Guilan University Of Medical Sciences Research Articles

Knowledge of emergency nurses and related factors toward geriatric: A cross-sectional study

Background: This study aimed to evaluate the geriatric knowledge of emergency nurses and related factors. Materials and Methods: This cross-sectional study was conducted on nursing students at Guilan University of Medical Sciences in Iran. The objective was to assess the geriatric knowledge of nurses working in the emergency departments of educational and therapeutic centers in Rasht City. The sample was selected through a census sampling method, including all nurses employed in these departments. Data collection was carried out using a three-part questionnaire, which included sections on “personal and occupational characteristics” and the “Questionnaire of Awareness about the Facts of Aging (FAQ)”. Results: A total of 190 emergency department nurses participated in this study. The mean age of the participants was 34.41 years (SD=6.37). The mean score for geriatric knowledge among the nurses was 6.58 (SD=2.24). No statistically significant associations were found between geriatric knowledge and the personal or occupational variables of the nurses. Also, the results showed that changes in nurses’ geriatric knowledge are explained to a small extent through personal and occupational characteristics. Conclusion: Overall, these results highlight the urgent need for targeted interventions to improve emergency nurses’ understanding of geriatric care. Furthermore, given the lack of significant correlations with demographic and occupational variables, future research should investigate additional factors that may influence emergency nurses’ knowledge in this area.

The Tendency to Use Substances/Drugs and its Association with Interpersonal Dependence in Iranian Medical Students.

Personality traits or disorders are now attracting more attention as factors in the initiation and continuation of substance/drug use. However, few studies have been conducted on the association between interpersonal dependence and substance/drug use. The present study aimed to investigate the association between this form of psychological dependence and the tendency to use substances/drugs in medical students. The present study was based on an analytical cross-sectional design and conducted on 310 medical students selected by stratified sampling at Guilan University of Medical Sciences in 2021. The Interpersonal Dependency Inventory and the Iranian Addiction Potential Scale were employed to assess the two variables of interpersonal dependence and the tendency to use substances/drugs. The correlation matrix shows that the tendency to use substances/drugs has a significant negative correlation with interpersonal dependence (P=0.0001, r=-0.285) in general and emotional reliance on another person (P=-0.0001, r=-0.264) and lack of social self-confidence (LSSC) (P=0.0001, r=-0.297) in particular. Female (F=8.57, P=0.004) and married (F=5.14, P=0.024) students showed more tendency to use substances/drugs than male and single students, but no significant difference was observed regarding interpersonal dependence. Academic course, residence status, parents' occupation, number of family members, and birth order did not significantly affect the scores. Interpersonal dependence can have different functions, depending on its level. Although interpersonal dependence at maladaptive levels can act as a risk factor and make a person vulnerable to some behavioral problems, at adaptive levels, it acts as a protective factor and reduces those problems.

Investigating the Job Burnout Levels and Related Factors in Medical Interns of Guilan University of Medical Sciences

Introduction: Job burnout is a state of mental fatigue resulting from a person's professional life and consists of three dimensions: emotional exhaustion, depersonalization, and decreased personal accomplishment. This study was conducted with the aim of determining the levels of job burnout and its related factors in medical internship students of Guilan University of Medical Sciences. Methods: This cross-sectional analytical study involved 71 medical interns of Guilan University of Medical Sciences participating by census in 2022. The Maslach Burnout Inventory and a socio-economic status questionnaire were completed by the students. The data were analyzed using descriptive statistical tests (percentage, frequency, mean, and standard deviation) and inferential statistics tests (Chi-square and Fisher's exact test) through SPSS (version 25). The P-value < 0.05 was regarded as statistically significant. Results: Out of 71 medical interns, 47.9% of medical students were female, while 52.1% were male. The findings showed that 44.1% of female (15 individuals) and 51.4% of male (19 individuals) experienced severe burnout, and 55.9% of female (19 people) and 48.6% of male (18 people) had moderate burnout. Participants earned high scores in emotional exhaustion (76.1%), depersonalization (67.6%), and decreased personal accomplishment (26.8%). There was a significant relationship between the internship level (P=0.00), the medical school GPA (P=0.011), the pre-internship test score (P=0.003), and the father's education rate (P=0.023) and the emotional exhaustion score. There was also a significant relationship between the depersonalization score and the internship level (P=0.003). Results indicated a significant statistical relationship between variables of maternal education (P=0.026), economic status (as assessed by the student or family regarding housing prices) (P=0.047), and medical school GPA (P=0.004) and the decreased personal accomplishment dimension score. ConclusionThe results of this study showed a high level of burnout among interns, with students scoring high in emotional exhaustion and depersonalization components. Therefore, according to the results of the present study, further research on preventive interventions and strategies to mitigate exposure to burnout factors would be beneficial.

