Document Type : Original Article
Authors
1 Medical Education Development Center, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Obstetrics and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran,
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.
Keywords
of the implementation of student‑centered teaching strategies
in an advanced practice nurse curriculum. Nurse Educ Pract
2007;7:53‑9.
2. Worrell JA, Profetto‑McGrath J. Critical thinking as an outcome
of context‑based learning among post RN students: A literature
review. Nurse Educ Today 2007;27:420‑6.
3. Ozturk C, Muslu GK, Dicle A. A comparison of problem‑based
and traditional education on nursing students’ critical thinking
dispositions. Nurse Educ Today 2008;28:627‑32.
4. Alizadeh M, Gharibi F, Asghari Jafarabadi M, Esmaeilnasab N,
Bostani Z, Zarghami F. Attitudes of medical instructors and
students of Tabriz University of Medic al Sciences towards Peer
Assisted Learning (PAL) system. Journal of Medical Education
and Development. 2012; 7(1):48‑57. [In Persian].
5. Saadatmand V, Poorgholami F, Abbasi Jahromi A, Jahromi B.
Convening operational workshops on teaching practical skills:
A perceived necessity. J Educ Ethics Nurs 2015;4:19‑24.
6. Clynes MP. A novice teacher’s reflections on lecturing as a
teaching strategy: Covering the content or uncovering the
meaning. Nurse Educ Pract 2009;9:22‑7.
7. Adib Hajbaghery M, Afazel MR. A comparison of the effects of
instructional methods on satisfaction, anxiety and learning of
nursing students. Horizons Med Educ Dev 2011;4:11‑5.
8. Mandeville D, Stoner M. Assessing the effect of problem‑based
learning on undergraduate student learning in biomechanics.
J Coll Sci Teach 2015;45:66‑75.
9. Luh SP, Yu MN, Lin YR, Chou MJ, Chou MC, Chen JY. A study
on the personal traits and knowledge base of Taiwanese medical
students following problem based0020zx\learning instructions.
Ann Acad Med Singapore 2007;36:743‑50.
10. Safari M, Yazdanpah B, Ghafarian HM, Yazdanpah S. Comparing
the effect of lecture and discussion methods on students’ learning
education. IJME 2006;6:59‑64.
11. Fattahi Bafghi A, Karimi H, Anvari M, Barzegar K. Comparison
of the effectiveness of two teaching methods of group discussion
and lecturing in learning rate of laboratory medicin students.
SDME 2007;4:51‑6.
12. Forsetlund L, Bjørndal A, Rashidian A, Jamtvedt G, O’Brien MA,
Wolf F, et al. Continuing education meetings and workshops:
Effects on professional practice and health care outcomes.
Cochrane Database Syst Rev 2009; Issue2. Art. No.: CD003030.
DOI: 10.1002/14651858.CD003030.pub2.
13. Mohebbi SA, Jafari SH, Saeidi RM, Amin YA. Cultural factors
affecting creative teaching from the teachers perspective of
nursing and midwifery faculty of Mashhad University of medical
sciences. Res Curriculum Plan 2014;11:74‑87.
14. Dadvar L, Dadgari A, Mirzaee M, Rezaee M. Evaluation of
educational goals achievement in fundamental nursing clinical
skills: Application OSCE among senior nursing students in ICU.
J Knowledge Health 2015;9:24‑31.
15. Golmohammadi R, Dashti GR. The study of styles learning
students in anatomical education by problem based learning and
lecturing in Sabzevar University of medical sciences. Q J Sabzevar
Univ Med Sci 2013;19:382‑9.
16. Naeemi Hoseyni F, Zare H, Hormozi M, Shaghaghi F, Kaveh MH.
A comparison of the effects of blended learning and lecture
based‑instruction on the students’ academic motivation and
satisfaction. JTE 2012;7:23‑32.
17. Page J, Meehan‑Andrews T, Weerakkody N, Hughes DL,
Rathner JA. Student perceptions and learning outcomes of
blended learning in a massive first‑year core physiology for allied
health subjects. Adv Physiol Educ 2017;41:44‑55.
18. Stacey E, Gerbic P. Effective Blended Learning Practices: Evidence
Based Perspectives in ICT‑Facilitated Education. Hershey, PA: IGI
Global; 2009.
