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Introduction With the emergence of the COVID-19 pandemic, universities immediately responded to protect students’ lives by implementing e-learning in order to stop the spread of the communicable disease within the academic population. This study aimed to describe iranian nursing students’ experiences of e-learning during the COVID-19 pandemic. Materials and methods The current study used a qualitative descriptive study. Ten nursing undergraduate students from a single Iranian university identified using purposive sampling methods. Face-to-face semi-structured interview conducted from May to July 2021 and analyzed through thematic analysis. Lincoln and Goba criteria were used to obtain data validity and reliability. Results Four themes emerged including"novelty of e-learning","advantages of e-learning", "disadvantages of e-learning"and"passage of time and the desire to return to face education". Participants evaluated e-learning as a novel method without proper infrastructure, it was initially confusing but became the new normal as their knowledge of the way to use it improved. Advantages included self-centered flexible learning and reduction in their concerns experienced with face-to-face learning. Disadvantages including changing the way they interact with teachers, decreasing interactions with classmates, problems with education files, superficial learning, hardware problems, family members’ perceptions of the student role, interference of home affairs with e-learning, cheating on exams and assignments and being far away from the clinical context. Conclusion The findings revealed that e-learning has been introduced as a new method for the current research participants and despite the perceived benefits, these students believed that e-learning could supplement face education but not replace it.

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Iranian nursing students experiences regarding the status of e-learning during COVID-19 pandemic

Teaching and learning have radically changed in the COVID-19 era and highlighted many novel aspects of online teaching and learning. Based on a qualitative content analysis of central European university students’ responses, the aim of this study is to discuss their reflections on the use of digital media in foreign language classes during the COVID-19 pandemic. The key method of this qualitative study includes focus group interviews. The results reveal both advantages and disadvantages of online foreign language teaching and their impact on students’ second language (L2) acquisition. The positive aspects involve satisfaction with being able to study a foreign language from the comfort from their homes, avoidance of commuting to school, ample opportunities to review the learning material, or improvement of listening skills. On the contrary, the negative aspects included a striking lack of social contact in the form of face-to-face classes, absence of collaboration between the teacher and students and between the students themselves in order to share and build on their knowledge and experience, health issues associated with a frequent exposure to technologies, or a lack of possibility to develop speaking skills. In conclusion, the authors of this study provide several implications for teaching practice, technology experts, and other stakeholders, which must be considered very seriously, as they represent the opinion of the users of online learning.

A qualitative analysis of students’ reflections on the current use of digital media in foreign language classes

Background The coronavirus disease 2019 (COVID-19) pandemic substantially undermined medical education and healthcare systems. Owing to the pandemic in South Korea, most medical schools needed to be flexible when conducting online and offline classes, but the guidelines did not reflect the specificity of medical schools. This study described the impact of modified anatomy education schedules at the Seoul National University College of Medicine (SNUCM) on students’ academic performance and satisfaction. Methods Anatomy education in SNUCM is divided into three regional units (the upper and lower limbs, trunk, and head and neck). Owing to the COVID-19 pandemic, the schedule was mixed with simultaneous and rotating schedules. The authors conducted exceptions for online lectures, cadaver dissections, and written and practical examinations in three classes of approximately 50 students each. Furthermore, the authors assessed students’ performance using three sets of written and practical examinations, and students completed a questionnaire regarding modified anatomy laboratory schedules. Results Despite the pandemic events in Seoul and South Korea during the laboratory sessions, all sessions were completed without any confirmed COVID-19 cases among the students, faculty, and staff. Most of the scores on the written and practical examinations significantly decreased in 2020 compared to those in 2019. However, in the trunk session that used the virtual anatomy application, the score on the practical examination in 2020 was significantly higher than that in 2019. Over 70% (79 and 77 out of 105 respondents on the upper and lower limbs and trunk, respectively) and 53% (55/105) students reported that there were no significant difficulties in studying anatomy in a face-to-face laboratory. Conclusions In conclusion, an adequate education program for cadaver dissection should be developed and provided to overcome the pandemic restrictions. The study findings could serve as a reference for anatomy education during the COVID-19 pandemic.

