Journal of Education and Health Promotion

Abstract BACKGROUND: A teacher’s appropriate use of nonverbal communication skills, mainly kinesics, can
play a crucial role in the success of the students. Medical educators are unaware of the effective use
of nonverbal communication as an instructional skill that can be used to engage learners, balance
learners’ participation by controlling the classroom environment, and motivate them to have a passion
for learning. The purpose of the study was to explore the students’ perceptions regarding the effect
of teachers’ kinesics on students’ learning and their learning environment. This can be helpful for
teachers in modifying their teaching styles and delivering quality education.
MATERIALS AND METHODS: A qualitative study with an exploratory design was conducted at a
private medical institute in 2021 for a duration of 6 months. Fourteen medical students volunteered
to participate in the study. Focus group discussions were conducted with the students to explore the
experiences of the medical students regarding the use of nonverbal communication skills by their
teachers and its effect on their learning in the classroom. The data collected was analyzed manually.
RESULTS: The results of the study revealed that teachers’ nonverbal behaviors in the classroom
significantly influence students’ motivation, engagement, and learning in the classroom. Students
preferred interaction with the teachers who were friendly and confident and used their nonverbal
communication skills (eye contact, facial expressions, hand gestures) effectively, compared to strict
and judgmental teachers.
CONCLUSION: Teachers need to motivate their students by improving their teaching styles and
incorporating nonverbal behaviors positively in the classroom. By creating an impactful learning
environment, students’ participation and learning will increase, which will, in turn, improve their
academic performance.

Abstract BACKGROUND: Metamemory can be described as an intentional endeavor to guide or control
one’s memory processes. In other words, awareness and knowledge of one’s own memory process
and strategies for using the memories effectively. Planning, allocating cognitive resources, selecting
strategies, assessing understanding, and evaluating performance all rely heavily on metamemorial
information. For efficient learning, good memory abilities are necessary. This study aimed to
understand metamemory functioning and to see if there were any gender differences in metamemory
functioning among medical students.
MATERIALS AND METHODS: This cross‑sectional study was conducted by collecting data from
350 medical students using the Memory Functioning Questionnaire in 2021. The sample group was
selected from medical colleges in South India such as Kerala, Karnataka, Tamil Nadu, Telangana,
and Andhra Pradesh using a purposive sampling technique. This questionnaire focused on the
seriousness of forgetting, the rate at which people recalled things over time, and frequency of use
of mnemonics and techniques that assist memory. Descriptive statistics, independent sample t‑test,
correlation, and regression were used for analysis.
RESULTS: There was a significant difference based on gender among medical students in general
memory functioning and frequency of forgetting (P < 0.001). Similarly, it was also found that gender
was a major predictor of general memory functioning and frequency of forgetting among medical
students (P < 0.001).
CONCLUSION: Most medical students believe they have a minor memory issue. Even if the majority
of medical students forget information, the vast majority of them believe they have an exceptional
memory. Gender acts as a significant predictor of general memory performance and forgetfulness.

Abstract BACKGROUND: The relationship between personality traits and learning styles is an attractive
subject for researchers. “Learning Style” indicates on a method of education for effective studying. The
Kolb’s Learning Style is a known theory in the field of learning style. The Kolb’s four learning styles
include: Divergent, convergent, assimilating, and accommodating. Furthermore, personality, known
as relatively fixed and durable characteristics that distinguish people from each other, and personality
contains five broad identified traits of extraversion, agreeableness, openness, conscientiousness,
and neuroticism. In this study, we intended to evaluate the relationship between personality traits
and learning styles in medical education students.
MATERIALS AND METHODS: This research was an observational analytic cross‑sectional study
that was conducted on medical education students at Iran University of Medical Sciences, between
2018 and 2019, and 31 students were participated as volunteers. NEO Five‑Factor Inventory and
the Kolb’s learning style inventory (version 3.1) were used to evaluate the students’ personality traits
and learning styles, respectively. The simple and multiple analysis of multinomial logistic regression
were used for statistical analysis.
RESULTS: The results indicated that if one unit would be added to the score of the “Extraversion”
personality trait, the estimated odds, by which the student’s learning style would become
“Accommodating” rather than “Assimilating,” is 1.3 times more than the basic condition, in which
“Extraversion” score would be remained unchanged (P = 0.035).
CONCLUSION: It seems that “Accommodating” learning style might be related to “Extraversion”
personality trait in medical education students. However, researches with a larger population are
suggested.