19. Tripathi Raakhi K, Kurle Dnyaneshwar G, Jalgaonkar Sharmila V,
Sarkate Pankaj V, Rege Nirmala N. Implementation of
supplemental E‑learning models for blended learning in
pharmacology. Natl J Physiol Pharm Pharmacol 2017;7:1084‑90.
20. Zolfaghari M, Negarandeh K, Ahmadi F. The evaluation of a
blended E‑learning program for nursing and midwifery students
in Tehran University of Medical Sciences. Iran J Med Educ
2010;10:398‑409.
21. Lapkin S, Levett‑Jones T, Bellchambers H, Fernandez R.
Effectiveness of patient simulation manikins in teaching clinical
reasoning skills to undergraduate nursing students: A systematic
review. Clin Simul Nurs 2010;6:e207‑22.
22. Haghani F, Ehsani M, Jaafari Mianabi S. Simulation. Dev Steps
Med Educ 2014;11:272‑9.
23. Zamanzadeh V, Abdollahzadeh F, Lotfi M, Aghazadeh A.
Assessing clinical education fields from the viewpoints of nursing
and midwifery instructors in Tabriz University of medical
sciences. Iran J Med Educ 2008;7:299‑306.
24. Jacobs M, Sanford J, Townsend‑Rocchiccioli J. Technology: Using
the WebQuest to engage learners in the online classroom. Nurse
Educator 2007;32:197‑8.
25. Valizadeh S, Abedi H, Zamanzadeh V, Fathiazar E. Challenges
of nursing students during their study: A qualitative study. Iran
J Med Educ 2008;7:397‑406.
26. Ghaed Mohammadi Z, Anaraki A, Khajaeeian A, Khajaeeian MM.
Why mother’s death? Payka Jalal. 1st ed.. Viec‑ chancellery health
of Bushehr university of medical Science: 2010.
27. Bahri N, Khadivzadeh T, Bahri N. Effect of integarated training program on clinical reasoning in rural midwifery attendance in
a continuing education workshop. Gamhai Tosae Dar Amozesh
2009;6:165‑72.
28. Badiyepeymaie Jahromi Z, Saadatmand V, Eslami Akbar R. Study
of students’ satisfaction and learning with blended education: An
action research study. J Educ Dev 2015;6:304‑12.
29. Liu WI, Edwards H, Courtney M. Review of continuing
professional education in case management for nurses. Nurse
Educ Today 2009;29:488‑92.
30. Elisabeth C, Christine WH, Ewa P. Teaching during clinical
practice: Strategies and techniques used by preceptors in nursing
education. Nurse Educ Today 2009;29:522‑6.
31. Bahadorani M, Yousefy A, Chagiz T. The effectiveness of
three methods of teaching medline to medical students:
Online, Face to Face and combined educational method. IJME
2006;6:35‑43.
32. Hojjati H, Sharifinia H, Nazari R. The effect of blended clinical
teaching on nursing students’ attitude toward psychiatric patients.
Iran J Educ Med Sci 2011;11:244‑38.
33. Sadeghnejad H, Khazaee T, Nasiri A. Comparison of the effect
of conceptual mapping and clinical simulation on the clinical
decision making of emergency medical students. Iran J Med Educ
2014;14:241‑51.
34. Adib HajbagheriM, SalsaliM, AhmadiF. Clinical decision‑making:
A way to professional empowerment in nursing. Iran J Med Educ
2004;10:3‑12.
35. Sharif F, Jahanpour F, Salsali M, Kaveh MH. Clinical decision
making process in last year nursing students: A qualitative study.
J Nurs Res 2010;5:21‑31.
36. Shahraki Moghaddam E, Manzari ZS, Ghandahari Motlagh Z.
Clinical decision‑making of nurses in intensive care units
in Mashhad educational hospitals. J Sabzevar Univ Med Sci
2016;24:107‑13.
37. Saeed Pour M. Effects of a Blended Learning and Traditional
Teaching on Self‑Regulation and Creative Thinking of Students
of Nursing and Midwifery. Master’s Thesis, Allameh Tabatabaei
University; 2010.
38. Karami A, Zarae Zavaraki S. Comparison of integarated education
with traditional education on critical thinking and happiness of
students. Q J Inf Commun Technol Educ Sci 2014;4:39‑57.
)