of art-based teaching methods. In order to assess the effectiveness of the integrating model, fellows’ performance was rated by two independent raters (standardized patients (SPs) and faculty members) using the BBN assessment checklist. This assessment tool measured seven different domains of BBN skill. Segmented regression was used to analyze the results of study. Performance of all oncology fellows (n = 19) was assessed for 228 time points during the study, by rating three time points before and three time points after the intervention by two raters. Based on SP ratings, fellows’ performance scores in post-training showed significant level changes in three domains of BBN checklist (B = 1.126, F = 3.221, G = 2.241; p

Background: Depression is a well-known complication of breast cancer, which is known to adversely affect quality of life, prognosis, and survival in breast cancer patients. Celecoxib, a nonsteroidal anti-inflammatory drug, which acts via the selective inhibition of cyclo-oxygenase (COX)-2, has been shown to have antidepressive effects. Objectives: Here, we aimed to compare the efficacy and safety of celecoxib, a selective inhibitor of COX-2, with diclofenac, a nonselective inhibitor of both COX-1 and COX-2 in reducing depressive symptoms and pain in breast cancer patients. Methods: A total of 52 outpatients with breast cancer with mild to moderate depression, who suffered from pain and needed analgesics, participated in the trial and underwent 6 weeks of treatment with either celecoxib (200 mg twice daily) or diclofenac (50 mg twice daily). Participants were investigated using the Hamilton Depression Rating Scale (HDRS). The primary outcome measure was to compare the antidepressant effects of celecoxib and diclofenac. Results: Repeated-measures analysis demonstrated significant effect for Time × Treatment interaction on the HDRS scores: F(1.76, 87.85) = 9.66; P < 0.001. By study conclusion, greater improvement was observed in the HDRS score of the celecoxib group compared with the diclofenac group ( P = 0.002). No one experienced remission (HDRS ≤ 7) in either group. Frequencies of adverse events were not significantly different between groups. Conclusion: Celecoxib seems to possess superior antidepressive effects compared with diclofenac in breast cancer patients with mild to moderate depression.