Abstract BACKGROUND: Demonstration‑Observation‑Assistance‑Performance (DOAP) and Video‑Assisted
Learning (VAL) are small‑group teaching/learning methods (TLM) in medical education. Comparison
studies between the two are scanty. There is a gap in knowledge, skills, and attitude among medical
interns toward Advanced Cardiac Life Support (ACLS). The author studied the effectiveness of DOAP
and VAL in training ACLS using mannequins and automated external defibrillator (AED)-simulators
among interns in 2021.
MATERIALS AND METHODS: This descriptive study was done in the Emergency Department of
a tertiary teaching hospital in South India. Out of 80 medical interns, 39 and 41 were allocated to
ACLS training by DOAP (Group 1) and VAL (Group 2), respectively, by convenient sampling with
random allocation, with the use of mannequins and AED‑Simulators (10 interventions in each small
group; three‑five participants in each session). Pre‑validated pre‑test and posttest multiple‑choice
questionnaires (MCQs) and attitude questionnaires, OSCE by two blinded assessors, and perception
by Likert‑based questionnaire were analyzed with appropriate statistical analysis.
RESULTS: The mean pretest and posttest MCQs and Attitude and OSCE scores of DOAP and VAL
showed no statistically significant difference between them (MCQ pre‑test 44.51 (11.43); 42.54 (6.56);
p = 0.350 and MCQ posttest, 78.97 (8.59); 77.22 (11.29); p = 0.438; OSCE 40.51 (2.43) and
40.63 (1.92); p = 0.804; Attitude: 11 (3), 11 (2); p = 0.567; 14 (2), 14 (3); p = 0.095). MCQ post‑tests
showed improved scores (p < 0.001) in both the methods and the standardized mean difference
based on the MCQ scores for the DOAP group was 3.02, and for the VAL group 3, showed the
effectiveness of both methods. Perception scores showed learners’ interest and positive feedback
to both methods and ACLS.
CONCLUSION: Both DOAP and VAL were equally effective TLMs in imparting knowledge, skills, and
attitude to medical interns with positive feedback. In DOAP, the learner performs under supervision
and clarifies doubts. As repeatable and cost‑effective, VAL is useful in resource‑limited settings.
Both can be used as complementary methods in training ACLS. The attitude of learners towards
ACLS improved with training.

Abstract BACKGROUND: Modern competency‑based medical education emphasizes student‑centered
teaching‑learning strategies where students take responsibility of their own learning. Student‑centered
approaches facilitate multifaceted learning such as observation, critical evaluation, analysis, deeper
understanding, and application of knowledge. The current study aims at assessing the students’
perception on utilization of clinical case problem‑solving approach (CCPS) to promote their lifelong
learning.
MATERIALS AND METHODS: The present cross‑sectional study was conducted at College of
Medicine and Health Sciences (CoMHS) during the year 2021‑2022. MD3 students of the academic
year 2021‑2022 were the study participants. The study was approved by institutional Ethic and Review
Committee. Students’ performances were assessed through pre‑test and post‑test performances.
Students’ feedback was collected through a predesigned questionnaire on a 3‑point Likert scale.
Cronbach’s alpha coefficient test was used to assess the reliability of the questionnaire. The data was
entered to Microsoft Excel and analyzed using SPSS software version 22. Paired t‑test was used to
compare pre‑test and post‑test scores and the data was expressed as numbers and percentages.
RESULTS: In total, 103 participants were included in the study. Post‑test scores were significantly
higher compared to pre‑test scores (p < 0.05). Questionnaire results showed that CCPS approach
was accepted as an effective learning strategy. Majority (>90%) of the students expressed CCPS
approach was interesting, motivated to learn, encouraged peer discussion, enhanced knowledge,
and clarified their topic‑related doubts. More than 80% students opined that CCPS enhanced their
critical thinking, problem‑solving ability, deep learning, and lifelong learning skills. Nearly 90% of
the students suggested for including such sessions for more topics in immunology course in future.
CONCLUSION: From our study results, it can be concluded that CCPS is an effective learning
strategy to encourage students’ engagement and promote their deep learning skills.

Abstract The interaction between medical students and frontline healthcare workers is one of the crucial
components of community medicine. The interaction of medical students with frontline healthcare
workers provides multiple opportunities. Medical students like to understand their job responsibilities
and their involvement in implementing the various national health programs at the community level.
Innovation is required to train our medical students better and enhance their learning. A learning and
teaching innovation was developed by us to provide insight into the various roles and involvement of
frontline healthcare workers in the community. One innovation is the A‑Z activity calendar of frontline
healthcare workers in teaching and learning in medical education.

