سخن سردبیر Editorial 1 780 780 2024/09/25 1403/7/4 2024/09/25 1403/7/4 مسعود میرزایی Masoud Mirzaei دانشگاه علوم پزشکی شهیدصدوقی، یزد، ایران. ایران ## ##

تبیین تجارب بالینی دانشجویان پرستاری از آموزش فرایند پرستاری به روش یاددهی-یادگیری تلفیقی در بیمارستان شهید قاضی طباطبایی تبریز: تحلیل محتوی کیفی قراردادی Investigating Students' Clinical Experiences of Learning the Nursing Process Using an Integrated Teaching-Learning Method at Shahid Qazi Tabatabaei Hospital: A Qualitative Content Analysis 1 1 مقدمه: روش یاددهی-یادگیری تلفیقی به ارتقای مهارت‌های شناختی دانشجو و به‌تبع آن افزایش کیفیت مراقبت کمک می¬کند. این مطالعه باهدف تبیین تجارب یادگیری دانشجویان پرستاری از آموزش فرایند پرستاری به روش یاددهی-یادگیری تلفیقی در طی کارورزی پرستاری انکولوژی انجام گرفت. روش بررسی: داده‌های حاصل از مصاحبه نیمه ساختاریافته با 19 دانشجو که آموزش بالینی پرستاری انکولوژی را به روش تلفیقی گذرانده بودند، به¬روش تحلیل محتوای کیفی قراردادی تجزیه‌وتحلیل شد. تجارب مشارکت‌کنندگان در قالب زیر طبقات و طبقات استخراج گردید. نتایج: از تحلیل داده‌ها چهار طبقه شامل یادگیری شناختی پایدار، یادگیری غیر شناختی، کاربرد مفاهیم آموخته‌شده در موقعیت‌های واقعی و پیشنهاد‌های دانشجویان برای ارتقای یادگیری فرایند پرستاری ظهور یافت. نتیجه‌گیری: روش تلفیقی به‌عنوان یک روش آموزشی خلاق و دانشجو محور ، به‌طور مؤثری مهارت‌های شناختی و غیر شناختی را افزایش می‌دهد و کاربرد عملی مفاهیم آموخته‌شده را تسهیل می‌کند. برای تحقق کامل این مزایا، روش تلفیقی باید در سراسر واحدهای آموزش بالینی، از ترم‌های پایین‌تر اجرا شود. به‌طور هم‌زمان، بهبود محیط‌های آموزش بالینی در دنیای واقعی، نتایج مثبت آموزشی را تسریع می‌کند و می‌تواند مهارت‌های شناختی و غیر شناختی دانشجو را بهبود بخشد و پایه¬ای برای به‌کارگیری مفاهیم آموخته‌شده در بالین باشد. 2 Introduction: Integrated teaching-learning methods have demonstrated potential in enhancing students' cognitive skills and, subsequently, the quality of patient care. This qualitative study aimed to explore the learning experiences of nursing students engaged in an integrated teaching-learning method during their clinical education in oncology nursing. Method: : Semi-structured interviews were conducted with 19 nursing students who had completed a clinical training program in oncology nursing using an integrated teaching-learning method. Conventional qualitative content analysis was employed to analyze the data, identifying sub-categories and categories related to students' experiences. Results: The analysis revealed four main categories: (1) sustained cognitive learning, (2) non-cognitive learning, (3) application of learned concepts in real-world situations, and (4) students' suggestions for improving the learning of the nursing process. Conclusion: The findings suggest that an integrated teaching-learning method, implemented as a creative and student-centered approach at the bedside, effectively enhances both cognitive and non-cognitive skills, facilitating the practical application of learned concepts. To fully leverage the benefits of this method, its implementation should be expanded across clinical education units, starting in lower semesters. Simultaneously, optimizing real-world clinical education environments will further accelerate positive educational outcomes, enhancing students' cognitive and non-cognitive skills and creating a foundation for applying learned concepts in clinical practice. 781 800 2024/09/252024/07/12 1403/4/22 2024/09/252024/09/17 1403/6/27 عارفه داودی Arefe Davoodi دانشگاه علوم پزشکی تبریز، تبریز، ایران. Iran arefehd431@gmail.com اکرم قهرمانیان Akram Ghahramanian دانشگاه علوم پزشکی تبریز، تبریز، ایران. Iran Integrated teaching-learning method Clinical education Nursing process Internship Qualitative research آموزش تلفیقی آموزش بالینی فرایند پرستاری کارآموزی در عرصه تحقیق کیفی 1. Kalyani MN, Jamshidi N, Molazem Z, et al. How do nursing students experience the clinical learning environment and respond to their experiences? A qualitative study. BMJ open. 2019;9(7):e028052.##2. Yazdankhahfard M, Ravanipour M, Mirzaei K. The gap in the clinical learning environment: The viewpoints of nursing students. Journal of Education and Health Promotion. 2020; 9(1):1-5.##3. Mamaghani EA, Rahmani A, Hassankhani H, et al. Experiences of Iranian nursing students regarding their clinical learning environment. Asian nursing research. 2018; 12(3):216-22. [Persian].##4. Houghton CE, Casey D, Shaw D,et al. Students’ experiences of implementing clinical skills in the real world of practice. Journal of clinical nursing. 2013;22(13-14):1961-9.##5. Tabari F, Ebadi A, Jalalinia S. Pathology of the Clinical Education of Medical-Surgical Nursing Courses: A Qualitative Study. Education Strategies in Medical Sciences. 2014; 6(4):209-15.##6. Karimi H, Kalati H, Amini S. Applying Blended Education Methods in Nursing Process Learning: An educational evaluation study. Iranian Journal of Medical Education. 2021; 21:533-6. [Persian].##7. Zhang T, Hu J, editors. Application of Blending Teaching Based on MOOC in the Training of Undergraduate Nursing Students' Cardiopulmonary Resuscitation Skills. 2nd International Conference on Education & Education Research (EDUER 2017) UK; 2017.##8. McPherson C, MacDonald C. Blending simulation-based learning and interpretative pedagogy for undergraduate leadership competency development. Journal of Nursing Education. 2017; 56(1):49-54.##9. Ataei M, Safaryan Hamadani S,et al. A review of current and effective educational methods in continuing medical education. Clinical Excellence. 2020; 9(3):12-22.##10. Wang L, Chen H, Yang L,et al. 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Blended learning compared to traditional learning in medical education: systematic review and meta-analysis. Journal of medical Internet research. 2020;22(8):e16504.##16. Wildemuth BM. Applications of social research methods to questions in information and library science: Bloomsbury Publishing USA; 2016.##17. Rolfe G. Validity, trustworthiness and rigour: quality and the idea of qualitative research. Journal of advanced nursing. 2006; 53(3):304-10.##18. Rourke L, Anderson T, Garrison DR, et al. Methodological issues in the content analysis of computer conference transcripts. International journal of artificial intelligence in education. 2001;12:8-22.##19. Khedmatizare M, Norouzinia R, Aghabarary M, et al. Assessment of Factors Affecting Student-Patient Relationship from the Viewpoints of Nursing Students in Alborz University of Medical Sciences. Journal of Nursing Education. 2021; 10(3):46-54. [Persian].##20. Tseng H-C, Chou F-H, Wang H-H, et al. The effectiveness of problem-based learning and concept mapping among Taiwanese registered nursing students. Nurse education today. 2011; 31(8):e41-e6.##21. Gholami M, Saki M, Toulabi T, et al. Iranian nursing students' experiences of case-based learning: A qualitative study. Journal of Professional Nursing. 2017; 33(3):241-9.