Journal of Education and Health Promotion

Abstract Abstract:
BACKGROUND: Any prediction of a person’s ability to succeed in a motor skill depends on the
detection and accurate measurement of the basic abilities for the performance of that skill. Task
analysis is needed to determine the psychomotor skills and abilities required to perform an action.
This study aimed to determine the components of psychomotor abilities for diagnostic upper
gastrointestinal (GI) endoscopy through procedural task analysis (PTA) and expert review.
MATERIAL AND METHODS: A multisource, multimethod task analysis was conducted in six
metropolitan teaching hospitals affiliated with the adult gastroenterology and hepatology training
centers in the Islamic Republic of Iran in 2019. Observation, video-recording, and think-aloud protocols
were used while diagnostic upper GI endoscopy was performed. To confirm the accuracy of the
PTA, the incorporated the views of the adult gastroenterology and hepatology subspecialty experts
through the checklist of PTA assessment criteria. Finally, to determine the psychomotor abilities for
each stage of the procedure, the study incorporated a panel of experts from occupational therapy,
physical education, physical medicine, and adult gastroenterology and hepatology subspecialty.
RESULTS: Of the 15 psychomotor abilities examined, 11 were determined for upper GI endoscopy
procedure, of which six cases (including visuospatial and perceptual abilities, hand–eye coordination,
multilimb coordination, finger dexterity, arm–hand steadiness, and manual dexterity) were the most
frequent.
CONCLUSIONS: PTA techniques and subsequent expert review were used to identify the components
of psychomotor abilities for diagnostic upper GI endoscopy. It is suggested that PTA is performed
for other procedures, and after psychomotor abilities are specified, proportional tests are developed.

Abstract BACKGROUND: Employing appropriate and deserving staff is goal of human resource
management (HRM). A group of staff at medical science universities are clinical teachers. Considering
the position and importance of these peoples, this study addresses the challenges of recruiting
clinical teachers.
MATERIALS AND METHODS: This is a qualitative study of the conventional content analysis done
in Isfahan medical university in 2018. The participants were selected through intensity sampling of
purposive sampling method, and data were obtained through semi‑structured interviews conducted
to survey 23 experts and clinical faculty members concerning the challenges involved in employing
clinical teachers. Data were analyzed using conventional content analysis method and OneNote 2013.
RESULTS: Two main categories and ten subcategories were classified as follows: HRM inadequacy
in educational departments with six subscales such as indefiniteness of the workforce status for HR
managers, reluctance of educational departments to increase human resources, nonproportionality
of the teacher–student ratio, recruitment of faculty based on the needs in the treatment sector,
weakness of the infrastructure to use nonfaculty teachers, and reduced public interest in employment
as a faculty and weakness of the selection process with four subscales based on data analysis such
as undesirable manner of selection, recruitment based on the score given by the national board of
medical examiners, purpose‑based calls to recruit predefined individuals, and personal and emotional
issues, rather than managerial standards, governing cooperation with teachers.
CONCLUSION: Recruitment process is part of HRM tasks. Employment system in a medical
sciences university must be considered to improve the clinical faculty recruitment. HRM inadequacy
in educational departments and weakness of the selection process are challenges that affect the
employment system. According to these findings, it is necessary to review the regulations and tasks
of HRM in medical sciences universities.

Abstract BACKGROUND: Adherence to medical ethics principles by medical professionals is required to
improve health‑care system’s quality. Recognizing medical ethics’ challenges and attempting to
resolve them are important in the implementation of medical ethics in practice. This study aimed to
explore such challenges at Iran’s medical sciences universities in 2018.
MATERIALS AND METHODS: This descriptive, qualitative study utilized a conventional content
analysis approach for data analysis. This study was conducted using purposeful sampling from
participants with experience in teaching or practicing of medical ethics field, and by considering
maximum variety of disciplines (e.g., gynecology, internal medicine, surgery, and medical ethics). The
data were gathered using semi‑structured interviews. The interview guide was designed based on
previous research findings by two members of the research team and contained the main interview
questions and participants had the opportunity to express their perspectives in detail. Participants
were chosen from clinical and ethical faculty members as well as managers. The data collection
process continued until the data saturation stage, beyond which no new information or concept
achieved by continuing interviews.
RESULTS: After interviewing 14 faculty members and managers, findings were classified into 4
themes, 9 categories, and 42 sub‑categories; four main categories of medical ethics challenges are
affected by cognitive, educational, practical, and structural factors, respectively.
CONCLUSION: This study suggested that medical ethics’ cognitive and educational challenges can
alleviate using educational programs intended for improving qualitative and quantitative aspects of
medical ethics teaching for medical professionals ranging from students to faculty members. Medical
ethics’ structural and practical challenges are within policymaking and scheduling activities dealt with
through future researches by health‑care system’s managers and planners.