Alexithymia and Suicidal Ideation in Iranian Patients With Psoriasis

Background: Evidence highlighted the high prevalence of some mental problems among individuals with psoriasis, including alexithymia and suicidal ideation. Objectives: The present study aims to investigate the prevalence and comorbidity of alexithymia and suicidal ideation in individuals with psoriasis in Iran. Materials & Methods: This cross-sectional study was conducted on 100 patients with psoriasis referred to Razi Dermatology Clinic and Beesat Clinic of hospitals affiliated to Guilan University of Medical Sciences, Rasht, Iran, in 2020. Psoriasis was diagnosed by a dermatologist, and the demographic and clinical characteristics of patients were recorded. The Toronto alexithymia scale (TAS-20) and the Beck scale for suicidal ideation (BSSI) were used to assess alexithymia and suicidal thoughts. Results: The mean age of patients was 37.56±10.58 years, and 51% were female. Among patients, 52% had alexithymia, 23% were at high risk of suicide, and 6% were at very high risk of suicide. The moderate severity of psoriasis had a significant association with suicidal thoughts (P<0.05). The TAS-20 score had a significant association with the male gender and younger age, and the BSSI score had a significant association with the psoriasis area (P=0.003). The highest score of BSSI was seen in those with psoriasis in the face and limb/trunk (10±4.36 and 8.56±8.52, respectively). Conclusion: Patients with psoriasis exhibit a significant prevalence of alexithymia and suicidal thoughts. Additionally, younger age and male gender were identified as factors associated with alexithymia in this population.

Evaluation of psychometric properties of sleep quality questionnaire among medical students of Guilan University of Medical Sciences

BackgroundSince evaluating sleep quality among students is of great importance and is one of the challenges facing the health field regarding this group, we were determined to conduct this study to evaluate the psychometric properties of the Sleep Quality Questionnaire (SQQ) among the medical students at the Guilan University of Medical Sciences.MethodsThis research was conducted as a cross-sectional study. In the procedure, a random group of medical students at Guilan University of Medical Sciences were provided with questionnaires and the study’s pre-prepared checklist and were asked to answer them accurately. The questionnaires used in this study include the Sleep Quality Questionnaire (SQQ), and the Pittsburgh Sleep Quality Index (PSQI). After collecting the entries, all the data were subjected to a statistical analysis using the SPSS software.ResultsIn this study, 249 medical students with an average age of 23.88 ± 2.46 were evaluated, of which 140 (56.2%) were female and the rest were male. According to the results, the average sleep quality for SQQ was 19.31 ± 8.06, and the Pittsburgh Sleep Quality Index (PSQI) was 7.95 ± 3.76. Based on the results obtained from the exploratory analysis, it was determined that no high overlap exists between the two evaluated factors in the sleep quality questionnaires, confirming their divergent validity. In evaluating the convergent validity, the correlation between the SQQ and PSQI questionnaires was reported as 0.642, which was significant (p < 0.001). Cronbach’s alpha for the SQQ questionnaire was equivalent to 0.882, which is verified since the minimum value is 0.70. Also, utilizing the test-retest method, the reliability was found to be 0.74, which is acceptable according to the minimum value of 0.70. SQQ scores had a direct and meaningful relationship with age (r = 0.185, p = 0.003). Based on the pairwise comparison, there was a significant difference in SQQ scores between the students in different stages and the duration of sleep.ConclusionThe current study’s findings indicate that the SQQ questionnaire possesses adequate validity and reliability, which could be utilized to evaluate sleep quality in domestic studies.

