Journal of Education and Health Promotion

Abstract Background: Although some tests for clinical reasoning assessment are now available, the
theories of medical expertise have not played a major role in this filed. In this paper, illness
script theory was chose as a theoretical framework and contemporary clinical reasoning tests
were put together based on this theoretical model. Materials and Methods: This paper is a
qualitative study performed with an action research approach. This style of research is performed in a context where authorities focus on promoting their organizations’ performance
and is carried out in the form of teamwork called participatory research. Results: Results are
presented in four parts as basic concepts, clinical reasoning assessment, test framework,
and scoring. Conclusion: we concluded that no single test could thoroughly assess clinical
reasoning competency, and therefore a battery of clinical reasoning tests is needed. This battery should cover all three parts of clinical reasoning process: script activation, selection and
verification. In addition, not only both analytical and non-analytical reasoning, but also both
diagnostic and management reasoning should evenly take into consideration in this battery.
This paper explains the process of designing and implementing the battery of clinical reasoning in the Olympiad for medical sciences students through an action research.

Abstract Marketing is one of the essential parts of any business corporation in the modern management. One can see the difference between corporations in gaining their goals, considering their
marketing methods. Gaining more advantage or acquiring more funds can be of reasons for
marketing, but these are not all the reasons. Perhaps the most important reason for marketing
is increasing the customer satisfaction. This, in turn, leads to more willingness in payment and
using services. Nowadays, due to rapid growth in ICT, changes in budgets, rapid growth in
development and use of knowledge, variety of users and their needs, marketing has become
an important factor in any library activities. Libraries are now more responsible in this regard,
because marketing is now an important tool in improving users’ satisfaction in using library
services. Hence, marketing is now very important for libraries to survive in the increasing pressures of competitive conditions of the information market. This article is tapping on issues such
as information marketing, principles of marketing, marketing techniques, developing markets,
and marketing skills. Some recommendations are also presented for marketing in libraries.

Abstract Introduction: This study addresses the design and validation of the experiential curriculum
model for medical education using a Feministic approach. Method: The present study was
conducted on two non separable planes. On the first plan, the model was designed based on
the Feministic approach using the theoretical study method and emphasizing the perspectives ascribed to Nell Noddings, Madeline Grumet and Janette Miller. Results: The levels of
this model include Expected Curriculum, Imaginal Curriculum, Concealed curriculum, Interactive curriculum (Manifest Curriculum, Latent Curriculum, Look the parenting), Transferential
Curriculum and Self Determination. On the second plane, to validate the combined model, a
phenomenologically qualitative study was conducted. In this study, using goal-oriented sampling, undergraduate and graduate (Master’s degree) students majoring in Dentistry, Nursing
at Islamic Azad University Khorasgan Branch, Esfahan as well as those at at Esfahan University
of Medical Sciences were selected. Deep interview was used to collect data. The findings were
analyzed using Van Manen’s six-stage model. To determine the reliability of the findings, reliability of reality reconstruction were used. Conclusion: The results obtained suggested that:
Education is in need of some conceptual reconstruction. On this way, women’s perceptions
and experience of education and of the interior epistemological and curricular system which
shape the discourse and performance of education must be addressed. Serving as a research
model offering the various planes of the experiential curriculum and focusing more sharply on
the dimensions of curriculum than the formal plane, the present study is recommended to the
decision-makers of higher education curricular system.

Abstract Background: Assessment is one of the teachers’ most important activities in teaching process
which bears many purposes. With the rapid change of different sciences,old methods and tools
are not meeting the present needs. Since in medical sciences, half of the educational course,
including nursing courses,occurs at patients’ bedside, the assessment of clinical competency
is of great importance. In this study the goals , skills and expected level of competency for
each skill and procedural skills needed for training nursing studentsreceivingcardiac care field
training compiled. Materials and Methods: This research was a descriptive measurement
study conducted in Esfahan in 2010-2011. Research community was nursing trainers who
are responsible for training students takingcardiac care field training coursesin state medical
science universities all over the country. Sampling was performed first in the form of the multistage cluster and then after selecting the colleges , their trainers entered the study in the form
of census. To gather the information, after literature review and performing a focusing group,
an initial questionnaire was compiled and survey was conducted using Delphi three-stage
method. Results: After literature review and focus group, 23 modules and 142 skills in the
first section and 14 general procedural skills and 15 special procedural skills in the second
stage were compiled. Finally after passing the Delphi stages, 150 skills in the form of 23 modules in the first section and 14 general procedural skill and 13 special procedural skills were
obtainedin the second section. The expectancy levels of all the skills were also determined.
Conclusion: This study has introduced an assessment pattern in the form of clinical performance logbook which can be a valuable tool for assessing the clinical competency of nursing
students receiving field training in cardiac care units(CCU).