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The impact of the modified schedules of anatomy education on students’ performance and satisfaction: Responding to COVID-19 pandemic in South Korea

Healthcare education providers are eager to apply technologies in teaching and learning activities; however, students are the consumers in higher education, and their opinion and experience should be considered. We performed a meta-synthesis of qualitative studies to help inform our understanding of Southeast Asian healthcare students' perceptions and experience of technology-based teaching and learning in their education. Our search strategy located 1599 articles from a dozen electronic research databases. Articles were analyzed for quality using the Hawker's Evidence Appraisal Tool, and 23 qualitative studies were included in the final meta-synthesis. Technologies investigated largely involved online or blended learning, with fewer exploring virtual reality, simulations, telehealth, game-based learning, and videos. Three overarching themes were synthesized: (i) culture does matter in the implementation of technology-based learning; (ii) the values and limitations of technology used for learning; and (iii) technology is part of daily life and creates new challenges in education. Technology is an asset to enhance the learning experience, but educators must be aware of its limitations. Pre-coronavirus disease 2019 (COVID-19) studies were more focused on technology and product, and were optimistically reported, whereas COVID-19-spanning studies focused on life experience and paid more attention to reporting on the inherent challenges. The educational approaches, theories, cultural aspects, and availability of facilities all play a vital role in steering successful technology use in learning. 

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A Meta-synthesis on Technology-Based Learning Among Healthcare Students in Southeast Asia

Since the onset of the COVID-19 pandemic, many higher education and health centers have faced challenges. Educational leaders have tried to manage the new situation, but the human infrastructure was not ready for such an event. This study aims to explain the challenges and opportunities of the COVID-19 pandemic for medical education. This qualitative study used conventional content analysis to collect data from face-to-face and semi-structured interviews. The interviews continued until data saturation was reached. The participants were 12 students and 14 faculty members at Shiraz University of Medical Sciences. To ensure data rigor, we used member checks, peer checks and an external observer. Three main categories and 15 subcategories were extracted. The findings showed that four subcategories, e.g. perception on feasibility of e-learning, standardizing of e-learning, dedicated teaching, and networking and interdisciplinary collaborations, affected the development of medical e-learning. The main opportunities from the COVID-19 pandemic for medical education were classified into five subcategories: attitudes to e-learning and adaptability, preventing students’ separation from the educational environment, documentation and monitoring education, take control of own learning, and increasing perceived usefulness. The main challenges were divided into four subcategories, e.g. noncompliance with virtual classroom etiquette, inadequate interactions, time limitations, and infrastructure defects and problems. Finally, participants believed that methods of evaluation in e-learning were more suitable for diagnosis and formative evaluations. Generally, two subcategories were extracted, e.g. formative and summative. Medical schools have necessarily moved towards e-learning to compensate for the interruption in classroom education, such that traditional classes have been replaced with e-learning. These rapid, extensive changes in teaching and learning approaches have consequences for medical schools.

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Challenges and opportunities from the COVID-19 pandemic in medical education: a qualitative study

Introduction: Undoubtedly, there are several obstacles in the path of medical professionalism. This study examines these obstacles in the relationship between physician and patient. Therefore, this study was conducted to explore the barriers of physician-patient relationships in professionalism based on physician experiences. Methods: It was a qualitative study with a conventional content analysis approach. Our participants were 14 patients and 11 physicians. The sampling method was purposive, and data was collected through semi-structured interviews and field notes. Interviews continued until data saturation. Results: Findings of the study regarding barriers of patient-physician relationship were classified into five main categories: misperception of the physician's identity, unprofessional behavior of the physician, physician’s sense of self-superiority, patients' cultural differences, and lack of supportive services in the health care system. Conclusion: The results of this study showed that the communication challenges between physician and patient were not limited to the physicians' education. Part of these challenges depends on the patients and their culture. Another part of these challenges is directly related to the medical and management system structure.