Abstract BACKGROUND: One of the main tasks of educational institutions, in addition to developing students’
professional competencies, is to develop decision‑making and problem‑solving skills, which are
themselves influenced by critical thinking that should be developed by instructors at the university.
The aim of this study was to compare the level of critical thinking skills in students and faculties of
Ahwaz Jundishapur University of Medical Sciences.
MATERIALS AND METHODS: In this cross‑sectional descriptive study, the sample consisted of
81 medical students and 52 faculty members of the medical school who were teaching and studying
in 2021. The research method was descriptiveanalytical and the data collection tool was the California
Critical Thinking Questionnaire Form B. SPSS‑18 software and t‑test were used to analyze the data.
RESULTS: The mean score of students’ critical thinking skills was 12.49 ± 4.43 and that of faculties
was 12.44 ± 3.76 and no significant difference was observed between the scores of the two
groups (P = 0.94).
CONCLUSION: The findings of the study show that the level of critical thinking skills in both faculties
and students is below the standard and poor. The results of the study indicate the weakness of critical
thinking in students and faculties in all dimensions, which indicates the need to teach critical thinking
skills at the university level. Therefore, educational planners and faculty officials should pay more
attention to developing critical thinking skills in their educational programs.

Abstract INTRODUCTION: Childbirth is regarded as an important life event for women, and growing numbers
of them are making the choice to give birth by cesarean delivery. Increasing rate of births by cesarean
section is an issue of concern in many countries. In order to reduce the rates of unnecessary cesarean
sections, it is essential to acquire information of the reasons that motivate physicians to carry out
cesarean sections rather than vaginal deliveries. The objective of present study is to evaluate whether
the education process for undergraduate medical students affects their decision‑making.
MATERIALS AND METHODS: The present study was cross‑sectional and questionnaire based.
A total of 292 students participated in the study. Out of which, 150 were first‑year students and
142 were doing internship in Maharashtra Institute of Medical Education and Research (MIMER),
Talegaon Dabhade, Maharashtra, India. The study was conducted in the months of June and July
2019. Data was collected with the help of person to person interview of all the participants who
satisfied the inclusion criteria after obtaining their informed consent. The data was entered by using
Microsoft Excel 2007 and was analyzed using Epi Info version 3.3.2. The data was tabulated and
analyzed according to responses which were given by the respondents.
RESULTS: A total of 292 students answered the questionnaire. Age of participants varied between
19 and 23 years. 130 males and 162 females were the subjects, out of which 40 students declared
fear of labor. Most of the students preferred vaginal delivery over cesarean sections in all the four
scenarios. The difference of opinion was significant in case of an uneventful pregnancy and normal
pregnancy under their care. For general population as healthcare manager this difference of opinion
was not significant. In case of one’s own or partner’s delivery, internship students preferred cesarean
section but this difference was statistically non‑significant.
CONCLUSION: Most of the students would recommend vaginal delivery because this form of delivery
has fewer risks as compared to cesarean section. Majority of students chose vaginal delivery for
the birth of their own child; however, a higher number of interns as compared to first year students
preferred cesarean section. Pain associated with vaginal delivery was the most common reason
given for choosing cesarean section. The student’s preference for childbirth changed in due course
of graduation toward cesarean section. This indicates a probable effect of medical education on
permissive culture of cesarean section as a mode of delivery.

Abstract BACKGROUND: This study aimed to investigate how medical students perceive their educational
environment, as well as the implications of motivation, learning strategies, and the factor of emotional
intelligence on academic achievement.
MATERIALS AND METHODS: In a cross‑sectional study, 3384 undergraduate students were
recruited from randomly selected Egyptian medical colleges. Students from second to final year, taking
fundamental and clinical courses and, at a minimum, three professional exams, were enrolled and
subjected to the Dundee Ready Educational Environment Measure scale, the Motivated Strategies
for Learning Questionnaire, and Emotional intelligence questionnaire.
RESULTS: The overall mean age of the studied students was 21.42 ± 1.61 years. Females
represented 63.5%, rural residents were 52.2% and students with enough income represented 88.0%.
The traditional system adopted 28.4% of the students versus 71.6% in the integrated system. Linear
regression using path analysis was conducted to study the predictors of academic achievement, and
it revealed that motivation was the highly significant predictor of academic achievement (β = 2.68,
CI95%:2.35–3.05, P < 0.001), followed by learning (β = 1.09, CI95%:0.80–1.41, P < 0.001), emotional
intelligence (β = 0.92, CI95%:0.87–0.97, P < 0.001), and the educational environment (β = 0.14,
CI95%:0.13–0.15, P < 0.001).
CONCLUSION: The study’s findings have implications for medical educators trying to understand the
personal factors that influence learning and performance in medical school. Students’ motivation was
the highly significant predictor of academic achievement followed by learning, emotional intelligence,
and educational environment. Perception of the learning environment had improved because of
the integrated student‑centered system, which fosters motivation and emotional intelligence. To
improve learners’ EI, optimal learning, and educational outcomes, the EI components can be taught
and fostered.