A comparative study of the effectiveness of self-management and group management on the amount of weight loss of nurses under low-calorie diet treatment: A simultaneous mixed-methods study.

Nursing is a profession that is associated with a lot of stress and a risk of being overweight or obese. The purpose of this research was to determine the comparative effectiveness of self-management (self-M) and group management (group-M) on nurses who were following a diet with the aim of proposing a proper planning and a healthy lifestyle for them. This study was a simultaneous mixed-methods design (interventional and qualitative). The participants were all overweight or obese nurses working in teaching hospitals at Guilan University of Medical Sciences in 2019 (n = 96). In the qualitative part, data were extracted from semi-structured interviews. For quantitative data analysis, relevant statistical methods such as Kolmogorov-Smirnov test, analysis of variance (ANOVA), and analysis of covariance (ANCOVA) were used. For qualitative data analysis, the conventional content analysis approach was used and Lincoln and Guba's criteria were applied to ensure the accuracy of the data. In both quantitative and qualitative sections, the results showed that following a diet treatment with group-M is more effective than self-M. The results showed that a healthy lifestyle can be achieved for nurses if they participate in training classes and group programs, which are proven to be effective based on this article and some other studies. Also, since weight gain and obesity, as one of the most important problems of health systems, continue to increase and can impose a heavy economic and social burden on human societies, various general policies should be used and these solutions can range from home to society to prevent and control them.

Nursing students’ metaphors of first clinical experiences of encountering patients with mental disorders

BackgroundPsychiatric wards are one of the most stressful medical centers. Apprenticeship in mental health can cause feelings of stress and anxiety among nursing students. Investigating nursing students’ beliefs about mental illnesses is very important to improve nursing education. The present study aimed to identify nursing students’ metaphors for their first clinical experiences of encountering patients with mental disorders.MethodsThis descriptive qualitative study was conducted on 18 undergraduate nursing students studying in two nursing colleges at Guilan University of Medical Sciences, in the north of Iran, in 2022. The data were collected through semi-structured interviews and analyzed using Critical Metaphor Analysis by the MAXQDA 2007 software.ResultsThe analysis of nursing students’ metaphors led to the emergence of 36 metaphors and 5 categories. These categories were “experience of dealing with a mental patient is similar to fear mixed with excitement”, " patient is similar to an errant human”, " psychiatric hospital is similar to a prison”, “nurse is similar to a prison guard”, and “clinical instructor is similar to a supporter, sympathetic and knowledgeable friend”.ConclusionsThe results showed their negative attitude towards the psychiatric hospital and health care providers. It is suggested that the findings of this study be taken into consideration in the planning of clinical education of nursing students.

Storytelling as an educational strategy for midwifery students: A qualitative study.

Narratives can provide a framework to teach the concepts of patient-centered care to the students. This article describes the experiences of midwifery students from employing of purposive storytelling as a teaching strategy in the education program. This qualitative study used an in-depth interview method to collect the experiences of midwifery students engaged in a narrative medicine training program. The narrative-based teaching activities focused on three patients to teach four themes (clinical manifestations, treatment options, prevention strategies, and ethics), and related to MMR (maternal mortality rate) concept offered to students from Guilan University of Medical Sciences in 2022-2023. At the end of the course, all students were invited to provide experiences regarding the teaching method. Conventional content analysis was performed simultaneously with data collection. Four-dimension criteria (Lincoln and Guba) were used to evaluate the rigor of the findings. Data analysis led to the extraction of three main categories and eight sub-categories: effective learning (extended learning, a safe learning environment, and boosted motivation for midwifery role), challenges on the way of learning (contagious sadness, shattered cohesion, and executive monopoly), and challenges on the way of performance improvement (the necessity of interdisciplinary education and the inevitability of a strong foundation). Narrative-based teaching may improve the learning experience of students, but it is not possible to train all the course content by this method, and it should ideally be a supplement to other educational methods, such as lecturing.