Abstract Introduction: Netiquette is appropriate behavioral etiquette when communicating through
computer networks or virtual space. Identification of a dominant organizational culture and
its relationship with a network culture offers applied guidelines to top managers of the university to expand communications and develop and learn organization through the use of the
internet. The aim of this research was to examine the relationship between netiquette and
organizational culture among faculty members of the Isfahan University of Medical Sciences
(IUMS), Iran. Materials and Methods: To achieve this aim, the research method in this study
was correlational research, which belonged to the category of descriptive survey research.
The target population comprised of 594 faculty members of the IUMS, from which a sample of
150 was randomly selected, based on a simple stratified sampling method. For collecting the
required data, two researcher-made questionnaires were formulated. Even as the first questionnaire tended to measure the selected sample members’ organizational culture according
to Rabbin’s model (1999), the latter was designed in the Health Management and Economic
Research Center (HMERC), to evaluate netiquette. The reliability of the questionnaires was
computed by Choronbach’s alpha coefficient formula and they happened to be 0.97 and 0.89,
respectively. Ultimately, SPSS Version #15 was used for the statistical analysis of the data.
Results: The findings revealed that the organizational culture and netiquette were below average level among the sample members, signifying a considerable gap in the mean. In spite of
that, there was no significant relationship between netiquette and the organizational culture
of the faculty members. Conclusion: Emphasizing the importance of cultural preparation and
a network user’s training, this research suggests that the expansion of network culture rules
among IUMS and organizational official communications, through the use of internet networks,
in order to promote university netiquette and convenience in communication development, on
the basis of special etiquette.

Abstract Background: Family health is one of the World Health Organization’s (WHO) programs
concerning individuals’ and families’ health and development. If properly implemented, family health may ensure the health of human beings and support their self-fulfillment; and may
pave the way for bringing up a healthier and better generation by achieving two important
and specific quantitative and qualitative results. This study aims at establishing the existing
problems in the medical education system with respect to family health, which may be managed by the family health professional if a Masters’ course educational program is developed.
Materials and Methods: In this cross-sectional, descriptive study, five Type-1 and four Type-2 and
Type-3 universities were randomly selected. Then, the faculty members of health services/public
health departments, health managers, health and treatment networks managers, personnel of
provincial health centers in family health units, and also public health B. S. students were surveyed
on the existing problems in the national health system which can be solved by family health professional. A questionnaire containing one open-ended and several demographic questions was sent
by mail for some and personally handed over to some others. Since the data were of a qualitative
nature, first the categories were specified through content analysis and then the opinions of each
category of individuals were differentiated based on the relevant categories. Results: Results obtained from the comments of the study population led to specification of problems in health system,
which could be solved by the family health senior expert. Such problems were categorized into six
groups as: Planning and implementation, research, education, management, service-providing, and
cultural problems. Conclusion: Given the problems in our nation concerning various family health
issues, the field of family health in the levels of associate and bachelor degrees cannot respond to
all public requirements, and health personnel in these levels do not possess various professional,
planning, research, and educational skills required to analyze family health problems. Therefore,
it is suggested that a Masters’ course educational program be developed.

Abstract Background: Despite their ascribed intellectual ability and achieved academic pursuits,
medical students’ academic achievement is influenced by motivation. This study is an endeavor to examine the role of motivation in the academic achievement of medical students.
Materials and Methods: In this cross-sectional correlational study, out of the total 422 medical
students, from 4th to final year during the academic year 2007–2008, at School of Medicine,
Isfahan University of Medical Sciences, 344 participated in completion of the Inventory of
School Motivation (ISM), comprising 43 items and measuring eight aspects of motivation. The
gold standard for academic achievement was their average academic marks at pre-clinical and
clinical levels. Data were computer analyzed by running a couple of descriptive and analytical tests including Pearson Correlation and Student’s t-student. Results: Higher motivation
scores in areas of competition, effort, social concern, and task were accompanied by higher
average marks at pre-clinical as well as clinical levels. However, the latter ones showed greater
motivation for social power as compared to the former group. Task and competition motivation
for boys was higher than for girls. Conclusion: In view of our observations, students’ academic
achievement requires coordination and interaction between different aspects of motivation.