Abstract BACKGROUND: The corona virus disease (COVID‑19) pandemic has caused widespread effect on
the lives of health care professionals. The postgraduate medical students, who are the major pillars
of medical institutions had to bear multitude of setbacks due to the pandemic involving academic,
research and well‑being issues.
MATERIALS AND METHODS: This was a cross sectional feedback based online survey done in the
month of October 2021 to study the effect of COVID‑19 pandemic induced changes in the postgraduate
medical education; amongst 78 students pursuing MD/MS degree in all departments of a tertiary medical
institute in Himalayan foothills of North India. The questionnaire consisted of ten questions; each of which
needed to be answered on a five point Likert scale ranging from strongly disagree to strongly agree. Results
were assessed for the most common answers of each question (represented by mode) and association
between various components of the questionnaire analyzed by Spearman’s rho correlation coefficient.
RESULTS: The internal consistency of the questionnaire as tested by Cronbach’s Alpha (0.82) was
good. Most number or respondents were from surgical branches (n = 31, 39.74%). There was a
generalized agreement towards preference of resumption of onsite education (75.64%), the lack of
variety of cases causing hampering of thesis work (88.46%) and increased mental stress during the
pandemic (58.9%). While more time for self‑study was seen as the only consensual positive aspect
of online teaching (64%), most students opined that technical glitches are a major roadblock in
online education (80.76%). Significant positive correlation was seen between disciplinary ease and
punctuality in online teaching (R = 0.543, P < 0.001), lack of interaction and its effect on learning and
mental health (R = 0.471; P < 0.001) and the lack of diversity in cases and difficulties in dissertation
work (R = 0.351; P < 0.05). Negative correlation was observed between the satisfaction from overall
learning through online teaching and the desire of resumption of offline classes (R = −0.491; P < 0.001).
CONCLUSION: COVID‑19 pandemic and its effects on medical education are long lasting.
A comprehensive approach is required to rebuild the medical education curriculum, inculcating both
traditional and newer virtual methods of education. A consistent support in academics and overall
growth needs to be provided to medical postgraduate residents who have been the first line fighters
in face of the massive disaster compromising their basic needs and education.

Abstract BACKGROUND: Online teaching has been practiced after lockdown due to Coronavirus Disease 
2019 (COVID‑19) pandemic which has replaced conventional classroom teaching. The aim of the 
present study was to know the perceptions regarding online learning as perceived by both teachers 
and students during COVID‑19 pandemic.
MATERIALS AND METHODS: The present study was cross‑sectional and questionnaire‑based. 
Web‑based respondent‑driven sampling technique was used to recruit participants for the present 
study. Three hundred and thirty‑two students and 130 teachers of varying ages and gender participated 
in the study. The link of web‑based questionnaire was sent to respondents through WhatsApp/
Facebook. Responses from all the participants were tabulated and analyzed using univariate 
analysis (Chi‑square test).
RESULTS: Prerecorded lectures (38.9%) and Webinar apps (35/8%) were the most common 
modules of online teaching by students. One‑third (34.3%) had the convenience to attend lectures 
from home whereas 44.3% had difficulty in concentration. Commonly cited disadvantage by students 
was inability to do practical work (37.9%). Regarding teaching faculty, 43.8% had no prior knowledge 
of online teaching. Sixty percent of teachers had 4 h/week of online teaching. No face‑to‑face 
interaction (67.7%) and internet issues (26.9%) were commonly stated barriers by faculty.
CONCLUSION: The pandemic has pushed the teachers and students toward newer teaching avenues. 
However, more needs to be done to supplement the existent teaching pattern and preparedness of 
teaching faculty by incorporating online assignments and assessment methods, strengthening digital 
infrastructure in medical schools, and training support for teachers.

Abstract BACKGROUND: Sufficient interaction between the trainers and the trainees in medical education 
is always one of the biggest challenges for an educational system. This study was designed to 
evaluate the effect of virtual interactions within the educational content of stroke on the effectiveness 
of teaching for general medicine students during COVID‑19 crisis.
MATERIALS AND METHODS: Eight medical students applying for stroke education were divided into 
two groups by simple random sampling (Rafsanjan Medical School, 2020). The first group participated 
in an online classroom via the Adobe Connect platform without virtual interaction. The second group 
used a video presentation containing interaction scenarios. The effectiveness evaluation of each 
type of educational content was done by comparison of the final exam scores and the results of an 
electronic satisfaction questionnaire in each group. Finally, using SPSS software version 18, the 
data were analyzed with independent samples t‑test.
RESULTS: This study showed that the mean of the examination scores of the interactive virtual content 
group (6.14 ± 1.46) was significantly higher than the online class group (4.50 ± 1.50) (P < 0.001), 
and also the results of satisfaction assessment showed that this group was more satisfied with their 
educational content (P = 0.005).
CONCLUSION: Evaluation of the virtual stroke training effectiveness for general medical students 
shows that the educational approach of video with virtual interactions is an effective learning method 
in medical topics and can be considered as an efficacious educational model in online teaching.