Publication Rate of Papers Extracted From the Medical Residency and Master’s Degree Theses of Guilan University of Medical Sciences From 2008 to 2018

Background: research theses can have a significant impact on the development of applied sciences, especially when their results are presented to the public. There are few studies about publishing papers based on residency and master’s theses. Objective: to determine publishing papers based on residency and master’s theses in Guilan University of Medical Sciences (GUMS) during 2008-2018. Methods: this descriptive cross-sectional study retrieved information on residency and master’s theses from 2008 to 2018. Then searched international and national medical databases according to the title of theses, keywords, and the names of supervisors, consultants, and students. Results: 449 (58. %) papers were published from 774 theses. 41.2%, 11.8%, 0.44% and, 46.56% were indexed in type one, two, three and, other types of scientific indexes respectively. 98.66% of papers were original articles. 383 (85.3%) of theses did not have statisticians’ consultants. And the maximum median time from defending theses to the publication of a paper was two years. Conclusion: publication of papers increased at GUMS compared to the past, and more than fifty percent were indexed in scientific indexes types one and two. However, associated factors with the publishing papers process should be surveyed.

Effect of Orem's self-care model on the quality of life in adolescents with diabetes type 1: A randomized clinical trial

The present study aims to determine the effect of Orem's self-care model on the quality of life in adolescents with diabetes type 1. A randomized controlled trial was conducted at Guilan University of Medical Sciences in Rasht, Iran. Adolescents diagnosed with type 1 diabetes constituted the study's participants. The research enrolled 80 diabetic patients, divided randomly into two groups: the control group and the intervention group. The study employed four blocks labeled A, B, C, and D, selecting the initial block through a lottery-based method. The intervention group received a series of eight training sessions structured by the Orem’s self-care model. In contrast, the control group received standard routine education without the structured sessions aligned with the aforementioned model. The data collection instruments used in this study comprised a demographic information questionnaire, an Orem’s health status questionnaire, and an SF-36 quality of life questionnaire. The study comprised 80 diabetic type 1 patients, with 40 assigned to the control group and 40 to the intervention group. The average age of the participants was 13.40 (SD=2.25). Notably, a substantial difference was observed in the change of scores about the physical dimension between the intervention and control groups (P=0.03). Additionally, a significant disparity in mental dimension scores was observed between the intervention and control groups (P=0.02). Our investigation demonstrated that the development and execution of an educational training program grounded in the Orem's self-care model yielded an enhancement in the quality of life among adolescent patients diagnosed with type 1 diabetes.

The Experience of Nursing Professors and Students about the Objective Structured Clinical Examination

Background: Clinical evaluation in medical sciences is one of the important components of education. One of these evaluations is the clinical assessment for final-year nursing students when they are going to graduate and start their profession. To this end, this study aimed to explore the experiences of nursing professors and students regarding the Objective Structured Clinical Examination (OSCE). Methods: This qualitative study was conducted using a content analysis approach on 7 nursing professors and 21 nursing students who completed OSCE in 2019 at the Nursing and Midwifery School of Guilan University of Medical Sciences in northern Iran. The participants were selected using purposive sampling and the data were collected through semi-structured individual interviews. The collected data were analyzed using the content analysis approach proposed by Graneheim and Lundman. The credibility of the findings was checked using the criteria proposed by Guba and Lincoln. Results: The data analysis revealed 3 main categories and 10 subcategories: OSCE as a highly efficient test(the requirement for reviewing the courses, student benchmarking, and randomly arranged questions), OSCE challenges (the low assessment ability of the test, the influence of the nursing instructor’s prior knowledge, and having little practical experience), the solutions to improve OSCE (diversification of evaluation techniques, shortening the distance between theory and practice, the effectiveness of the OSCE scores for graduation, and the application of stress reduction methods). Conclusion: Despite some problems such as its stressful nature and its unknown format for students, OSCE seems to be effective for the clinical assessment of students before their graduation. Taking advantage of the professors’ and students’ perspectives can eliminate or reduce the problems and improve the positive points for planning and conducting the OSCE in the future.

Frequency of Smoking, Alcohol Consumption, and Substance Use in Relation to General Health Indicators in Guilan University of Medical Sciences.

