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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.

Introduction: Education and research are two thinking based processes. Nowadays, the main function of educational institutions is evaluated by thinking. This study aimed to determine the dominant thinking styles among medical and dental students of Ilam University of Medical Sciences (IUMS). Materials and methods: This cross-sectional study was conducted on all medical and dental students of IUMS in the academic year of 2016-2017. Data was collected by Sternberg’s standard thinking style inventory and a demographic data questionnaire. Data analysis was carried out with the software SPSS 20 using descriptive statistical analysis methods and t-test. Results: In total, 497 students of IUMS participated in the study. Among whom 395 (79.5%) were medicals students and 102 (20.5%) were dental students. The findings showed significant differences between the legislative and executive thinking styles of medical and dental students (P=0.042 and P=0.024 respectively), more specifically, the mean score of legislative thinking style was found to be higher among dental students than that of medical students, and the opposite relation was found in the mean scores of executive thinking style. Comparison of mean scores of thinking style dimensions between medical and dental students showed significant differences in some but not all dimensions. Conclusion: Considering the differences found in thinking styles of medical and dental students and their effects in emergence of unique behavioral and decision-making characteristics in medical and dental students, educational planners and professors should attempt to adjust their teaching methods and professional approach according to students individual features in terms of thinking style and preferences so as to foster the growth and flourish of their thinking, academic, and clinical capabilities. The results of the study showed significant differences between the legislative and executive thinking styles of medical and dental students, also regarding the different dimensions of thinking styles of medical and dental students, some significant differences in some but not all dimensions were reported.

Objective:Internationally, the distribution of specialized physicians is a growing concern. The choice of medical specialties is a central issue in attempts to change this problematic situation. The current study aimed to explain the process of choosing clinical specialties in Iran’s medical graduates.Materials and Methods:The authors used grounded theory methodology. In 2016-2017, they conducted 14 in-depth, face-to-face, semi structured interviews with a purposive and theoretical sample of 10 medical graduates based on two criteria (those who intended to participate in the medical assistant exam and those who participated in the exam and their test scores had not yet been announced).Results:After analysis of the interviews, 883 primary codes, 64 subcategories, 14 subclasses, and 4 main categories were obtained. The results of data collection and analysis at four levels by Strauss and Corbin (2008), which led to the theory and model in this field, showed the effectiveness of the process of choosing specialty results from the coordination between three dimensions of study, career, and favorable conditions imagined for the future life that takes place in a supportive environment with a developed welfare system and an inclusive academic culture.Conclusion:With the help of the findings of such a study, the process and the main elements involved in this process can be determined and the causal relationships and mechanisms can be identified and intervened, which in turn leads to choosing medical specialty in line with the national priorities.

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: Assessing the effectiveness of in-service training courses in order to achieve the desired goals and reduce the waste of costs and opportunities in the system is necessary. The purpose of this study was to determine the effectiveness of the “pharmacopeia home health” course considering its importance in different aspects using the Kirkpatrick model. MATERIALS AND METHODS: The present study was a quasi-experimental conducted at community health workers (CHWs) on three levels of reaction, learning, and behavior. In each phase, a valid questionnaire was used to measure the outcome according to the Ministry of Health guidelines with pretest and posttest measurements. The data were analyzed through SPSS 23, using descriptive statistics and repeated measures test and general linear model. RESULTS: The results of the study showed that at the level of reaction in terms of content and holding, conditions of implementation were favorable. Findings at the level of learning showed that the training course was only effective in enhancing the knowledge and awareness about drug maintenance and had no significant effect on other areas. In the third level, the results of the CHWs' performance showed that in some areas, the results were influenced by the demographic variables. CONCLUSION: The present study showed the effectiveness of education in different areas using on the Kirkpatrick model. Given the lack of impact of education in some areas in the present study and on the other, it is necessary to consider cooperative learning methods in order to develop the effectiveness of the courses.

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.