Abstract BACKGROUND: In India, competency‑based medical education (CBME) is gaining foothold to
transform the medical student into a doctor fulfilling community and societal needs. With that end
in view the teaching faculty are getting sensitized and trained by the National Faculty Development
Program (FDP). We aimed to assess the awareness about FDP among teaching faculty in medical
colleges and study the attitude and perceived barriers to implementation of CBME.
METHODOLOGY: A cross‑sectional, electronically distributed, questionnaire‑based study was
conducted among medical faculty in India. The questionnaire identified participants’ awareness,
attitude, and perceived barriers to CBME. Descriptive analysis was employed for continuous variables
and internal comparison employing Chi‑square test with α <0.05 for statistical significance.
RESULTS: Among 251 participants 90.2% faculties from private institutes had undergone FDP as
against 71% from Government sector (P = 0.008). We observed that 92.4% were aware, 80.2%
had undergone Curriculum Implementation Support Program and 95.2% did agree that CBME will
improve the medical education system. Major challenges perceived were high student to faculty
ratio (67.7%), ill developed infrastructure (41.4%) and difficulties in assessment (41.1%). The popular
solutions suggested were to increase faculty strength (73.7%), improve infrastructure (69.3%), extra
remuneration (35.9%) and increase administrative support (30.7%). There was significant difference
of opinions between teaching faculty of government and private sector (P = 0.017).
CONCLUSION: Most of the medical faculty are aware of the need and have acquired a positive
attitude towards enforcement of CBME. However, significant barriers do exist in the form of manpower
and resources which need to be addressed.

Abstract BACKGROUND: Conducting online classes and assessment during the COVID‑19 pandemic is
not without challenges. The world of medical education is adapting online training and assessment
because of COVID‑19 pandemic restrictions. The present study was conducted to assess the
students’ perception regarding the process, difficulties encountered and perceived effectiveness of
online assessment.
MATERIALS AND METHODS: Online viva‑voce (theory and visual based) was conducted in
a government medical college in Karwar, Karnataka, India using videoconferencing application
(Google Meet) to 149 second MBBS students as a formative assessment in 2020 over 3 months.
Ten students per day joined Google Meet, 10 questions were asked to each student and assessed
using a tutor marking system (on‑spot). A feedback questionnaire (Google Form) was administered
to students who attended online Viva‑Voce. Data was analysed using descriptive and inferential
statistics (Student’s t‑test).
RESULTS: Out of 149 students, 132 participated and responded to a feedback questionnaire.
Majority of the participants (91%) agreed that questions covered all topics kept for viva, 82% of
them felt it would be helpful for performance in final examinations. Thirty percent of students faced
network issues at their places, 45% felt nervous while facing viva in the presence of other students
and 35% of participants preferred online methods over traditional viva voce. Online viva voce can
be transparent (90%) and less biased (88%) if done in structured format.
CONCLUSION: Online viva‑voce may become relevant and effective in medical education
assessment with transparent marking system for students’ performance.

Abstract BACKGROUND: With the emergence of COVID, we are forced to use e‑learning in form of arranging 
online classes for students. Medical educators all over the world are conducting online classes for 
students. This study aimed to evaluate the perception of online learning among MBBS students and 
teachers through a questionnaire‑based survey.
MATERIALS AND METHODS: A cross‑sectional study was done in the AIIMS, Bhopal. The study 
was based on questionnaire (online Google form) response received from 43 number of faculty and 
156 number of students.
STATISTICAL ANALYSIS USED: Chi‑square test and unpaired t‑test were used for statistical 
analysis using statistical software Systac 13.2.
RESULTS: Handling software, technical issues, and lack of face‑to‑face interaction were more 
significant problems in students compared to faculty. The desire for the social site which causes 
disturbances in learning was a significant problem in the students compared to faculty. Giving 
and taking assessment problem was reported by 60% and 63.8% of faculty and students, 
respectively (P = 0.67). Both groups preferred the Google Classroom platform (P = 0.16). 
Students (65.3%) preferred audiovisual recording, while faculty (72%) preferred PowerPoint with 
narration. PowerPoint presentation without narration was the least preferred (10.8%). Both groups 
stressed the importance of training (P = 0.17) and infrastructure development (P = 0.85). Students, 
as well as faculty, strongly discouraged e‑learning for practical/clinical teaching.
CONCLUSIONS: Students, as well as faculty, have mixed reactions toward e‑learning. Most 
importantly affected in the present scenario is practical/clinical teaching and assessment. Every 
attempt needs to be done to strengthen infrastructure and impart training to students and faculty.