##22. Esfijani A. Investigating the Effects of Blended Instruction on Students’ Academic Performance and Satisfaction. Journal of New Educational Approaches. 2018; 13(1):45-66. [Persian].##23. Keshmiri F, Nasiriani K. Professional responsibilitis of nursing students in clinical education: A Delphi study. Nursing And Midwifery Journal. 2022; 20(5):398-407. [Persian].##24. Sadeghnezhad H, Khazaei T, Nasiri A. Comparing the effect of concept mapping to clinical simulation on emergency medical studentsclinical decision making. Iranian Journal of Medical Education. 2014; 14(3):241-51[Persian].##25. Talebi A, Nourbakhsh N, Mottaghi P, et al. New Teaching/learning model for medical students, according to integration of usual educational methods in Isfahan University Of Medical Sciences. Iranian Journal of Medical Education. 2011; 10(5). [Persian].##26. Wang L, Liao B, Yang H, et al. Exploring Nursing Undergraduates' Experiences with a Redesigned Blended Learning Course: A Descriptive Qualitative Study. Nursing Open. 2023; 10(4):2689-95.##27. Fallahi S, Yousefi P, Abedini S. The relationship between the components of clinical pharmacology curriculum and nursing students' clinical skills. Development Strategies in Medical Education. 2022; 9(2):3-10. [Persian].##28. Mbakaya BC, Kalembo FW, Zgambo M, et al. Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: a mixed-method study. BMC nursing. 2020; 19:1-14.##29. Kestel S, Korkmaz F. Effectiveness of blended learning in nursing process teaching: First-year nursing students. Teaching and Learning in Nursing. 2023;18(4):e212-e9.##30. Al-Osaimi DN, Fawaz M. Nursing students' perceptions on motivation strategies to enhance academic achievement through blended learning: A qualitative study. Heliyon. 2022; 8(7).##31. Rakhshan M, Jahromi MK. Exploration of Nursing Student’s Lived Experiences of Encounter with Theory and Practice Gap. Journal of Nursing Education (JNE). 2024;12(6):35-47. [Persian].##32. Rowe M, Frantz J, Bozalek V. The role of blended learning in the clinical education of healthcare students: a systematic review. Medical teacher. 2012;34(4):e216-e21.##33. Hinneburg J, Hecht L, Berger-Höger B, et al. Development and piloting of a blended learning training programme for physicians and medical students to enhance their competences in evidence-based decision-making. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. 2020;150:104-11.##34. Parandavar N, Rezaee R, Mosallanejad L, et al. Designing a blended training program and its effects on clinical practice and clinical reasoning in midwifery students. Journal of education and health promotion. 2019;8. [Persian].##35. Alfayoumi I. The impact of combining concept-based learning and concept-mapping pedagogies on nursing students' clinical reasoning abilities. Nurse education today. 2019;72:40-6.##36. Wihlborg J, Edgren G, Johansson A, et al. Using the case method to explore characteristics of the clinical reasoning process among ambulance nurse students and professionals. Nurse Education in Practice. 2019;35:48-54.##37. Wadowski PP, Litschauer B, Seitz T, et al. Case-based blended eLearning scenarios—adequate for competence development or more? Neuropsychiatrie. 2019;33(4):207-11.##38. Asgari Z, Pahlavanzadeh S, Alimohammadi N, et al. Quality of holistic nursing care from critical care nurses' point of view. Journal of Critical Care Nursing. 2019;12(1):9-14. [Persian].##39. Karimi Moonaghi H, Mohsenizadeh SM. 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ارزیابی آموزش بالینی بر اساس مدل کارآموزی شناختی با استفاده از پرسشنامه آموزش بالینی ماستریخت Evaluation of Clinical Education Based on Cognitive Apprenticeship Model Using Maastricht Clinical Education Questionnaire 1 1 چکیده مقدمه: یکی از ارکان اصلی در آموزش دانشجویان پزشکی، آموزش بالینی است. از جمله اصول زیربنایی آموزش بالینی، مدل کارآموزی شناختی است که شامل شش بعد الگو بودن، مربی‌گری، داربست، پیکره-بندی، بازاندیشی و اکتشاف است. هدف از انجام این پژوهش، ارزشیابی آموزش بالینی دانشگاه علوم پزشکی کرمان براساس مدل کارآموزی شناختی در سال 1401 بود. روش بررسی: در این پژوهش توصیفی-تحلیلی/ مقطعی، پرسشنامه آموزش بالینی ماستریخت بین ۱۵۰ نفر دانشجوی رشته پزشکی عمومی در مقطع کارآموزی و کارورزی در بخش‌های داخلی، جراحی، زنان، کودکان و روانپزشکی توزیع شد و با نرخ پاسخگویی ۷۴٪ توسط ۱۱۲ نفر تکمیل شد. نتایج: حیطه پیکره‌بندی بالاترین امتیاز را در ارزشیابی آموزش بالینی دانشگاه علوم پزشکی کرمان براساس مدل کارآموزی شناختی از دیدگاه دانشجویان کسب کرد و کمترین امتیاز به حیطه بازاندیشی تعلق گرفت. آموزش بالینی در بخش داخلی بیشترین تطابق را با مدل کارآموزی شناختی داشت. نتیجه‌گیری: شناخت نقاط قوت و ضعف آموزش بالینی، اولین قدم در جهت بهبود کیفیت آموزش پزشکی می‌باشد. در گام‌های بعد، دست‌اندرکاران و برنامه‌ریزان برنامه‌های توانمندسازی اعضای هیات علمی باید اقدام به طراحی، اجرا و ارزشیابی برنامه‌های توانمندسازی آموزشی ویژه اعضای هیات علمی بالینی با هدف ارتقای مهارت‌های آموزشی ایشان در محیط آموزش بالینی نمایند. 2 Introduction: One of the main aspects of medical students is clinical education. The cognitive apprenticeship model is one of the principles of clinical education and contains six dimensions, including modeling, coaching, scaffolding, articulation, reflection, and exploration. This research aimed to evaluate the clinical education at Kerman University of Medical Sciences based on the cognitive apprenticeship model in 2021. Method: In this descriptive-analytical cross-sectional research, the Maastricht Clinical Education Questionnaire was separated among 150 students, and with a response rate of 74%, 112 of them completed this. Results: In the evaluation of the clinical education at Kerman University of Medical Sciences, the score of the articulation domain was higher than others, and the lowest score was given to the reflection domain. Clinical education in the internal medicine department was the most consistent with the cognitive apprenticeship model. Conclusion: Identifying the strengths and weaknesses of clinical education is the first step toward improving the quality of medical education. In the subsequent steps, the practitioners and planners of the faculty member empowerment programs should design, implement, and evaluate educational empowerment programs for clinical faculty members to improve their academic skills in the clinical education environment. 801 810 2024/09/252024/07/122024/05/5 1403/2/16 2024/09/252024/09/172024/08/24 1403/6/3 مهلا سلاجقه Mahla Salajegheh دانشگاه علوم پزشکی کرمان، کرمان، ایران. Iran mahla.salajegheh90@gmail.com Medical Education Clinical Faculty Evaluation آموزش پزشکی اعضای هیأت علمی بالینی ارزشیابی 1. Zhu Z, Xing W, Lizarondo L, Guo M, Hu Y. Nursing students’ experiences with faculty incivility in the clinical education context: a qualitative systematic review and meta-synthesis. BMJ open. 2019; 9(2): e024383.##2. Vignos PJ, Parker WT, Thompson HM. Evaluation of a clinic education program for patients with rheumatoid arthritis. The Journal of rheumatology. 