Journal of Education and Health Promotion

Abstract BACKGROUND: Continuous evaluation is necessary to achieve appropriate quality in educational 
programs. The aim of this study was to evaluate the doctoral program of medical education at Isfahan 
University of Medical Sciences based on the CIPP model.
MATERIALS AND METHODS: This descriptive and educational evaluation study was conducted 
in 2020 at Isfahan University of Medical Sciences. The study population consisted of all heads of 
department, faculty members, students, and PhD graduates of medical education from 2010 to 2020 
who were enrolled in the study by census method. The data collection tool was a researcher‑made 
questionnaire of CIPP evaluation model which was used when validity and reliability of them were 
confirmed. The data obtained from the questionnaires were analyzed in two levels of descriptive 
statistics of mean and standard deviation and inferential statistics one‑sample t‑test.
RESULTS: Based on the CIPP model, the mean evaluation scores from the perspective of the heads of 
department, faculty members, and graduates were 4.1 ± 0.1, 3.64 ± 0.42, and 3.33 ± 0.66, respectively, 
which were significantly higher than the average (P ≤ 0.05). However, the mean evaluation score 
was not significantly higher than the average from the viewpoint of the students (3.24 ± 1.17).
CONCLUSION: Based on the results of the study, the status of the doctoral course in medical 
education at Isfahan University of Medical Sciences was assessed as appropriate by the subjects of 
the study including the heads of department, faculty members, and graduates. It was not, however, 
acceptable according to the students. Based on the results, it is suggested that evaluation be done 
continuously and measures are taken to correct the weaknesses and enhance the strengths.

Abstract BACKGROUND: The scientific Olympiad is an event that creates a competitive environment for
student groups of medical universities across the country to solve problems that can help improve
the health system. This study aims to explain the issues of the scientific Olympiad program of Iranian
medical students.
MATERIALS AND METHODS: This study was conducted using content analysis method, and the
data were collected through 21 semi‑structured, in‑depth interviews with experts from December
2018 to April 2020. Participants were selected using purposive sampling methods. Twenty‑one
students, domain leaders, question designers, Olympiad executive experts, and teachers (11 males
and 10 females) participated in the interviews. Data analysis was performed based on the steps of
Graneheim and Lundman’s method. The interviews were recorded, transcribed, and subjected to a
qualitative analysis by MAXQDA 2018 software.
RESULTS: From the analysis of data, four themes, including inattention to context, inattention to
input, inattention to process, and inattention to output, emerged.
CONCLUSIONS: The scientific Olympiad can lead to interuniversity scientific exchanges and paves
the way for the promotion of education and evaluation of learners in medical universities, but if not
correctly implemented and the problems of previous periods are not solved, it will not help the health
system and can impose considerable costs on the system.

Abstract BACKGROUND: Since the purpose of medicine science is health promotion, education of this group
is very important. The use of new evaluation methods is one of the first educational needs. Given
that many conventional clinical evaluation methods are not able to fully evaluation students in the
clinical settings and only evaluate limited information, This study is designed to evaluate the impact
of direct observation of procedural skills (DOPS) and mini‑clinical evaluation exercise (mini‑CEX)
on nursing students and their clinical satisfaction skills.
MATERIALS AND METHODS: This quasi‑experimental study was conducted in 2018 to evaluate
the dialysis unit of the 6th semester nursing students of Babol University of Medical Sciences in Iran.
Samples were selected by the census method and then random allocation. Data collection was
performed using two questionnaires and two checklists to evaluate the clinical skills and satisfaction
of the two groups of testing and control. Moreover, the data were analysed with using the SPSS
software (version 18, IBM SPSS Inc., Chicago, IL, USA) through the descriptive and analytical
statistics (Chi‑square test and t‑test).
RESULTS: The results showed that the intervention group compared with the control evaluation score
of 13/73 ± 2/44, 11/74 ± 2/43, P < 0.002, respectively. Furthermore, the mean score of satisfaction of
the intervention group with the DOPS method compared to the traditional method of the control group
was 72/50 ± 7/31, 63/48 ± 9/31, P < 0.001, respectively. As well as, the mean score of satisfaction
with the mini‑CEX method of the intervention group compared to the traditional method of the control
group was 73/28 ± 7/78, 63/48 ± 9/31, P < 0.002, respectively.
CONCLUSIONS: The results of this study showed that students who were evaluated by DOPS
and mini‑CEX methods had a higher score of clinical performance evaluation and higher level of
satisfaction. Nursing professors can improve the learning process and the satisfaction of nursing
students by using direct feedback on such evaluation methods.