Abstract BACKGROUND: Gamification involving application of elements of game play that provides unique 
opportunities to learners to sail through complex medical concepts is gaining importance in medical 
education. The current study was aimed at assessing the perception of medical students regarding 
checkerboard game in enhancing learning process.
MATERIALS AND METHODS: The present prospective cross‑sectional study was conducted at the 
microbiology department. The fifth-year medical students of the academic year 2018–19 were the 
participants. Pre‑ and post‑test scores and self‑administered questionnaire regarding effectiveness 
of the checkerboard game‑based learning were used as assessing tools. The data were collected, 
tabulated, and statistically analyzed using SPSS version 20. The pre‑ and post‑test scores of students 
were statistically analyzed using paired t test. A descriptive analysis on the 3‑point Likert scale of 
effectiveness survey was measured and expressed in percentages.
RESULTS: In total, 124 fifth-year medical students participated in the study. Majority (89.5%) of them 
liked the game, nearly 86% opined that game was enjoyable and created interest. Approximately 
88% indicated game helped them to understand the topic, enhanced learning, and thus improved the 
knowledge. Most students (79%) also believed that game encouraged critical thinking and problem 
solving, while 75% felt that it improved their communication skills. Around 70% felt that game was 
also useful for exam preparation and nearly 90% recommended to use the game more frequently.
CONCLUSION: From the results of the study, it can be concluded that checkerboard game‑based 
learning method is effective in fostering learning process and cognition of medical students in the 
microbiology course.

Abstract BACKGROUND: This study was designed to assess the clinical judgment of medical students in
surgery clinical decision‑making by a standard examination after lecture‑based learning (LBL) or
problem‑based learning (PBL).
MATERIALS AND METHODS: A prospective randomized trial study on 175 medical students
whom were randomly allocated to three groups was performed during November 2017 and January
2018. LBL group (n = 103), PBL group led by an attending (n = 39), and PBL group (n = 33) led by
an intern. Chi‑squared test and independent student t‑test were used to compare between the two
groups. All the analyses were performed by the two‑sided method using the Statistical Package for
the Social Sciences software (SPSS version 22; SPSS, Inc., Chicago, IL, USA), and a P < 0.05 set
as statistically significant.
RESULTS: The students in the PBL group scored significantly higher on the posttraining multiple‑choice
examination, compared to the LBL group (P = 0.048). However, there was no significant difference
between the PBL group led by an attending and the PBL group led by an intern (P = 0.892).
CONCLUSION: We concluded that PBL remarkably increased the students’ scores in the
problem‑solving examination, as compared to the conventional method. We found no significant
differences in PBL facilitated by an attending or an intern.

Abstract BACKGROUND: Faculty development programs as useful approaches for organizational development
improved competencies in faculty members which assist them to cope with workload and environment
changes. Evaluating organizational development for faculty development programs provides insight
into the impact of these programs on system development. The aim of present study was conducted
to study the organizational development for faculty development programs at Kerman University of
Medical Sciences.
MATERIALS AND METHODS: This analytical and cross‑sectional study was conducted between
October and December 2020. The organizational development for faculty development questionnaire
was sent to a simple random sampling of 100 faculty members who had been participated in the
“Medical Education Fellowship” program. The data were analyzed using descriptive statistics including
independent sample t‑test, one‑way ANOVA, and post hoc, using version 24.0 of SPSS.
RESULTS: The response rate was 82%. Most of the faculty highly agreed that the “Medical Education
Fellowship” program had produced organizational development. The score of the “Development and
sustaining faculty development programs” domain (mean = 3.35, standard deviation [SD] =0.96) was
higher than “Development and innovation in teaching and learning process” (mean = 3.31, SD = 0.74).
CONCLUSIONS: Specific characteristics of the organizational development process for faculty
development programs in health profession education were recognized. The findings emphasized on
the importance of these interventions on creating developments in the broader community system.