2023;50(1):156-65.##3. Gibson SJ, Porter J, Anderson A, Bryce A, Dart J, Kellow N, et al. Clinical educators’ skills and qualities in allied health: a systematic review. Medical education. 2019; 53(5): 432-42.##4. Frye AW, Hemmer PA. Program evaluation models and related theories: AMEE guide no. 67. Medical teacher. 2012; 34(5): e288-e99.##5. Lyons K, McLaughlin JE, Khanova J, Roth MT. Cognitive apprenticeship in health sciences education: a qualitative review. Advances in Health Sciences Education. 2017; 22(3): 723-39.##6. Matsuo M, Tsukube T. A review on cognitive apprenticeship in educational research: Application for management education. The International Journal of Management Education. 2020; 18(3): 100417.##7. Minshew LM, Olsen AA, McLaughlin JE. Cognitive apprenticeship in STEM graduate education: A qualitative review of the literature. AERA Open. 2021;7: 23328584211052044.##8. Tariq M, Iqbal S, Haider SI, Abbas A. Using the cognitive apprenticeship model to identify learning strategies that learners view as effective in ward rounds. Postgraduate Medical Journal. 2021; 97(1143): 5-9.##9. Jalalpour s Zs. Evaluation of medical students from clinical professors of Bushehr University of Medical Sciences based on the cognitive model of teacher-student. Journal of Medical education and Development. 2014; 9(13): 329. [Persian]##10. Stalmeijer RE, Dolmans DH, Wolfhagen IH, Muijtjens AM, Scherpbier AJ. The Maastricht Clinical Teaching Questionnaire (MCTQ) as a valid and reliable instrument for the evaluation of clinical teachers. Academic Medicine. 2010; 85(11): 1732-8.##11. Nejadkoorki H, Norouzi A, Salajegheh F, Salajegheh M. Psychometric evaluation of Maastricht clinical teaching questionnaire based on the cognitive apprenticeship model. Journal of Education and Health Promotion. 2023; 12(1): 434.##12. Vaughan B. Clinical educator self-efficacy, self-evaluation and its relationship with student evaluations of clinical teaching. BMC medical education. 2020; 20(1): 1-11.##13. Rahiem SMA, Habieb E-TE-SA, El-Shaer A. Impact of Clinical Supervision Program on Nursing Students' Achievement. IOSR J Nurs Health Sci. 2020; 9(1): 13-26.##14. Boerboom TB, Mainhard T, Dolmans DH, Scherpbier AJ, Van Beukelen P, Jaarsma AC. Evaluating clinical teachers with the Maastricht clinical teaching questionnaire: How much ‘teacher’is in student ratings? Medical teacher. 2012; 34(4): 320-6.##15. Konishi E, Saiki T, Kamiyama H, Nishiya K, Tsunekawa K, Imafuku R, et al. Improved cognitive apprenticeship clinical teaching after a faculty development program. Pediatrics International. 2020; 62(5): 542-8.##16. Al Ansari A, Tabbara KS. Evaluating the Reliability and Validity of the Maastricht Clinical Teaching Questionnaire in Bahrain. Oman Med J. 2019; 34(5): 427-33.##17. Rodino AM, Wolcott MD. Assessing Preceptor Use of Cognitive Apprenticeship: Is the Maastricht Clinical Teaching Questionnaire (MCTQ) a Useful Approach? Teaching and Learning in Medicine. 2019; 31(5): 506-18.##18. Bjerkvik LK, Hilli Y. Reflective writing in undergraduate clinical nursing education: A literature review. Nurse Education in Practice. 2019; 35: 32-41.##19. Larsen DP, London DA, Emke AR. Using reflection to influence practice: student perceptions of daily reflection in clinical education. Perspectives on medical education. 2016; 5(5): 285-91.##20. Vafadar Z, Parandeh A. Nursing StudentsExperiences of Narrative Writing-Reflection in Clinical Education: A Qualitative Study. Iranian Journal of Medical Education. 2019; 19: 78-89.##21. Robbins BT, Behal ML, Wiegand AM, D’Amico H, Cain JJ, Schadler A, et al. Assessing Cognitive Apprenticeship Impact on Clinical Reasoning in Third-Year Student Pharmacists. American Journal of Pharmaceutical Education. 2024; 88(1): 100625.##22. Williams CR, Minshew LM, Wolcott MD. The cognitive apprenticeship model as a framework for desired precepting qualities to inform preceptor development. Currents in Pharmacy Teaching and Learning. 2024; 16(1): 5-16.## ##

بررسی تأثیر مداخله آموزشی به روش یادگیری مبتنی بر مورد بر حساسیت و شجاعت اخلاقی دانشجویان پرستاری Investigating the Effect of Educational Intervention Using the Case-based Learning Method on the Sensitivity and Moral Courage of Nursing Students 1 1 مقدمه: مطالعه حاضر با هدف تعیین تأثیر آموزش با استفاده از روش یادگیری مبتنی بر مورد Case base Learning بر سطح حساسیت و شجاعت اخلاقی دانشجویان پرستاری انجام شد. روش بررسی: مطالعه حاضر نیمه تجربی با گروه کنترل غیر هم‌ارز است. جامعه پژوهش شامل دانشجویان پرستاری دانشگاه علوم پزشکی می‌باشد که به صورت سرشماری وارد مطالعه شدند (۶۱ نفر). برنامه آموزشی طراحی شد و روش اصلی یادگیری مبتنی بر مورد Case base Learning(CBL) بود. از پرسشنامه حساسیت اخلاقی لاتزن جهت بررسی سطح حساسیت اخلاقی و از پرسشنامه سکرکا جهت تعیین سطح شجاعت اخلاقی استفاده شد. دانشجویان قبل و دو مرتبه بعد از مداخلات آموزشی پرسشنامه‌ها را تکمیل کردند. داده‌ها با آزمون‌های توصیفی و تحلیلی (Pearson, RM-ANOVA) آنالیز شد. نتایج: تعداد ۶۱ نفر از دانشجویان در مطالعه حاضر شرکت کردند. ۲۹ نفر در گروه مداخله و ۳۲ نفر در گروه کنترل قرار داشتند. میانگین سنی شرکت‌کنندگان ۴۹/۰± ۴۱/۱۸ بود. نمرات حساسیت اخلاقی دانشجویان به صورت معنی‌داری در گروه مداخله و کنترل در طول زمان (یک هفته و سه ماه بعد مداخله) نسبت به قبل از مداخله تغییر کرده است (p-value= 0.02). در مورد نمرات شهامت اخلاقی اگرچه بهبود داشت اما تغییر معناداری بین گروه مداخله و کنترل قبل و یک هفته و سه ماه بعد از مداخله گزارش نشده است (p-value =0.82). نتیجه‌گیری: نتایج حاضر نشان داد مداخله آموزش با استفاده از روش یادگیری مبتنی بر مورد، موجب بهبود حساسیت اخلاقی دانشجویان و حفظ آن در طول زمان شد اما بهبود شجاعت اخلاقی در طول زمان بصورت معنیداری گزارش نشده است. 2 Introduction: The study aimed to assess the impact of Case-based Learning on nursing students' sensitivity and moral courage. Method: The present study is semi-experimental with non-equivalent control group. The research population is nursing students in Medical Sciences who entered the study by census (61 people). The educational program was designed, and the principal learning method was based on case-based learning (CBL). Latzen's ethical sensitivity questionnaire was used to check the level of moral sensitivity, and Sekerka's questionnaire was used to determine the level of moral courage. The students completed the questionnaires before and twice after the educational interventions. The data were analyzed with descriptive and analytical tests (Pearson RM-ANOVA). Results: The number of 61 students participated in the present study. The 29 people were in the intervention group and 32 in the control group. The average age of the participants was 18.41 ± 0.49. The study results showed that the moral sensitivity scores of the students in the intervention and control groups changed significantly over time (one week and three months after the intervention) compared to before the intervention (P = 0.02). Regarding moral courage scores, no significant change was reported between the intervention and control groups before, one week, and three months after the intervention (P = 0.82). Conclusion: The present results showed that the educational intervention using the case-based learning method improved the student's moral sensitivity and maintained it over time. However, improvement in moral courage over time has not been reported significantly. 