Abstract CONTEXT: Universities of medical sciences are responsible for educating and training human
resources (HRs) that provide services to all members of the community. Clinical educators play a
significant role in the promotion of health and education in medical sciences universities.
AIMS: The aim of this study was to prioritize and develop a model to illustrate the relationship between
faculty recruitment challenges in medical sciences universities.
SETTINGS AND DESIGN: Interpretive structural modeling (ISM) is a system design method initially
introduced by Warfield (1974). This method helps create order in the complex interconnections
between components of a system by interpreting the opinions of a group of experts. It both determines
the priority of elements influencing one another and uncovers the association between the elements
of a multipart set in a hierarchical structure.
SUBJECTS AND METHODS: In this method, the identified challenges were built into a paired
comparison questionnaire to be completed by policymakers and experts. By the same token, the
obtained results were analyzed with the ISM technique.
STATISTICAL ANALYSIS: The four steps include identified variables related to the issue, structural
self‑interaction matrix, initial reachability matrix, and final reachability matrix was used for analysis.
According to these steps, the ISM model was portrayed.
RESULTS: The ISM model was developed in ten levels that divided into three parts including key
challenges, strategic challenges, and dependent challenges.
CONCLUSION: Health promotion and quality of education in medical sciences universities is
dependent on quality of faculty recruitment system. According to the results, it is imperative that HR
managers and policymakers improve existing rules and develop policies to solve the challenges in
this area.

Abstract INTRODUCTION: As an integral and the most important part of medical education, clinical education
provides the opportunity to prepare medical students as professionals. This study explores the
standpoints of informants concerning the optimal conditions for clinical education and its components,
including learning opportunities, clinical settings, and clinical tutors, with the aim to improve clinical
teaching and standards.
METHODS: The study design is built on qualitative content analysis with the directed approach. The
participants were selected using purposive sampling with maximum variation, and the data were
collected through online focus group discussion (FGD) and semi‑structured individual interviews
conducted either face‑to‑face or on the telephone.
RESULTS: Twenty vice‑chancelleries of education and medical education planners from across the
country participated in this study. Concepts resulted in four main categories: educational settings,
tutors, creating learning opportunities, and learning situations. The concepts were sorted into 15
subcategories, also 21 subclass 1 and 14 subclass 2. The most extensive subcategories comprised
variety of educational settings, teaching team conditions, and learning strategies.
CONCLUSION: Optimal conditions for clinical education are associated with the use of educational
settings close to the real workplace of general practitioners such as general inpatient settings,
outpatient settings, and emergency department. Moreover, optimal conditions require the provision
of learning opportunities by organized team of tutors and team member empowerment along with
policy‑making and planning on the national scale by the Ministry of Health in consideration of local
conditions.

Abstract OBJECTIVE: This study aimed to explore factors influencing the results of faculty member evaluation
from the viewpoints of faculty members affiliated with Isfahan University of Medical Sciences, Isfahan,
Iran.
MATERIALS AND METHODS: This qualitative study was done using a conventional content analysis
method. Participants were faculty members of Isfahan University of Medical Sciences who, considering
maximum variation in sampling, were chosen with a purposive sampling method. Semi‑structured
interviews were held with 11 faculty members until data saturation was reached. The interviews were
transcribed verbatim and analyzed with conventional content analysis method for theme development.
Further, the MAXQDA software was used for data management.
RESULTS: The data analysis led to the development of two main themes, namely, “characteristics
of the educational system” and “characteristics of the faculty member evaluation system.” The first
main theme consists of three categories, i.e. “characteristics of influential people in evaluation,”
“features of the courses,” and “background characteristics.” The other theme has the following as
its categories: “evaluation methods,” “evaluation tools,” “evaluation process,” and “application of
evaluation results.” Each category will have its subcategories.
CONCLUSIONS: Many factors affect the evaluation of faculty members that should be taken into
account by educational policymakers for improving the quality of the educational process. In addition
to the factors that directly influence the educational system, methodological problems in the evaluation
system need special attention.

Abstract Introduction: One of the important criteria in the promotion of faculty members is in the scope of
their educational roles and duties. The purpose of this study was the assessment of reasonability
and attainability of educational criteria for scientific rank promotion from the perspective of
the faculty members of Medical Sciences Universities in Iran. Materials and Methods: This
descriptive study was conducted in 2011 in 13 Universities of Medical Sciences in Iran. Through
stratified sampling method, 350 faculty members were recruited. A questionnaire developed by
the researchers was used to investigate the reasonability and attainability of educational criteria
with scores from 1 to 5. The self-administered questionnaire was distributed and collected
at each university. The mean and standard deviation of reasonability and attainability scores
were calculated and reported by using the SPSS software version 16. Results: Faculty members
considered many criteria of educational activities reasonable and available (with a mean score
of more than 3). The highest reasonability and attainability have been obtained by the quantity
and quality of teaching with the mean scores (3.93 ± 1.15 and 3.82 ± 1.17) and (3.9 ± 1.22
and 4.13 ± 1.06) out of five, respectively. The mean and standard deviation of total scores of
reasonability of educational activities were 50.91 ± 14.22 and its attainability was 60.3 ± 13.72
from the total score of 90. Discussion and Conclusion: The faculty members of the Universities of
Medical Sciences in Iran considered the educational criteria of promotion moderately reasonable
and achievable. It is recommended to revise these criteria and adapt them according to the mission
and special conditions of medical universities. Furthermore, providing feedback of evaluations,
running educational researches, and implementing faculty development programs are suggested.

