Journal of Education and Health Promotion

Abstract INTRODUCTION: Proper empowerment of medical students in encounter with the complexities of the
clinical environment is one of the requirements for health services. In this regard, the development of
problem‑solving skills, critical thinking is essential for medical education. The purpose of this study
was to investigate the effect of designing a blended training program on the practice and clinical
reasoning of midwifery students.
MATERIALS AND METHODS: In a quasi‑experimental study with control group, 41 undergraduate
midwifery students were randomly assigned to two intervention and control groups by four blocking.
In the first group, the 15‑h workshop was held in the traditional teaching method and in the second
group in the blended method, about three emergency aspects of midwifery. Data were collected
and analyzed through objective structured clinical examination and clinical assessment evaluation
before and after the educational intervention.
RESULTS: The mean and standard deviation of the age of participants were 23.54 ± 2.19 years.
The mean score of clinical practice before the beginning of the study in the integrated training group
was 16.68 ± 5.49 and at the end of the study was increased to 35.75 ± 4.54, which was significant
between the two groups (P = 0.035). The clinical reasoning score was changed at the beginning of the
study in the blended training group of 6.77 ± 3.57 and at the end of the intervention was 11.58 ± 2.83.
There was no significant difference between the two groups (P = 0.81).
CONCLUSION: The results showed that the use of blended methods in comparison with conventional
education can improve clinical practice, but the improvement of students’ ability in clinical reasoning
requires more effort.

Abstract BACKGROUND: Cardiovascular diseases are the major public health problem in many countries
and are responsible for more than half of the deaths in above 50‑year‑old women. The most common
curable risk factor of these disorders is hypoestrogenemia resulting from menopause. The present
study aimed to investigate the effect of melatonin on plasma lipid levels in menopausal women.
MATERIALS AND METHODS: The present double‑blind, placebo‑controlled, clinical trial was
conducted in 2013–2014 on 240 menopausal women between 40 and 60 years old referring to
the Gynecology and obstetrics clinics of Shiraz University of Medical Sciences who were randomly
divided into two groups. The intervention group received 3 mg melatonin tablets and the control
group received the placebo for 3 months. The data were gathered using the demographic information
questionnaire and lipid profile test before and 3 months after the intervention. Then, the data were
analyzed through the SPSS statistical software (version 16). The repeated measures analysis of
variance, the least significant difference, the independent‑sample t, the Chi‑square, and Fisher’s
exact tests were done for data analysis.
RESULTS: The two study groups were similar regarding the demographic and clinical variables
at the beginning of the study. In the melatonin group, the amount of triglyceride increased from
140.34 ± 48.29 before the study to 151.24 ± 54.60 3 months after the intervention and no significant
difference was observed between the two groups in this regard (confidence interval [CI] = 95%,
P > 0.05). In addition, no significant difference was found between the two groups concerning
low‑density lipoprotein cholesterol level (CI = 95%, P = 0.125).
CONCLUSION: Melatonin was not effective in reduction of lipid levels. However, further controlled
studies are needed to be conducted on the issue.