811 823 2024/09/252024/07/122024/05/52024/05/22 1403/3/2 2024/09/252024/09/172024/08/242024/09/3 1403/6/13 فاطمه کشمیری Fateme Keshmiri دانشگاه علوم پزشکی شهید صدوقی یزد Iran Keshmiri1395@gmail.com سیده الهام فضل جو Seyede Elham Fazljoo دانشگاه علوم پزشکی شهیدصدوقی، میبد، ایران. Iran efazljoo@gmail.com، Moral sensitivity Moral courage Education Case-based learning Nursing student حساسیت اخلاقی شهامت اخلاقی آموزش یادگیری مبتنی بر مورد دانشجویان پرستاری 1. International Council of Nurses (2012) The ICN Code of Ethics for Nurses. http://www.icn.ch/who-we-are/code-of-ethics-for-nurses ##2. Pajakoski E, Rannikko S, Leino-Kilpi H, Numminen O. Moral courage in nursing - An integrative literature review. Nurs Health Sci. 2021;23(3):570-85.##3. Tuvesson H, Lützén K. Demographic factors associated with moral sensitivity among nursing students. Nursing Ethics. 2017;24(7):847-55.##4. Chambers DW. Developing a Self‐Scoring Comprehensive Instrument to Measure Rest's Four‐Component Model of Moral Behavior: The Moral Skills Inventory. Journal of dental education. 2011;75(1):23-35.##5. Morton KR, Worthley JS, Testerman JK, Mahoney ML. Defining features of moral sensitivity and moral motivation: Pathways to moral reasoning in medical students. Journal of moral education. 2006;35(3):387-406.##6. Omid A YN, Adibi P. The Outcomes of Ethics Education to Medical Students Based on Moral Reasoning Models. Iranian Journal of Medical Education 2014;13 (12):1099-113.##7. Numminen O, Repo H, Leino-Kilpi H. Moral courage in nursing: A concept analysis. Nursing ethics. 2017;24(8):878-91.##8. sadrollahi a kz. A survey of professional moral sensitivity and associated factors among the nurses in west Golestan province of Iran. Iranian Journal of Medical Ethics and History of Medicine. 2015;8(3):50-61.##9. Mahdiyoun SA, Pooshgan Z, Imanipour M, Razaghi Z. Correlation between the nurses, moral sensitivity and the observance of patients' rights in ICUs. Medical Ethics Journal. 2017;11(40):7-14.##10. Hassanpoor M, Hosseini M, Fallahi Khoshknab M, Abbaszadeh A. Evaluation of the impact of teaching nursing ethics on nurses' decision making in Kerman social welfare hospitals in 1389. Iranian Journal of Medical Ethics and History of Medicine. 2011;4(5):58-64.##11. Karimi Noghondar M, Tavakkoli N, Borhani F, Mohsenpour M. Ethical sensitivity: A comparison between the nursing students and nurses of Azad University. 2016;8(5):69-76.##12. Roshanzadeh M, Borhani F, Mohammadi S. Moral sensitivity and moral distress in critical care Unit Nurses. Medical Ethics Journal. 2017;10(38):19-28.##13. Gibson E. Longitudinal learning plan for developing moral courage.Teaching and Learning in Nursing. 2019;14(2):122-4.##14. Comrie RW. An analysis of undergraduate and graduate student nurses’ moral sensitivity. Nursing ethics. 2012;19(1):116-27.##15. Bickhoff L, Sinclair PM, Levett-Jones T. Moral courage in undergraduate nursing students: A literature review. Collegian. 2017;24(1):71-83.##16. Escolar-Chua RL. Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students. Nursing ethics. 2018;25(4):458-469. ##17. Black S, Curzio J, Terry L. Failing a student nurse: A new horizon of moral courage. Nursing Ethics. 2014;21(2):224-38.##18. Mohammadi S, Borhani F, Roshanzadeh M. Relationship between moral distress and moral courage in nurses. Iranian Journal of Medical Ethics and History of Medicine. 2014;7(3);26-35##19. Gallagher A. Moral distress and moral courage in everyday nursing practice. Online journal of issues in nursing. 2011;16(2):8.##20. Milliken A. Nurse ethical sensitivity:An integrative review. Nursing ethics. 2018;25(3):278-303.##21. McLeod-Sordjan R. Evaluating moral reasoning in nursing education. Nursing ethics. 2014;21(4):473-83.##22. Spekkink A, Jacobs G. The development of moral sensitivity of nursing students: A scoping review. Nursing ethics. 2021;28(5):791-808.##23. Kim MS. Influence of moral sensitivity and ethical values on biomedical ethics awareness of nursing students. The Journal of Korean Academic Society of Nursing Education. 2015;21(3):382-92.##24. 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ارتباط وضعیت آموزش بالینی با انگیزش تحصیلی دانشجویان مرحله بالینی رشته پزشکی دانشگاه علوم پزشکی گناباد The Relationship Between Clinical Education Status and Academic Motivation of Clinical-Stage Medical Students at Gonabad University of Medical Sciences 1 1 مقدمه: انگیزش در تحصیل و یادگیری از چالشهای اساسی در آموزش بالینی است. مطالعه حاضر با هدف بررسی ارتباط وضعیت آموزش بالینی و انگیزش تحصیلی دانشجویان مرحله بالینی رشته پزشکی دانشگاه علوم پزشکی گناباد انجام گرفت. روشها: این مطالعه مقطعی بر روی 198 دانشجوی کارآموز و کارورز رشته پزشکی دانشگاه علوم پزشکی گناباد در سال تحصیلی 1402-1401 به روش سرشماری انجام شد. ابزار گردآوری دادهها پرسشنامه بررسی وضعیت آموزش بالینی و پرسشنامه انگیزش تحصیلی هارتر بود. به منظور توصیف وضعیت آزمودنیها از آمار توصیفی (میانگین و انحراف معیار) استفاده شد و داده ها از طریق آزمونهای t مستقل، پیرسون و اسپیرمن با نرم افزار spss تجزیه و تحلیل شدند. یافتهها: میانگین نمره وضعیت آموزش بالینی کارآموزان 56/16±51/93 و کارورزان 08/12±12/93 بود. همچنین میانگین نمره انگیزش تحصیلی کارآموزان 30/11 ± 07/102 و کارورزان 54/11 ± 07/100 بود. وضعیت کلی آموزش بالینی با میانگین نمره 31/93 در حد نسبتا متوسط و انگیزش تحصیلی با میانگین 44/11±05/101 درحد بالایی بود و بین وضعیت آموزش بالینی و انگیزش تحصیلی ارتباط معناداری مشاهده شد (0.454 r=). نتیجهگیری: با توجه به ضعف در وضعیت آموزش بالینی و همچنین وجود ارتباط مستقیم بین وضعیت آموزش بالینی و انگیزش تحصیلی، پیشنهاد میگردد مسئولین دانشگاه خصوصا در معاونت آموزشی و معاونت درمان دانشگاه توجه و برنامهریزیهای ویژهای جهت بهبود وضعیت آموزش بالینی دانشگاه داشته باشند. 2 Introduction: Motivation in education and learning are significant challenges in clinical education. This study aimed to determine the relationship between clinical education status and academic motivation among clinical-stage medical students Gonabad University of Medical Sciences. Method: This cross-sectional study was conducted with 198 medical interns and residents at Gonabad University of Medical Sciences during the academic year 2021-2022 using a census method. Data collection tools included the Clinical Education Status Questionnaire and the Harter Academic Motivation Questionnaire. Descriptive statistics (mean and standard deviation) were used to describe the participants' status, and data were analyzed using independent t-tests, Pearson, and Spearman correlation tests. Results: The mean score for clinical education status among interns was 51.93 ± 16.56, while for residents, it was 12.93 ± 08.12. The mean score for academic motivation among interns was 102.07 ± 11.30, and for residents, it was 100.07 ± 11.54. Overall, the clinical education status averaged 93.31, indicating a relatively moderate level and Academic motivation averaged 101.05 ± 11.44, indicating a high level, with a significant correlation observed between clinical education status and academic motivation (r = 0.454). Conclusion: Given the weakness in the clinical education status, as well as the direct relationship between clinical education status and academic motivation, it is recommended that university officials, particularly in the educational and clinical departments, focus on special attention and planning to improve the clinical education status at the university. 