Barriers of physician-patient relationships in professionalism: A qualitative study


 Background: Professional identity is a vital component of medical education that affects the future practice of medical students. There is a notice of the lack of a reliable and valid Persian scale to measure the students' readiness for professional identity.Objective: This present study aims to determine whether or not the PSIQ can be adapted for Persian healthcare professions.Methods: A cross-sectional study was performed among medical students (years of 4-7) in Shiraz medical school. A total of 175 students completed the Persian version of PSIQ using convenience sampling. Categorical confirmatory factor analysis (CCFA) and Cronbach's alpha coefficient were used to investigate the questionnaire's validity and reliability. Moreover, R.3.6.2 software, by using the lavaan and semPlot packages in it, was used for data analysis and the path diagram.Results: The indices of the goodness of fit of the model were used for the professional self-identity, which including root mean square error of approximation (RMSEA), Tuker-Lewise index (TLI), and comparative fit index (CFI) ( RMSEA=0.055, CFI=0.996, and TLI=0.994). The Cronbach's alpha coefficients for these three factors of "profession-specific tasks," "generic attributes," and "inter-personal tasks" subscales were 0.762, 0.622, and 0.747, respectively (p-value<0.05). The internal consistency of the whole questionnaire measured by Cronbach's alpha was 0.873. The set of these fit statistics show that the hypothesized three-factor model fits the sample data. Therefore, all nine items were significantly loaded on the three domains (Profession specific tasks, Generic attributes, Interpersonal tasks). Conclusion: The Persian translated version of the PSIQ may be an appropriate, valid and reliable tool for assessing medical students' health professional self-identity attitudes in Iran.

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Reliability and Validity of the Persian Version of the Professional Self Identity Questionnaire (PSIQ)

Background: Pregnancy and childbirth are sensitive and particular periods in women’s lives. Midwives play an essential role in ensuring mother’s and fetus’s health by the recognition of the needs and complexities of this period. Midwives increase the quality of care, gain the trust of pregnant women, communicate more effectively with them, and increase their satisfaction and cooperation by following the ethical principles and standards that express their professional commitment to society. Therefore, the awareness of the principles of professional ethics and adherence to the Charter of Patients’ Rights is a critical element of the midwife’s success in ensuring mother’s and neonate’s health. Therefore, monitoring the observance of these principles by midwives, similar to other health care providers, is essential to improve the quality of services and ultimately parturients’ satisfaction. For this purpose, it is necessary to have a valid and reliable tool to assess midwives’ professional ethics status. Objectives: In this study, a questionnaire was developed to assess this issue by parturients, who are primary stakeholders in this process. Methods: This qualitative and quantitative study was performed to design a reliable and valid questionnaire evaluating midwives’ professional ethics by parturients. Based on the literature review and consultation with midwifery professors and staff, the initial questionnaire was prepared with 26 items. A survey of 15 experts evaluated the content and face validity ratio. The final questionnaire with 20 items was completed by 200 parturients hospitalized in Valiasr Hospital of Fasa University of Medical Sciences, Fars, Iran, within 2018 - 2019. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the construct validity. The reliability was confirmed by the determination of internal consistency. Results: The 26 items of the questionnaire defined in the first step were reduced to 20 items with a content validity ratio higher than 0.49 and a content validity index higher than 0.79. Using EFA and CFA, 20 items were included in two dimensions and confirmed. Its reliability was reported as 0.89 using Cronbach’s alpha. Conclusions: This study aimed to design a valid and reliable questionnaire for the assessment of midwifery professional ethics in the delivery process. One strength of the present study, compared to those of mentioned studies, is performing both EFA and CFA. In this study, some goals of EFA consist of determining questionnaire dimensions, standardizing questionnaires, reducing the items (from variables to factors), and assessing homogeneity and discrimination in construct validity. The EFA is often used in the early stages of research to collect information about the interactions in a set of variables. The obtained results revealed that the designed questionnaire is a valid and reliable tool for the evaluation of midwifery professional ethics by parturients, which can be applied in other studies in Iran.

Soolmaz Zare

Papers

Challenges and opportunities from the COVID-19 pandemic in medical education: a qualitative study

Barriers of physician-patient relationships in professionalism: A qualitative study

Reliability and Validity of the Persian Version of the Professional Self Identity Questionnaire (PSIQ)

Designing a Valid and Reliable Questionnaire for Evaluation of Professional Ethics of Midwives by Parturients