Abstract BACKGROUND: Self‑regulated learning (SRL) is a critical skill for medical students to reach their
learning goals in the bedside clinical rotations. This study was performed with the aim of comparing
SRL and motivation of 4th year medical students who are in their educational transition between
students with mentors and those without mentors.
MATERIALS AND METHODS: This study was cross‑sectional. A total of 196 medical students
were invited to complete a form consisting the motivation and SRL questionnaire through Google
form during their 1st year of clinical clerkship, while some of them had participated in the mentoring
program beforehand. data correlation and regression analysis were employed.
RESULTS: Comparing SRL and motivational beliefs scores between students with mentors and
without mentors indicated that motivational beliefs mean score in students with mentors (87.5 ± 8.44)
was significantly higher compared to the others (83.49 ± 7.36) (P = 0.005). Among SRL subscales,
planning and examination stress were significantly different between two groups with higher
scores for mentees (P = 0.033 and 0.021). Having a mentor predicted motivational beliefs with
OR = 7.974 (1.391–45.719) and P = 0.020.
CONCLUSION: Considering a significant correlation between mentor possession and the scale of
motivation beliefs, future longitudinal and interventional research besides the customized mentoring
program is required to understand the role of mentoring programs on SRL as a cause‑and‑effect
relationship to recommend the peer mentoring program to enhance SRL skills in the medical students
especially during their transition to the new clinical environment.

Abstract BACKGROUND: The COVID‑19 pandemic has negatively impacted the mental health of health‑care
workers worldwide. This study aimed to estimate the prevalence of psychological distress in medical
interns during the pandemic and examine the factors influencing it.
MATERIALS AND METHODS: A cross‑sectional online survey was conducted using snowball
sampling among 764 medical interns across India, who were evaluated using the Kessler
Psychological Distress Scale, Fear of COVID‑19 Scale, and semi‑structured questionnaires. Univariate
analysis was done using Chi‑square test, unpaired t‑test, and ANOVA, while multivariate analysis
was conducted using binary logistic regression.
RESULTS: 57.5% of the interns reported psychological distress, with 39.8% having moderate‑to‑severe
distress. Past consultation with a mental health professional (odds ratio [OR]: 2.15; 95% confidence
interval [CI]: 1.42–3.26) and perceived lack of support from friends (OR: 2.33; 95% CI: 1.33–3.99)
and faculty (OR: 2.15; 95% CI: 1.41–3.28) were the most significant predictors of distress. Fear
of COVID‑19 was higher in interns who were female, were medically ill, were dissatisfied with the
pandemic preparedness at the hospital, and perceived the faculty to be less approachable and
supportive. Majority of the interns felt that the pandemic had hampered their learning and were
worried about an extension to their internship and their performance in the postgraduate entrance
examinations.
CONCLUSIONS: Psychological distress was highly prevalent among interns, with several workplaces
and personal factors affecting the distress levels. Most interns perceived a negative impact of the
pandemic on their learning and career. Addressing these issues could help alleviate the distress
and bolster the mental health of interns.

Abstract BACKGROUND: The use of active teaching methods in ethics education, instead of being merely
teacher centred, can lead students to problem‑solving in a practical way. Therefore, this study was
conducted with the aim of comprehensive medical ethics education based on educational approaches
and the effect of this approach on students’ learning and moral reasoning skills.
MATERIALS AND METHODS: This quasi‑experimental intervention study was performed on seventy
physiopathology medical students who had taken the medical ethics course. The students’ educational
program included teaching theoretical concept of medical ethics, discussing ethical cases and clinical
reasoning in class, and then discussing in forum environment and individual assignments in the
learning management system (LMS) system and completing the portfolio. Student evaluation was
associated students’ knowledge, attitu de, and moral reasoning skills and learning. A comprehensive
program including forum participation, individual assignments in LMS, theory and objective structured
clinical examination (OSCE) tests, and portfolio completion was used to evaluation of students. The
students’ learning was compared to students of the previous year, which was conducted through a
traditional teacher‑centered method. Data analysis was conducted using IBM® SPSS® Statistics 21
at two levels of descriptive statistics and analytic statistics.
RESULTS: The results showed that there was a significant difference between the mean learning of
students compared with traditional class (P < 0.05). Furthermore, comparison of students’ practical
scores through the OSCE test showed its impact on changing students’ knowledge, attitude, and
performance in moral reasoning.
CONCLUSION: According to research findings, it seems that the mentioned model is one of the
important and new issues as a suitable method of teaching medical ethics. Furthermore, it can be
suitable model in other medical courses. The more research in multicentral may be need to assess
other effects on students’ learning indicators.