824 835 2024/09/252024/07/122024/05/52024/05/222024/01/23 1402/11/3 2024/09/252024/09/172024/08/242024/09/32024/08/13 1403/5/23 هاشم فلاح Hashem Fallah دانشگاه علوم پزشکی کرمان Iran Hashemfallah2404@gmail.com رقیه ارشاد سرابی Roghaye Ershad Sarabi دانشگاه علوم پزشکی کرمان Iran a.ershadsarabi@gmail.com مهلا سلاجقه Mahla Salajegheh دانشگاه علوم پزشکی کرمان Iran mahla.salajegheh90@gmail.com مهدی بصیری مقدم Mahdi Basiri Moghadam دانشگاه علوم پزشکی گناباد Iran basiri1344@gmail.com مریم حجی پور Maryam Hajipour دانشگاه شهید بهشتی Iran Hajipoormaryam69@gmail.com Clinical education Academic motivation Medical students آموزش بالینی انگیزش تحصیلی دانشجویان پزشکی 1. 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بررسی رابطه بین نگرش به مدیریت تعارض و سبک‌های مدیریت تعارض در دانشجویان پزشکی Investigating the Relationship between Attitude towards Conflict Management and Conflict Management Styles in Medical Students 1 1 مقدمه: درک رابطه بین نگرش دانشجویان پزشکی نسبت به مدیریت تعارض و سبک‌های مدیریت تعارض غالب آنها برای بهبود توانایی آن‌ها در مدیریت مؤثر موقعیت‌های چالش‌برانگیز بسیار مهم است. این مطالعه با هدف تعیین ارتباط نگرش دانشجویان پزشکی نسبت به مدیریت تعارض با سبکهای مدیریت تعارض انجام شد. روش بررسی: این یک مطالعه توصیفی تحلیلی بود که 244 دانشجوی سال اول پزشکی عمومی دانشگاه علوم پزشکی تهران بصورت داوطلبانه و به روش در دسترس در آن مشارکت داشتند. از پرسشنامه نگرش به مدیریت تعارض (CMAQ) و پرسشنامه سبک‌های مدیریت تعارض (DUTCH) به منظور جمع آوری داده ها استفاده شد. برای تجزیه و تحلیل داده‌ها از ضریب همبستگی پیرسون و آزمون t مستقل استفاده شد. نتایج: دانشجویان از دو سبک حل مسئله (18/2±80/15) و مصالحه (23/2±00/15) بیشتر استفاده کردند. نتایج ضریب همبستگی پیرسون نشان داد که بین میانگین نمره نگرش به مدیریت تعارض با میانگین نمره سبک مصالحه و حل مساله همبستگی مثبت معناداری وجود دارد (014/0=P و 162/0 =r و 000/0=P و 287/0 =r). همچنین بین میانگین نمره نگرش به مدیریت تعارض با میانگین نمره سبک اجتناب همبستگی منفی معناداری وجود دارد (010/0=P و 170/0- =r). نتایج آزمون t نشان داد در سبک رقابت بین دانشجویان دختر و پسر اختلاف معنی داری وجود دارد (038/0P=). نتیجه‌گیری: نتایج این مطالعه نشان داد، دانشجویان پزشکی که نگرش مثبت‌تری نسبت به مدیریت تعارض دارند، در موقعیت‌های چالشی بیشتر از سبک‌های حل مسأله و مصالحه استفاده می‌کنند. 2 Introduction: Understanding the relationship between medical students' attitudes towards conflict management and their dominant conflict management styles is crucial for improving their ability to effectively handle challenging situations. This study aimed to determine the relationship between medical students' attitudes towards conflict management and their conflict management styles. Method: This was a descriptive, analytical study involving 244 first-year general medicine students from Tehran University of Medical Sciences. The Conflict Management Attitude Questionnaire (CMAQ) and the Conflict Management Styles Questionnaire (DUTCH) were used to collect data. Pearson's correlation coefficient and independent t-tests were employed for data analysis. Results: The results showed that students predominantly used problem-solving (15.80 ± 2.18) and compromising (15.00 ± 2.23) styles. Pearson's correlation analysis revealed a significant positive correlation between the average score of attitudes towards conflict management and the average scores of the compromising and problem-solving styles (P = 0.014, r = 0.162; P = 0.000, r = 0.287, respectively). Additionally, a significant negative correlation was found between the average score of attitudes towards conflict management and the average score of the avoiding style (P = 0.010, r = -0.170). The t-test results indicated a significant difference in the competing style between male and female students (P = 0.038). Conclusion: Identifying the strengths and weaknesses of clinical education is the first step towards improving the quality of medical education. Then the faculty development programs planners should design, implement and evaluate educational development programs for clinical faculty to improve their educational skills in the clinical education environment. 836 845 2024/09/252024/07/122024/05/52024/05/222024/01/232024/06/1 1403/3/12 2024/09/252024/09/172024/08/242024/09/32024/08/132024/09/21 1403/6/31 فاطمه محسنی Fatemeh Mohseni دانشکده علوم پزشکی گراش، گراش، ایران ایران mohseni.fa81@gmail.com محبوبه خباز مافی نژاد Mahboobeh Khabaz Mafinejad دانشگاه علوم پزشکی تهران، تهران، ایران ایران m-mafinejad@sina.tums.ac.ir آزاده سیاری فرد Azadeh Sayarifard دانشگاه علوم پزشکی تهران، تهران، ایران ایران drsayarifard@gmail.com علی نوروزی Ali Norouzi دانشگاه علوم پزشکی زنجان، زنجان، ایران ایران ali_norozy@yahoo.com Conflict Management Style Attitude Medical student سبک مدیریت تعارض نگرش دانشجوی پزشکی 1. Wang W, Ting S. Development of a computational simulation model for conflict management in team building. International Journal of Engineering Business Management. 2011;3:14.##2. Chan JC, Sit EN, Lau W. Conflict management styles, emotional intelligence and implicit theories of personality of nursing students: A cross-sectional study. Nurse education today. 2014;34(6):934-9.##3. Lee L, Berger DH, Awad SS, Brandt ML, Martinez G, Brunicardi FC. Conflict resolution: practical principles for surgeons. World Journal of surgery. 2008;32(11):2331-5.##4. Pavlakis A, Kaitelidou D, Theodorou M, Galanis P, Sourtzi P, Siskou O. Conflict management in public hospitals: the Cyprus case. International nursing review. 2011;58(2):242-8.##5. Kumar S. Burnout and doctors: prevalence, prevention and intervention. Healthcare. 2016: MDPI.##6. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of internal medicine. 2012;172(18):1377-85.##7. Siau CS, Wee L-H, Ibrahim N, Visvalingam U, Ling Yeap L, Yeoh S, et al. Predicting burnout and psychological distress risks of hospital healthcare workers. Malaysian Journal of Public Health Medicine. 2018;1:125-36.##8. Ramsay MA. Conflict in the health care workplace. Baylor University Medical Center Proceedings. 2001: Taylor & Francis.##9. Broukhim M, Yuen F, McDermott H, Miller K, Merrill L, Kennedy R, et al. Interprofessional conflict and conflict management in an educational setting. Medical teacher. 