Abstract INTRODUCTION: Inequalities persists in distribution, accessibility, and utilization of oral health
services between urban and rural population. One approach to lessen this inequality is by incorporating
rural outreach programs in the academic curriculum of health‑care professionals.
OBJECTIVES: The objective of the study was to evaluate the effectiveness of outreach
programs on academic development, personal development, and civic responsibilities of dental
students and also to assess the changes in the domain scores within and between genders
postintervention.
METHODOLOGY: The study population consisted of 100 dental students. The study methodology
followed a before and after without control informal experimental study designs. At baseline, the
participants were administered pretested structured questionnaire developed by D. Diaz Gallegos.
Intervention involved posting participants in various rural outreach activities and academic field visits in
various public health installations. Apostintervention questionnaire developed by Anu F. Shinnamon et al.
was administered to assess the change from the baseline. The change in domain scores was assessed
using paired and unpaired t‑test appropriately. P ≤ 0.05 was considered as statistically significant.
RESULTS: The baseline scores of academic, personal, and civic domains were 6.05 ± 2.44,
8.04 ± 2.84, and 6.36 ± 2.23 which increased to 6.52 ± 2.10, 13.56 ± 3.44, and 8.55 ± 2.71
postintervention, respectively (P ≤ 0.05). When comparing within genders, there was increase from
the baseline, and this change in the scores postintervention was statistically significant (P = 0.001).
The mean scores of all three domains between genders were statistically insignificant.
CONCLUSION: The outreach programs developed and enhanced the subject’s academic skills,
leadership qualities, self‑confidence, communication skills, managerial skills, and responsibilities
toward the rural community.

Abstract INTRODUCTION: Hospital care transformation plan (HCTP) was implemented, in 2014, with the aim
of ensuring all Iranians have fair access to hospital care, mainly in the public sector. It was assumed
that HCTP would lead to increased quality and effectiveness of health care in public hospitals. To
explore whether HCTP has achieved its aim, this study has investigated the impact of this plan on
performance indicators (PIs) of the public hospitals.
MATERIALS AND METHODS: This cross‑sectional descriptive study was conducted in 2016. The
study population included all hospitals in the Isfahan City. Data (10 selected PIs) were collected
through formal reports which were available at the Isfahan University of Medical Sciences and
analyzed using Statistical Package for Social Sciences (version 17). The statistical significant level
analysis was 0.05.
RESULTS: After HCTP, it was shown an increase of (1) Bed occupancy, bed turnover, occupied
bed‑days, inpatients visits, and number of surgeries in all types of hospitals, (2) Outpatients’ visits in
all hospitals except private ones, (3) Emergency visits in public and social security hospitals, and (4)
Natural deliveries in public and semi‑public hospitals. Furthermore, the average length of stay and
hospital mortality rate has decreased in all types of hospitals after HCTP implementation.
DISCUSSION AND CONCLUSION: Although, improving PIs of hospitals were not directly stated
and known objectives of HCTP implementation, it seems HCTP could improve the performance of
all hospitals, including involved and noninvolved ones.

Abstract Background: To have high‑quality primary health care services, an adequate doctor–patient
communication is necessary. Because of time restrictions and limited budget in health system,
an effective, feasible, and continuous training approach is important. The aim of this study is
to assess the appropriateness of a communication skills training program simultaneously with
routine programs of health care system. Materials and Methods: It was a randomized field
trial in two health network settings during 2013. Twenty‑eight family physicians through simple
random sampling and 140 patients through convenience sampling participated as intervention
and control group. The physicians in the intervention group (n = 14) attended six educational
sessions, simultaneous organization meeting, with case discussion and peer education method.
In both the groups, physicians completed communication skills knowledge and attitude
questionnaires, and patients completed patient satisfaction of medical interview questionnaire
at baseline, immediately after intervention, and four months postintervention. Physicians and
health network administrators (stakeholders), completed a set of program evaluation forms.
Descriptive statistics and Chi‑square test, t‑test, and repeated measure analysis of variance
were used to analyze the data. Results: Use of routine program as a strategy of training was
rated by stakeholders highly on “feasibility” (80.5%), “acceptability” (93.5%), “educational
content and method appropriateness” (80.75%), and “ability to integrating in the health
system programs” (approximate 60%). Significant improvements were found in physicians’
knowledge (P < 0.001), attitude (P < 0.001), and patients› satisfaction (P = 0.002) in intervention
group. Conclusions: Communication skills training program, simultaneous organization meeting
was successfully implemented and well received by stakeholders, without considering extra time
and manpower. Therefore it can be a valuable opportunity toward communication skills training.