Document Type : Original Article


1 Nursing and Midwifery Care Research Center, School of Nursing and Midwifery,

2 Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: An active teaching method has been used widely in medical education. The aim
of this study was to determine the effectiveness of the four‑phase teaching method on midwifery
students’ emotional intelligence (EQ) in managing the childbirth. Materials and Methods: This
was an experimental study that performed in 2013 in Isfahan University of Medical Sciences.
Thirty midwifery students were involved in this study and selected through a random sampling
method. The EQ questionnaire (43Q) was completed by both the groups, before and after the
education. The collected data were analyzed using SPSS 14, the independent t‑test, and the
paired t‑test. The statistically significant level was considered to be <0.05. Results: The findings
of the independent t‑test did not show any significant difference between EQ scores of the
experimental and the control group before the intervention, whereas a statistically significant
difference was observed after the intervention between the scores of two groups (P = 0.009).
The paired t‑test showed a statistically significant difference in EQ scores in the two groups
after the intervention in the four‑phase and the control group, respectively, as P = 0.005 and
P = 0.018. Furthermore, the rate of self‑efficiency has increased in the experimental group
and control group as 66% and 13% (P = 0.024), respectively. Conclusion: The four‑phase
teaching method can increase the EQ levels of midwifery students. Therefore, the conduction
of this educational model is recommended as an effective learning method.


1. Moonaghi HK, editor. The Effect of Video‑Based Instruction Versus
Demonstration on Learning of Clinical Skills. The 17th International
Nursing Research Congress Focusing on Evidence‑Based Practice.
2. Mohamadirizi S, Bahadoran P, Fahami F, Ehsanpour S. The
Effect of Teaching through Demonstration on Midwifery
Student’s Self‑efficacy in Delivery Management. Iran J Med Educ
3. Greif R, Eggera L, Basciania RM, Lockey A, Vogta A. Emergency
skill training‑A randomized controlled study on the effectiveness
of the 4‑stage approach compared to traditional clinical teaching.
Resuscitation 2010;81:1692‑7.
4. Lake FR, Hamdorf JM. Teaching on the run tips 5: Teaching a skill.
Med J Aust 2004;181:327‑8.
5. Bagherian A, Sadeghi M. Assessment of the effect of
Tell‑Demonstration‑Observation‑Action educational method on
dental students’ quality of learning. Iran J Med Educ 2012;11:764‑6.
6. Sharma RN. Advanced Educational Technology 2 Vols.
United Kingdom: Set: Atlantic Books; 2003.
7. Ehlers V. Teaching aspects of health care. Cape town: Juta and co,
Ltd:; 2002.
8. Bitsika E, Karlis G, Iacovidou N, Georgiou M, Kontodima P, Vardaki Z,
et al. Comparative analysis of two venipuncture learning methods
on nursing students. Nurse Educ Today 2014;34:15‑8.
9. Schwerdtfeger K, Wand S, Schmid O, Roessler M, Quintel M,
Leissner KB, et al. A prospective, blinded evaluation of a
video‑assisted ‘4‑stage approach’ during undergraduate student
practical skills training, BMC Med Educ 2014;14:104.
10. Kordi M, Mohamadirizi S, Shakeri MT. The relationship between
occupational stress and dysmenorrhea in midwives employed
at public and private hospitals and health care centers in
Iran (Mashhad) in the years 2010 and 2011. Iran J Nurs Midwifery
Res 2013;18: 316‑22.
11. Moral RR, Salvador JJR, de Torres LP, Castillejo JA. Effectiveness of
a clinical interviewing training program for family practice residents:
A randomized controlled trial. Fam Med 2003;35:489‑95.
12. Abraham A, Cheng TL, Wright JL, Addlestone I, Huang Z,
Greenberg L. Assessing an educational intervention to improve
physician violence screening skills. Pediatrics 2001;107:E68.
13. Salovey P, Mayer JD, Caruso D. The positive psychology of
emotional intelligence. Handb Posit Psychol 2002;159:171.
14. Nelis D, Quoidbach J, Mikolajczak M, Hansenne M. Increasing
emotional intelligence: (How) is it possible? Pers Individ Dif
15. Zahiroddin A, Dibajnia P, Gheidar Z. Evaluation of emotional
intelligence among students of 4th grade in different medical majors in Shahid Beheshti University of Medical Sciences. R Journal
16. Janati and his coleagues, evalluating the degree of EQ and
self‑esteam of the nursing and midwifery students in medical
department in Mozandaran University. The Journal of Mozandaran
Medical University; 2011;21:261‑254.
17. Nooryan K, Gasparyan K, Sharif F, Zoladl M. The Effect of Teaching
Emotional Intelligence (EI) Items on Job Related Stress in Physicians
and Nurses Working in ICU Wards in Hospitals, Yerevan, Armenia.
Int J Collab Res Intern Med Public Health 2011;3:704‑13.
18. Rafiee F, Oskouie SH, Mohammadi R, Yarandi A, Kabiri F, Peyrovi H,
et al. Caring behaviors of student nurses following clinical
experience through role play and traditional method. Iran J Nurs
19. Foronda C, Gattamorta K, Snowden K, Bauman EB. Use of
virtual clinical simulation to improve communication skills of
baccalaureate nursing students: A pilot study. Nurse Educ Today
20. Pike T, O ’Donnell V. The impact of clinical simulation on learner
self‑efficacy in pre‑registration nursing education, Nurse Educ Today
21. Jenko M, Frangez M, Manohin A. Four‑stage teaching technique
and chest compression performance of medical students compared
to conventional technique. Croat Med J 2012;53:486‑95.
22. Zraick RI, Allen RM, Johnson SB. The use of standardized patients to
teach and test interpersonal and communication skills with students
in speech‑language pathology. Adv Health Sci Educ Theory Pract
23. Schwartz LR, Fernandez R, Kouyoumjian SR, Jones KA, Compton S.
A Randomized Comparison Trial of Case-based Learning versus
Human Patient Simulation in Medical Student Education. Acad
Emerg Med 2007;14:130‑7.
24. Salehiniya H. Importance contamination of data in study and medical
articles. Iran J Med Educ 2014;14:471‑3.
25. Kordi M, Mohamadirizi S, Shakeri MT, Fadardi JS, Hafizi L.
Relationship between Job Stress with Menstrual Bleeding Pattern
among Midwives. Hayat 2012;18:1‑11.