2019;41(4):408-16.##10. Wright AA, Katz IT. Beyond burnout—redesigning care to restore meaning and sanity for physicians. The New England Journal of Medicine. 2018;378(4):309-11.##11. Reeves S, Fletcher S, Barr H, Birch I, Boet S, Davies N, et al. A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Medical teacher. 2016;38(7):656-68.##12. Makary MA, Sexton JB, Freischlag JA, Holzmueller CG, Millman EA, Rowen L, et al. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. Journal of the American College of Surgeons. 2006;202(5):746-52.##13. Greer LL, Saygi O, Aaldering H, de Dreu CK. Conflict in medical teams: opportunity or danger? Medical education. 2012;46(10):935-42.##14. Kaufman DM, Laidlaw TA, MacLeod H. Communication skills in medical school: exposure, confidence, and performance. Academic Medicine. 2000;75(10):S90-S2.##15. Thomas EJ, Sexton JB, Helmreich RL. Discrepant attitudes about teamwork among critical care nurses and physicians. Critical care medicine. 2003;31(3):956-9.##16. Curran VR, Sharpe D, Forristall J. Attitudes of health sciences faculty members towards interprofessional teamwork and education. Medical education. 2007;41(9):892-6.##17. Bridges D, Davidson RA, Soule Odegard P, Maki IV, Tomkowiak J. Interprofessional collaboration: three best practice models of interprofessional education. Medical education online. 2011;16(1):6035.##18. Park J, Hawkins W, Hawkins M, Hamlin E. Attitudes toward interprofessional collaboration among students in the health care professions. Advances in Social Work. 2013;14(2):556-72.##19. Rios K, DeMarree KG, Statzer J. Attitude certainty and conflict style: Divergent effects of correctness and clarity. Personality and Social Psychology Bulletin. 2014;40(7):819-30.##20. Mohseni F, Mohammadi A, Mafinejad MK, Gruppen LD, Khajavirad N. Development and validation of conflict management attitude questionnaire for medical students. BMC medical education. 2022;22(1):860.##21. De Dreu CK, Evers A, Beersma B, Kluwer ES, Nauta A. A theory‐based measure of conflict management strategies in the workplace. J Organ Behav: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior. 2001;22(6):645-68.##22. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005;15(9):1277-88.##23. Tang SF, Kirkbride PS. Developing conflict management skills in Hong Kong: An analysis of some cross-cultural implications. Management Education and Development. 1986;17(3):287-301.##24. Kaushal R, Kwantes CT. The role of culture and personality in choice of conflict management strategy. International journal of intercultural relations. 2006;30(5):579-603.##25. Butts T. Manager as mediator: Attitude, technique, and process in constructive conflict resolution in the workplace. Advancing workplace mediation through integration of theory and practice. 2016:189-217.##26. Ajirowo WO. Effect of Conflict Management Styles on Employees’ Work Attitude in Selected State Owned Tertiary Institutions in Kwara State, Nigeria: Kwara State University (Nigeria). 2019.##27. Jelphs K. Communication: soft skill, hard impact? Clinician in Management. 2006;14(1).##28. Cross S, Rosenthal R. Three models of conflict resolution: Effects on intergroup expectancies and attitudes. Journal of Social Issues. 1999;55(3):561-80.##29. Shiva RA, Sanjar S, Hamid J. Relationship between the attitude toward change and conflict management styles of Tabriz petrochemical managers. European Journal of Experimental Biology. 2013;3(5):644-8.##30. Vandergoot S, Sarris A, Kirby N, Ward H. Exploring undergraduate students’ attitudes towards interprofessional learning, motivation-to-learn, and perceived impact of learning conflict resolution skills. Journal of interprofessional care. 2018;32(2):211-9.##31. Yousefi S. Attitude-based strategic and tactical negotiations for conflict resolution in construction. 2009.##32. Hastings TJ, Kavookjian J, Ekong G. Associations among student conflict management style and attitudes toward empathy. Currents in Pharmacy Teaching and Learning. 2019;11(1):25-32.##33. Gbadamosi O, Ghanbari Baghestan A, Al-Mabrouk K. Gender, age and nationality: Assessing their impact on conflict resolution styles. Journal of Management Development. 2014;33(3):245-57.##34. Chusmir LH, Mills J. 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سنجش دانش، نگرش و عملکرد اخلاق پزشکی در دانشجویان دانشکده دندانپزشکی بیرجند در سال 1400 Knowledge, Attitudes and Practices Related to Healthcare Ethics among Dental Students in Birjand in 2021 1 1 مقدمه: آموزش اخلاق پزشکی جهت حفظ قانونمندی و تداوم اعتماد عمومی به دندانپزشکی بسیار حیاتی است؛ بنابراین، این مطالعه با هدف سنجش دانش و نگرش و عملکرد اخلاق پزشکی دانشجویان دانشکده دندانپزشکی بیرجند در سال 1400 انجام شد. روش بررسی: در این مطالعه مقطعی توصیفی-تحلیلی، 117 نفر از دانشجویان که واحد اخلاق پزشکی را گذرانده بودند، شرکت داشتند. داده‌ها با استفاده از یک پرسشنامه مشتمل بر دو بخش اطلاعات دموگرافیک و سؤالات مرتبط با حیطه‌های دانش، نگرش و عملکرد جمع‌آوری شد. سنجش دانش و نگرش از طریق یک پرسشنامه که در مطالعات قبلی استفاده و روایی و پایایی آن تأییدشده بود، انجام شد. سنجش عملکرد با استفاده از پرسشنامه محقق ساخته صورت گرفت که پایایی آن با روش آلفای کرونباخ 78/0 به دست آمد. تجزیه‌وتحلیل داده‌ها با استفاده از آزمون‌های تی‌مستقل و آنالیز واریانس یک‌طرفه، من‌ویتنی و کروسکال‌والیس با سطح معنی‌داری 05/0 =α انجام شد. نتایج: میانگین نمره دانش، نگرش و عملکرد دانشجویان به ترتیب 09/6 ± 11/34، 73/5 ± 07/47 و 02/6 ± 74/31 بود. بین عملکرد و نگرش دانشجویان رابطه معناداری وجود داشت (403/0=r، 05/0>p). همچنین میانگین نمرات نگرش برحسب جنسیت تفاوت معنی‌‌داری داشت (020/0=p)، دانشجویان دختر میانگین نمره نگرش بالاتری نسبت به پسران داشتند. نتیجه‌گیری: بر اساس نتایج مطالعه، علیرغم دانش خوب، نگرش و عملکرد دانشجویان در سطح متوسطی قرار داشت؛ بنابراین، آموزش مناسب اخلاق دندانپزشکی در بین دانشجویان به‌ویژه دانشجویان پسر ضروری به نظر می‌رسد. 2 Introduction: Medical ethics education is very vital to maintaining legality and maintain public trust in dentistry. Therefore, this study aimed to measure the knowledge, attitude, and practice of medical ethics of Birjand dental faculty students in 2021. Method: In this descriptive-analytical cross-sectional study, 117 dental students who passed or were passing the medical ethics unit participated. The data was collected using a questionnaire consisting of two sections (demographic information and questions related to the areas of knowledge, attitude and performance). The knowledge and attitude were measured through a questionnaire that was used in previous studies and its validity and reliability were confirmed. Performance was measured using a researcher-made questionnaire, the reliability of which was obtained by Cronbach's alpha method of 0.78. Data analysis was done using Independent Samples T-tests, One-way analysis of variance, Mann-Whitney and Kruskal-Wallis tests at the significance level of 0.05. Results: The mean score of students' knowledge, attitude, and practices was 34.11 ± 6.09, 47.07 ± 5.73, and 31.74 ± 6.02, respectively. There was a significant relationship between performance and attitude of students (r = 0.403, P < 0.05). Furthermore, there was a significant difference in the mean score of attitudes according to gender (p = 0.020), female students had a higher mean score of attitudes than males. Conclusion: Based on the study's results, despite good knowledge, students' attitudes and performance are at an average level. Therefore, proper education on dental ethics among students, especially male students, seems necessary. 