The risk of substance use is increasing among university students, especially medical students. This study aimed to investigate the frequency of smoking, alcohol consumption, and substance use and its relationship with general health indicators among the students of Guilan University of Medical Sciences (GUMS) in 2020. The differences in the frequency of substance use were also investigated from 2005. This was a cross-sectional analytical study conducted on 406 students of GUMS, Iran, in 2020. The data were collected through three online questionnaires including a demographic questionnaire, the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and the General Health Questionnaire (GHQ). The data were entered into SPSS software version 22 and analyzed using Chi-square, Fisher's Exact tests, and logistic regression at a significance level of 0.05. In this study, 53.9% of the participants were female, 46.1% were male, and 54.4% of them experienced using substances in their lifetime. The highest prevalence of use was in consumers of tobacco (46.8%), alcoholic beverages (34.7%), and cannabinoid compounds (19%). Besides, 48.5% of the participants were suspected of having some degree of psychiatric disorders, among which depression (11.6%) and anxiety (8.4%) were the most common. Moreover, substance use during students' lifetime had a statistically significant association with anxiety, depression, and mental health. The results of this study showed the prevalence of smoking, alcohol consumption, and substance use among the students of GUMS is worrying. The relationship between consumption and consumer's health indicators highlights the necessity of intervention and purposeful planning by policymakers in this field.

Effectiveness of Gamification in Enhancing Learning and Attitudes: A Study of Statistics Education for Health School Students.

Gamification is the use of game design elements in non-game contexts. It is considered a student-centered instructional design to motivate student learning and academic behavior. In this study, the effects of gamification on learning statistics (hypothesis testing issue) and attitude toward statistics in comparison with the common e-learning approach were investigated. The students' experience and critical elements of gamification on learning statistics were assessed, too. In a before and after trial, in a census manner, 64 health faculty students of Guilan University of Medical Sciences, Rasht, Iran, non-randomly were assigned to the intervention (n=42) and control (n=22) groups. Learning activities were gamified in the intervention group, while the control group received traditional problem-solving in the learning management system. Narrative, avatar, level, point, progress bar, scoreboard, challenge and feedback elements were used in the game experience. The implementation of gamification was applied based on Landers' theory of gamified content. Valid and reliable Persian version of the Survey Attitude toward Statistics questionnaire measured the students' attitude before and after the intervention. The EGameFlow questionnaire and a valid and reliable researcher-made exam measured the users' experience of gamified content and learning hypothesis testing after the intervention. The independent samples T-test, analysis of covariance and the partial eta-squared effect size were calculated by SPSS software, version 26. Compared to the control group, the intervention group had a more positive attitude toward learning difficulty (moderate partial eta-squared 0.099), value and cognitive competency (weak partial eta-squared=0.01 and 0.05). Learning between the two groups was not different (P=0.522). There was a significant correlation between learning and the students' perceived experience with feedback (r=0.583, P<0.001), concentration (r=0.509, P=0.005), and challenge (r=0.421, P=0.023) of the gamified content. It suggests using gamification on learning statistics while optimizing the design with more focus on the feedback, challenge and concentration elements.

Exploring the Midwives' Experiences of Providing Delivery Care for Women with Suspected or Confirmed COVID-19 Infection: A Qualitative Study.

Midwives were at the forefront of caring for pregnant women during the COVID-19 pandemic, therefore, the present study was conducted with the purpose of exploring midwives' experiences of providing delivery care for women with suspected or confirmed COVID-19 infection. In this qualitative study, 18 midwives working in the public hospitals affiliated with Guilan University of Medical Sciences (Iran). Who had experience in providing delivery care to women with suspected or confirmed COVID-19 infection were selected using purposive sampling. Data were collected via individual semi-structured interviews until reaching data saturation, and analyzed through conventional content analysis. Data analysis led to the extraction of three main categories and six sub-categories. The main categories included "COVID-19 and organizational support" with two sub-categories including lack of resources/neglecting the role of midwives, "COVID-19 and positive achievements" with two sub-categories including professional resilience/turning threats into opportunities, "COVID-19 and informational support" with two sub-categories, including up-to-date training/empowering pregnant women. According to the findings, to realize and guarantee the provision of high-quality maternity care to pregnant women in dealing with epidemic diseases such as COVID-19 in the future, the attention of policymakers and healthcare service officials to the physical and psychological needs of midwives is necessary. Also, organizational and informational support, improving job satisfaction, and paying attention to the importance of midwives' role in the medical team are recommended. Moreover, empowering pregnant women during epidemic diseases is essential.