Abstract Background: Information and communication technology (ICT) has brought many changes in
medical education and practice in the last couple of decades. Teaching and learning medicine
particularly has gone under profound changes due to computer technologies, and medical
schools around the world have invested heavily either in new computer technologies or in
the process of adapting to this technological revolution. In order to catch up with the rest of
the world, developing countries need to research their options in adapting to new computer
technologies. Materials and Methods: This descriptive survey study was designed to assess
medical students’ computer and Internet skills and their attitude toward ICT. Results: Research
findings showed that the mean score of self-perceived computer knowledge for male students in
general was greater than for female students. Also, students who had participated in various prior
computer workshops, had access to computer, Internet, and e-mail, and frequently checked
their e-mail had higher mean of self-perceived knowledge and skill score. Finally, students with
positive attitude toward ICT scored their computer knowledge higher than those who had no
opinion. Conclusions: The results have confirmed that the medical schools, particularly in
developing countries, need to bring fundamental changes such as curriculum modification
in order to integrate ICT into medical education, creating essential infrastructure for ICT use
in medical education and practice, and structured computer training for faculty and students.

Abstract Background: Considering the significance of quality of life in chronic diseases and the role of
education in its improvement, this study was performed to investigate the effect of cognitivebehavioral therapy on improving the quality of life of cardiovascular patients in Isfahan city.
Materials and Methods: In this experimental study, 56 patients, who referred to Chamran
Hospital and Isfahan Cardiovascular Research Center, were randomly selected and assigned
to two groups, i.e. experiment and control. The experiment group was trained in eight sessions, each session taking 2 hours. Both groups received MacNew quality of life questionnaire
before and 2 weeks after treatment. Some demographic data were also gathered along with
the questionnaire. Data were analyzed by SPSS software using statistical tests such as independent t-test, Chi-square, and analysis of covariance. Results: Observing the possible effect
of pre-test, cognitive-behavioral therapy had a significant effect on the total score of quality
of life and its three subscales. Conclusion: It seems that along with other medical therapies,
making use of cognitive-behavioral intervention is an appropriate method for improving the
quality of life of cardiovascular patients.

Abstract Background: Growth and development in any country’s national health system, without an
efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the
system’s goals. The balanced scorecard (BSC) is a technique widely used to measure the
performance of an organization. The basic core of the BSC is guided by the organization’s
vision and strategies, which are the bases for the formation of four perspectives of BSC. The
goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in
Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods:
This is a combination (quantitative–qualitative) research which was done at Al-Zahra Academic
Medical Center in Isfahan University of Medical Sciences in 2011. The research populations
were hospital managers at different levels. Sampling method was purposive sampling in which
the key informed personnel participated in determining the performance indicators of hospital
as the BSC team members in focused discussion groups. After determining the conceptual
elements in focused discussion groups, the performance objectives (targets) and indicators
of hospital were determined and sorted in perspectives by the group discussion participants
. Following that, the performance indicators were calculated by the experts according to the
predetermined objectives; then, the score of each indicator and the mean score of each
perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by
the participants in the focus discussion group included five strategies, which were customer
satisfaction, continuous quality improvement, development of human resources, supporting
innovation, expansion of services and improving the productivity. Research participants also
agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community
perspective (customer), two objectives and three indicators were agreed upon, with a mean
score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed  upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives
and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial
perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%.
Conclusion: One way to create demand for hospital services is performance evaluation by
paying close attention to all BSC perspectives, especially the non-financial perspectives such
as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the
hospital managers improve their performance indicators. The learning and growth perspective
obtained the highest score, and the financial perspective obtained the least score. Since the
learning and growth perspective acts as a base for all other perspectives and they depend
on it, hospitals must continuously improve the service processes and the quality of services
by educating staff and updating their policies and procedures. This can increase customer
satisfaction and productivity and finally improve the BSC in financial perspective.