846 856 2024/09/252024/07/122024/05/52024/05/222024/01/232024/06/12024/06/13 1403/3/24 2024/09/252024/09/172024/08/242024/09/32024/08/132024/09/212024/09/1 1403/6/11 صدیقه ابراهیمی پور Sediqe Ebrahimipour دانشگاه علوم پزشکی بیرجند ایران sdent22@gmail.com شیما بیجاری Shima Bijari دانشگاه علوم پزشکی بیرجند ایران Shima.bijari223@gmail.com زهرا پرهیزگار Zahra Parhizgar دانشگاه علوم پزشکی مشهد ایران parhizgar.zahra91@gmail.com علی عابدی Ali Abedi دانشگاه علوم پزشکی بیرجند ایران Niniboy98@gmail.com Knowledge Attitude Performance Medical ethics Student Dentistry دانش نگرش عملکرد اخلاق پزشکی دانشجو دندانپزشکی 1. Najafi E, Amini-Rarani M, Moeeni M. Correlates of Demand for Basic Dental Services in Iranian Households. Journal of Isfahan Dental School. 2022; 18(1):59-69.##2. Shahsavaran H, Hajinabi K, Houshmand B, Farahani M. A Proposed Model for Dental Services Management in Iran. Quarterly Journal of Management Strategies in Health System. 2021; 6(3):188-202.##3. Baghban Y, Asgari I. An Overview of Dental Assistants' educational Status and Performance in Iran. Caspian Journal Of Dental Research. 2022;11(1):38-45.##4. Martin N, Sheppard M, Gorasia G, Arora P, Cooper M, Mulligan S. Awareness and barriers to sustainability in dentistry: A scoping review. Journal of dentistry. 2021;112:103735.##5. Duong ML, Villa A, Patton L, Frazier K, Khajotia S, Kumar P, et al. Dentist-administered vaccines: An American Dental Association Clinical Evaluators Panel survey. Journal of the American Dental Association (1939). 2022; 153(1):86-87.##6. Rischke R, Schneider L, Müller K, Samek W, Schwendicke F, Krois J. Federated Learning in Dentistry: Chances and Challenges. Journal of dental research. 2022;101(11):1269-1273.##7. Nitschke I, Hahnel S, Jockusch J. Health-Related Social and Ethical Considerations towards the Utilization of Dental Medical Services by Seniors: Influencing and Protective Factors, Vulnerability, Resilience and Sense of Coherence. International journal of environmental research and public health. 2021; 18(4):2048.##8. Lim M, Liberali S, Calache H, Parashos P, Borromeo GL. Perspectives of the public dental workforce on the dental management of people with special needs. Australian dental journal. 2021;66(3):304-313.##9. Mörch CM, Atsu S, Cai W, Li X, Madathil SA, Liu X, et al. Artificial Intelligence and Ethics in Dentistry: A Scoping Review. Journal of dental research. 2021;100(13):1452-1460.##10. Doyle DJ. Exploring the Hippocratic Oath: A Critical Look at Medicine's Oldest Surviving Guide to Medical Ethics. Ethics in Biology, Engineering Medicine: An International Journal. 2021;12(1):21-30.##11. Ramos R, Silva R, Cebola P, Félix S, Mariz de Almeida A. Evaluation of self-perception of awake bruxism in dentistry students – clinical case series. Ann Med. 2021;53(Suppl 1):S58##12. Agarwal A, P A, Mishra S. Ethics In Dentistry: Dental Profession: LAP LAMBERT Academic Publishing; 2022.##13. Sharma P. The importance of team morale. BDJ Team. 2021;8(1):22-23.##14. Mirzaei sa, Gharakhani M. Scientific Associations and Promotion of Professional Ethics in Science in Iran. Sociological Review. 2022;28(2):267-285.##15. Fayyaz AF. Determining the Attitude of Medical Students (interns and residents) towards the Course of Medical Ethics at AJA University of Medical Sciences. Nurse and Physician within War. 2022;10(35):6-15.##16. Amiri P. Professional Ethics in Media within the Islamic Revolution. Quarterly Scientific Journal of Applied Ethics Studies. 2020;16(39):117-144.##17. Forrest FG. Valuemetrics: The Science of Personal and Professional Ethics: BRILL; 1994.##18. Janakiram C, Gardens SJ. Knowledge, attitudes and practices related to healthcare ethics among medical and dental postgraduate students in south India. Indian journal of medical ethics. 2014;11(2):99-104.##19. Hariharan S, Jonnalagadda R, Walrond E, Moseley H. Knowledge, attitudes and practice of healthcare ethics and law among doctors and nurses in Barbados. BMC medical ethics. 2006;7:E7.##20. Elyassi Gorji N, Bagheri Nesami M, Nahvi A. Attitudes toward professional ethics in dentistry students of faculty of dentistry of Sari in 2019. Journal of research in dental sciences. 2021;18(2):136-142.##21. Mohebbi Amin S, Rabiei M, Keizoori AH. A review of students’ evaluation of the medical ethics curriculum. Iranian Journal of Medical Ethics and History of Medicine. 2015;8(3):77-86.##22. Elsheikh NMA, Osman IMA, Husain NE, Abdalrahman SMA, Nour H, Khalil AA, et al. Final year dental students' perception and practice of professionalism and ethical attitude in ten Sudanese dental schools: A cross-sectional survey. Journal of family medicine and primary care. 2020;9(1):87-92.##23. Althobaiti MH, Alkhaldi LH, Alotaibi WD, Alshreef MN, Alkhaldi AH, Alshreef NF, et al. Knowledge, attitude, and practice of medical ethics among health practitioners in Taif government, KSA. Journal of family medicine and primary care. 2021;10(4):1759-1765.##24. Bahrani F, Farzin M, Nozari L. Shiraz dentists’ knowledge of professional ethics. Iranian Journal of Medical Ethics and History of Medicine. 2012;5(6):69-80.##25. Pais V, Vaswani V, Pais S. To evaluate the knowledge, attitude and practice of healthcare ethics among medical, dental and physiotherapy postgraduate students—a pilot study. International Journal of Ethics Education. 2021;6:1-11.##26. Hertrampf K, Groß D, Karsten G, Wenz HJ. The influence of clinical experience on dental students' ethical awareness. European journal of dental education. official journal of the Association for Dental Education in Europe. 2019;23(2):101-109.##27. Shorr AF, Hayes RP, Finnerty JF. The effect of a class in medical ethics on first-year medical students. Academic medicine. journal of the Association of American Medical Colleges. 1994;69(12):998-1000.##28. Jabarifar SE, Khalifesoltani F, Nilchian F, Yosefi A, Hosseinpour K. Evaluation of under- and post-graduate Dental students of Isfahan Faculty of Dentistry in relation to communication skills and professional ethics. Journal of Isfahan Dental School. 2012;7(5):753.##29. Johnston C, Haughton P. Medical students' perceptions of their ethics teaching. Journal of medical ethics. 2007;33(7):418-422.##30. Nasab MM, Tofighi S. Comparison of the student’s and faculty members’ opinions about reform in GP education in Hamedan, Lorestan and Ahvaz Universities of Medical Sciences–2003. Journal of Medical Education. 2004;6(1):e105113.##31. Sabet A, Fili A, Poya A, Majidi A. Providing a Predicting Model of Ethics in Research among Students Ethics in Science and Technology. 2018;12(4):81-88.##32. Asaar S, heybar H, Bijanzadeh M, Tabesh H. Teaching Medical Ethics to Medical Interns Using Display and Analysis of Performance Approach to Patients. Educational Development of Judishapur. 2016;7(3):225-230.##33. Or CK, Karsh B-T. A systematic review of patient acceptance of consumer health information technology. Journal of the American Medical Informatics Association. 2009;16(4):550-560.##34. Adhikari S, Paudel K, Aro AR, Adhikari TB, Adhikari B, Mishra SR. Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting, Nepal. BMC medical ethics. 2016;17(1):68.## ##