Abstract Introduction: To achieve a valid evaluation of faculty members, it is necessary to develop an
inclusive and dynamic system of evaluation addressing all the activities and responsibilities of
faculty members. Among these responsibilities, educational activities comprise an important part
which needs to be investigated. This study aimed to investigate the current system of evaluating
the faculty members’ educational duties. Methods: In this descriptive cross-sectional study,
a checklist for investigating the current evaluation system and was developed confirmed by a
focus group. The data for checklist were collected through a researcher-made questionnaire
and interview with eight experts of faculty evaluation that worked in different Iranian Medical
Universities. For completion of information, the available documents and records were studied.
Finally, the current evaluation system of different universities was depicted. Results: The
developed checklist had six themes and 123 subthemes. The extracted themes included:
Tools, evaluators, processes, appropriateness of faculty field of work with evaluation, feedback
status, and university status regarding decisions made based on faculty evaluation results.
As for comprehensiveness, all evaluation items except for evaluation and assessment skills
and religiosity from personality traits subtheme were fully investigated. The evaluation tools
were not enough for different types of education such as clinical education. In six universities,
the feedbacks provided were only for making inter/intra department comparison, and no
scientific suggestions were included. The results of evaluations were used only for the faculties’
promotions. Discussion: Suitability between evaluation and performance components is a
necessity in every evaluation system. The study showed this does not exist in Iranian Universities.
For instance, there was no appropriate tool for the evaluation of clinical education. Also, the results
of the faculty evaluation were not used for the improvement of their educational performance.

Abstract Background: The pharmacists’ roles and responsibilities toward the pharmaceutical care practice
have developed considerably during the recent years. Objectives: The aim of this program is to
explore the opinions and performances of community pharmacists with regard to their professional
tasks and responsibilities in Isfahan city. Materials and Methods: A descriptive cross-sectional
questionnaire survey of community pharmacists was conducted on a sample of 150 pharmacists
using the Delphi process. Data were collected on the opinions and performances of the
pharmacists’ task, professional responsibility and expertise, organizational and managing skills,
and sociodemographic information. Results: The response rate was 93.3%. High expressions
of agreement were found with most of the task and professional responsibilities and managerial
skills and the mean rates of the self-reporting performance of most key tasks were ‘always’. The
important differences were found in two opinions about the pharmacists’ responsibilities, (a)
declining to dispense the prescribed drug that was not appropriate for the patient’s illness and (b)
keeping the patient’s medical records for future needs. The pharmacists’ opinions on various forms
of professional expertise were diverse, especially on recognizing that the required medications
were not prescribed for the patient, being informed on the pharmacotherapy subsequence
and predicting the therapeutic outcomes, interpreting the laboratory tests results, and assisting
persons in need of emergency first aid. Conclusion: Pharmacists largely agreed with most
of the professional tasks and responsibilities, however, new educational programs should be
developed to promote the pharmacists’ knowledge and skills concerning pharmacotherapy. Also
an extended role for pharmacists needs to be addressed in the pharmacy regulations and laws.

Abstract 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.

Abstract Background: Although some tests for clinical reasoning assessment are now available, the
theories of medical expertise have not played a major role in this filed. In this paper, illness
script theory was chose as a theoretical framework and contemporary clinical reasoning tests
were put together based on this theoretical model. Materials and Methods: This paper is a
qualitative study performed with an action research approach. This style of research is performed in a context where authorities focus on promoting their organizations’ performance
and is carried out in the form of teamwork called participatory research. Results: Results are
presented in four parts as basic concepts, clinical reasoning assessment, test framework,
and scoring. Conclusion: we concluded that no single test could thoroughly assess clinical
reasoning competency, and therefore a battery of clinical reasoning tests is needed. This battery should cover all three parts of clinical reasoning process: script activation, selection and
verification. In addition, not only both analytical and non-analytical reasoning, but also both
diagnostic and management reasoning should evenly take into consideration in this battery.
This paper explains the process of designing and implementing the battery of clinical reasoning in the Olympiad for medical sciences students through an action research.