Assessment of Students` Cultural Needs In Guilan University Of Medical Sciences

Introduction: Paying attention to the cultural background of universities as one of the influential factors in hidden curriculum leads to the academic and social success of students. It is necessary to be aware of the diverse and numerous cultural needs of students in order to making decisions and cultural planning in the university. This study was conducted with the aim of determining the cultural needs of students of Shahid Beheshti school of nursing and midwifery in Rasht. Method: This is a descriptive analytical cross- sectional study that was conducted on 237 students of the Shahid Beheshti school nursing and midwifery in Rasht in 2022. The research tool was a researcher-made questionnaire with a 5-point Likert scale with 47 items and seven subscales. Data were analyzed using descriptive statistics methods including frequency, mean and standard deviation and Spiroman, Shapiro-Wilk, Mann-Whitney U, Friedman and Bonferroni correction tests through SPSS. Results:The results showed that 137 students (57.8%) were female, 211 students (89%) not working, 152 students (63.7%) native and 226 students (%95.4) single and average age of students was 21.3±3.6 years. The students’ culturally related needs in order of priority; development of sports activities, artistic skills, the need related to social customs and traditions, the development of social skills, spiritual matters, the need related to political thinking and religious matters. The results showed that there is no statistically significant difference between students' cultural needs and gender (p&lt;0.005). Conclusion: According to the results of this study, Students have diverse cultural needs. From the viewpoints` of students, the need to develop sports and artistic activities is in priority. Therefore, it is recommended that the seven needs identified in this study should be taken into consideration by the university officials and to make appropriate planning should be done to meet these needs.

Patients’ Preferences and Attitudes Toward Receiving Bad Medical News: A Quantitative Study from Guilan Academic Hospitals

Background: Breaking bad medical news is one of the most difficult tasks of physicians. In this regard, communication skills play a vital role. Objectives: This study aimed to investigate patients’ preferences and attitudes toward receiving bad medical news in academic hospitals affiliated with Guilan University of Medical Sciences. Methods: This cross-sectional descriptive study was conducted on patients over 18 years of age from March 2021 to December 2021. A questionnaire taken from Alrukban’s study regarding patients’ demographic characteristics, preferences, and tendencies while receiving bad news was filled out through a face-to-face interview. Results: In this study, 600 patients were interviewed, 96% of which preferred to know their disease diagnosis, 76.2% preferred to be the first person to receive bad news, and employed individuals with younger ages and higher levels of education significantly preferred to be the recipients of illness news. Furthermore, 40.7% of patients preferred not to be accompanied by anyone when receiving bad news, 82.3% preferred to be broken bad news by the head of the medical team, and 50.8%, particularly female, younger, and employed patients, preferred the physician to start the conversation containing some information about the disease. Also, younger female patients significantly preferred the physician to stay with them and provide additional information after presenting the diagnosis in a completely private space. Conclusions: Most patients preferred to know about their diagnosis. The impact of socio-demographical variables, including age, gender, level of education, and marital status, should be considered when breaking bad news.

Knowledge, Attitudes, and Compliance with Covid-19 Guidelines among Nursing Students at a Medical University in Iran

To prevent the spread of Covid-19, healthcare staff require up-to-date knowledge. There is limited information about the level of knowledge, attitudes, and compliance with Covid-19 guidelines among nursing students in Iran. This study aimed to determine knowledge, attitudes, and compliance with Covid-19 guidelines and related factors among nursing students at Guilan University of Medical Sciences in the north of Iran. This cross-sectional study was conducted on 190 undergraduate nursing students. Samples were recruited by convenience sampling according to the inclusion criteria. The research instruments included demographic characteristics and knowledge, attitude, and practice towards Covid-19 questionnaires. Descriptive and inferential statistics were used to analyse the data using SPSS software version 21 with a significant level of 0.05. In this study, 131 (68.9%), 182 (95.8%), and 81 (42.6%) of the study participants had good knowledge, positive attitude, and good compliance with Covid-19 guidelines, respectively. Results showed that the mean scores of knowledge, attitude, and compliance with Covid-19 guidelines were 14.66 (SD=3.03), 30.35 (SD=4.13), and 11.05 (SD=4.00), respectively. There was a significant relationship between knowledge and some demographic characteristics (gender, job, and housing status), between attitude and gender and economic status, and between compliance and gender and academic semester (P&lt;0.05). Managers can use the results of this research to plan and provide arrangements to improve compliance with precaution guidelines during future events similar to Covid-19.