Abstract BACKGROUND: The outbreak of coronavirus disease 2019 (COVID‑19) has turned attention to the
essential competencies needed to confront pandemics for a physician. However, medical students,
as future physicians, are not adequately trained for such a situation. This study aimed to determine
the essential competencies for a medical student to face the COVID‑19 pandemic.
MATERIALS AND METHODS: We performed this mixed‑method needs assessment study at Shiraz
University of Medical Sciences in May–June 2020 in three steps: the first step was a brainstorming
session followed by a nominal group technique with the experts’ participation. The second step
was determining the validity of competencies by calculating the content validity ratio. In the third
and last step, three rounds of the modified Delphi technique were held with the participation of
22 medical faculty members and 45 undergraduate medical students to reach a consensus about
the competencies utilizing quantitative analysis.
RESULTS: A total of 30 key competencies essential for a medical student were obtained through the
current study. They were categorized into four major themes: (1) developing knowledge and abilities
for effective diagnosis and treatment of COVID‑19, (2) demonstrating safety principles correctly,
(3) demonstrating effective behavior, and (4) determining the meta‑competencies.
CONCLUSIONS: Although medical students will be the frontline physicians in the future pandemics, they
are not prepared to display the diversity of requisite skills to practice effectively and safely. This study
provides essential competencies for medical students during the COVID‑19 pandemic and underlines
the importance of a paradigm shift from traditional time‑based to competency‑based education.

Abstract BACKGROUND: A doctor–patient relationship built on the concept of empathy is so essential to
attain the best clinical outcomes in medicine. Since empathy has a positive role in interpersonal
relationships and medical outcomes, its assessment is highly crucial. The aim of this study was to
assess the empathy in last‑year medical students using the Persian version of the Jefferson Scale
of Physician Empathy (JSPE) and correlate empathy scores with demographic features.
MATERIALS AND METHODS: In this cross‑sectional study, last‑year medical students at Shiraz
Medical School, Shiraz, Iran, were recruited for this study. In this research, we used the Persian
version of JSPE. The validity and reliability of the Persian version of this tool were confirmed in the
previous research. For the analysis of data, we employed descriptive statistics and the independent
sample t‑test.
RESULTS: One hundred and eighty‑five final‑year medical students were included in this study.
The maximum score of the questionnaire was 140, and the total mean score of empathy was
98.15 ± 13.29. The females’ total mean score (102.05 ± 11.89) was higher than the males’
score (93.57 ± 13.46). The difference between the mean score of gender and empathy was
significant (P value <.001), but there was no significant difference between empathy and the two
other demographic factors (P > 0.05).
CONCLUSIONS: Although physicians would gain the essential characteristics of empathy during their
career, attending professors and other responsible policymakers in medical education should focus
more on the factors related to physicians’ empathy to train better and more professional physicians.

Abstract BACKGROUND: There is growing acknowledgment that medical education can be a stressful
experience for students and may have a devastating effect on their psychological well‑being. The
present article, therefore, aimed at investigating students’ academic resilience as a mediating variable
in self‑efficacy‑test anxiety relation.
MATERIALS AND METHODS: In this cross‑sectional correlational study, a convenience sample
of 243 medical students was selected and participated, three prevalidated questionnaires were
applied, that is, general self‑efficacy questionnaire, academic resilience questionnaire, and test
anxiety questionnaire. To analyze the data, Pearson’s correlation coefficient as well as structural
equation modeling (SEM) were used.
RESULTS: According to Pearson’s coefficients, self‑efficacy was found to be positively correlated
with academic resilience (r = 0.437, P ≤ 0.01) and negatively with test anxiety (r = −0.475, P ≤ 0.01).
SEM results also indicated that self‑efficacy positively impacts on academic resilience (β = 0.43,
P < 0.001) and negatively on test anxiety (β = −0.37, P < 0.001). In addition, results demonstrated the
mediating role of academic resilience in self‑efficacy‑test anxiety relationship (β = −0.108, P < 0.001).
CONCLUSION: This study showed that academic resilience could play a mediating role in students’
self‑efficacy‑test anxiety relationship.

Abstract BACKGROUND: Clinical training during internship is an important part of medical education. The
maternity ward is a clinical environment in which medical students pass their obstetrics and gynecology
internship to obtain competencies in this field. The present study was conducted to explain medical
interns’ manner of learning in the maternity ward.
MATERIAL AND METHODS: The present study was conducted using a qualitative approach with
the inductive content analysis method. This study observed the maternity wards of teaching hospitals
affiliated to medical sciences universities of Isfahan and Shahrekord. Data were collected through
observation and semi‑structured individual interviews.
RESULTS: Two main categories and seven subcategories emerged from the analysis of the data.
Inadequate participation in learning opportunities included the following three subcategories: the
incongruousness of the learning opportunities with the educational goals, inadequate readiness for
participation in learning opportunities, and the overlap between learning opportunities and diminished
autonomous practice. Inadequate formal and structured education included the following four
subcategories: inadequate learning support and direction, subordinate roles and aimless presence,
the pale educational role played by the attendants and senior residents, and learning through the
support of midwifery educators.
CONCLUSION: Participation in and access to learning opportunities in the maternity ward are very
difficult for interns. Interns, therefore, need to attend the maternity ward by a structured program and
in the company of training supervisors or competent educators to obtain the required competencies
in pregnancy and childbirth.