نیم نگاهی به تبعات اقتصادی مهاجرت متخصصین: دغدغه آموزش پزشکی A glance at the economic consequences of migration of specialists: the concern of medical education 1 1 مهاجرت پدیده جدیدی نیست. اولین مهاجرت‌ها، به قبل از تاریخ نسبت داده می شود اما آنچه امروزه، توجه بسیاری را به خود جلب کرده است، رشد روزافزون آن است (1). 2 Migration is not a new phenomenon. The first migrations are attributed to prehistoric times, but what has attracted a lot of attention today is its increasing growth (1). 857 858 2024/09/252024/07/122024/05/52024/05/222024/01/232024/06/12024/06/132024/09/24 1403/7/3 2024/09/252024/09/172024/08/242024/09/32024/08/132024/09/212024/09/12024/09/24 1403/7/3 پروین رضایی گزکی Parvin Rezaei دانشگاه علوم پزشکی کرمان، کرمان، ایران. ایران مهلا سلاجقه Mahla Salajegheh دانشگاه علوم پزشکی کرمان، کرمان، ایران. ایران economic consequences migration medical education تبعات اقتصادی مهاجرت آموزش پزشکی 1. Dortaj F, Rezaei P. Elite migration, a phenomenon to ponder: kerman university of medical sciences; 2008 .##2.Botezat A, Incaltarau C, Nijkamp P. Nurse migration: Long-run determinants and dynamics of flows in response to health and economic shocks. World Development. 2024; 174: 106445.##3. F A. The inclination to immigration and the related factors among Iranian physicians. Hakim. 2006; 8(3): 9-15.##4. Ghaffarian A, Ferdosi M. Migration of Medical Staff; Has the Alarm Sounded? Letter to Editor. Journal of Birjand University of Medical Sciences. 2022; 29(4): 397-401.##5. Haghdoost AA, Noorihekmat S, Talaei B, Malekpour Afshar R, Salavati B, Behzadi F, et al. An Investigation of Factors Associated with Emigration of the Health Workforce in Iran in 2022. Iranian Journal of Culture and Health Promotion. 2022; 6(2): 205-13.## ##

فعالیتهای قابل واگذاری در آموزش پزشکی و اهمیت آنها Entrustable professional activities in medical education and their importance 1 1 اعتماد یک مفهوم اساسی برای مراقبت‌های بهداشتی ایمن و مؤثر است. بیماران باید به پزشکان خود اعتماد کنند و ارائه دهندگان مراقبت‌های بهداشتی باید در یک سیستم مراقبت بهداشتی به یکدیگر اعتماد داشته باشند. فعالیتهای قابل واگذاری واحدهایی از عملکرد حرفه‌ای هستند که به عنوان وظایف یا مسئولیت‌هایی تعریف می‌شوند که باید به محض اینکه کارآموز به توانمندی خاص کافی دست یافت، برای اجرای بدون نظارت به کارآموز سپرده شود. بسیاری از حرفه‌‌های پزشکی را می‌توان با فعالیت‌هایی که متخصص باید انجام دهد توصیف کرد. آنچه در آموزش پزشکی پس از اتمام دوره حائز اهمیت است این است که این فعالیت‌ها با اطمینان انجام شود. در عمل انتظار معقول این است که اکثر کارآموزان در حوالی زمان فارغ التحصیلی توانمندی برای انجام تمامی فعالیتهای قابل واگذاری را به دست آورند، اما دانشجویان باهوش ممکن است در زمانی زودتربه این توانمندی دست یابند. اخیراً در آموزش پزشکی در مقطع عمومی در ایالات متحده و کانادا نیز کاربرد فعالیتهای قابل واگذاری آغاز شده است. در حیطه های دیگر به غیر از پزشکی، در رشته‌های دیگر مانند پرستاری، دامپزشکی، و مامایی نیز فعالیتهای قابل واگذاری به طور فعال توسعه یافته است. 2 Trust is a fundamental concept for safe and effective health care. Patients need to trust their doctors and healthcare providers need to trust each other in a healthcare system. Entrustable professional activities are units of professional performance defined as tasks or responsibilities that should be entrusted to the trainee for unsupervised performance once the trainee has achieved sufficient specific competence. Many medical professions can be described by the activities that the specialist must perform. What is important in medical education after completing the course is that these activities are performed confidently. In practice, it is reasonable to expect that most trainees will have the ability to perform all Entrustable professional activities around the time of graduation, but bright students may achieve this ability sooner. Recently, the use of Entrustable professional activities has also begun in general medical education in the United States and Canada. In other fields, other than medicine, such as nursing, veterinary medicine, and midwifery, Entrustable professional activities have been actively developed. 859 861 2024/09/252024/07/122024/05/52024/05/222024/01/232024/06/12024/06/132024/09/242024/09/5 1403/6/15 2024/09/252024/09/172024/08/242024/09/32024/08/132024/09/212024/09/12024/09/242024/09/16 1403/6/26 حمید مهدوی فرد Hamid Mahdavifard دانشگاه علوم پزشکی نیشابور ایران mahdavifh1@mums.ac.ir 1. Ten Cate OJJogme. Nuts and bolts of entrustable professional activities. 2013; 5(1): 157-8. ##2. Ten Cate OJKjome. A primer on entrustable professional activities. 2018;: 30(1): 1. ##3. Ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Academic medicine. 2007; 82 (6): 542-7.##4. Schultz K, Griffiths J, Lacasse M. The application of entrustable professional activities to inform competency decisions in a family medicine residency program. Academic Medicine. 2015; 90(7); 97-88.. ##5. ten Cate TJO, Snell L, Carraccio C. Medical competence: the interplay between individual ability and the health care environment. Medical teacher. 2010; 32(8): 75-669. ##6. Sterkenburg A, Barach P, Kalkman C, Gielen M, ten Cate O. When do supervising physicians decide to entrust residents with unsupervised tasks? Academic Medicine. 2010; 85(9): 17-1408.##7. Ten Cate O, Hart D, Ankel F, Busari J, Englander R, Glasgow N, et al. Entrustment decision making in clinical training. Academic Medicine. 2016; 91(2):8-191.##8. Cate Ot. Entrustment as assessment: recognizing the ability, the right, and the duty to act. Journal of Graduate Medical Education. 2016; 8 (2): 2-161.##9. Long D. Editor Competency based residency training: the next advance in graduate medical education. Risk Control and Quality Management in Neurosurgery; 2001: Springer.##10. Nousiainen MT, McQueen SA, Ferguson P, Alman B, Kraemer W, Safir O, et al. Simulation for teaching orthopaedic residents in a competency-based curriculum: do the benefits justify the increased costs? Clinical Orthopaedics and Related Research. 2016; 935: 44-474.## ##