Promoting dairy consumption behavior in the school setting: an experiment based on the transtheoretical model

BackgroundNutrition education is a key component of health promotion programs which leads to the improvement of students’ nutritional behaviors. The transtheoretical model (TTM) is one of the models extensively used in changing people’s behaviors. This study aimed to change the dairy consumption behavior based on the TTM in female students.MethodsA controlled trial was conducted with 159 female students (intervention group: 56; control group: 103) in the 10-11th grades from two public schools in Soumesara city located in the west of Gilan Province, Iran. Demographic characteristics, knowledge, TTM constructs and stage of change of dairy consumption were collected using a valid and reliable researcher-made questionnaire. Data were gathered before and one month after the educational intervention. Chi-square test, t-test and ANCOVA were used to analyze the data and a p-value < 0.05 was considered statistically significant.ResultsFifty-two students from the intervention and 93 from the control group completed the study. Only 15% of the students were in the action or maintenance stages of dairy consumption. After the intervention, mean scores of behavioral processes of change, cognitive processes of change, decisional balance, and self-efficacy improved in the intervention group (P < 0.05 for all). Also, 37% and 16% of the participants in the intervention and control groups, respectively, were in the action or maintenance phase (P < 0.001).ConclusionsThis study showed that implementing an intervention based on the TTM would positively affect students’ dairy consumption behaviors. Also, it is suggested that the TTM be assessed in terms of other daily nutritional needs in students to promote their nutritional behaviors.Trial RegistrationThe study was registered in the Iranian Registry of Clinical Trials (IRCT) (available online at https://en.irct.ir/trial/50003) on April 11, 2020 with the number IRCT20200718048132N1 and was approved by research ethics committee of Guilan University of Medical Sciences, Iran.

Comparison of the Clinical Outcomes of Plastering and Bandage Treatment Methods in Patients With Ankle Sprains: A Randomized Clinical Trial Study

Department of Orthopedics, Orthopedic Research Center, Faculty of Medicine, Poorsina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Explaining the Role of Medical Teachers in Electronic Learning Environments

Introduction: E-learning environments are now increasingly used by medical schools around the world. In designing any electronic learning environment, attention to different components such as learner characteristics, teacher's role, curriculum approach, teaching-learning process, content and educational media should be considered by designers. In this regards, the role of teachers and presentation of new educational roles for him and having teaching skills in the virtual environment is very important. This study aimed to explain the role of medical teachers of Guilan University of Medical Sciences in electronic learning environments. Methods: This qualitative study was conducted with content analysis approach during 14 months (the year 2021-2022) on 15 medical teachers and medical students who were selected by the purposive sampling method. Data were collected using semi- structured interviews and were coded through MAXQDA20 software. Categorization of codes and extraction of classes were done according to the guided content analysis approach based on Graneheim and Lundman. The Guba and Lincoln criteria were used to ensure the rigor. Results: Analyzing the statements of the participants led to the identification of the professor's presence-cognitive theme in electronic learning environments. The main classes included appropriate teaching process in the e-learning environment (subcategories include: using virtual education in appropriate courses, designing appropriate teaching content, revision in students evaluation and using appropriate teaching methods to facilitate learning), and the teacher's participation in creating a sense of belonging to the e-learning environment (subcategories include: the effective presence of the teachers, the social presence of the teachers, the educational leadership and creating a sense of belonging in the students). Conclusion: According to the results of the study, acquisition of virtual teaching skills, cognitive presence of teachers in e-learning environments and attention to the formation of a sense of belonging to the environment in students are the most important roles of medical teachers in e-learning environments. University administrators should provide sufficient resources to manage new educational environments, remove administrative and structural barriers, and motivate faculty members to use electronic education systems.