Journal of Advances in Medical Education & Professionalism

Abstract Introduction: The electronic exam is one of the foremost imperative instruments for evaluating students’ execution. Accordingly, this study aimed to identify the advantages and challenges of electronic exams based on Iranian and international studies.
Methods: The present qualitative study used meta-synthesis in the first phase. Thus, keywords such as electronic exams, online exams, electronic assessment, and online assessment in Iranian
and international databases for 2005-2021 were searched. In the second phase, using the Shannon entropy technique, the advantages and challenges of electronic exams were weighted.
Results: Challenges of e-exams were classified into seven subcategories (poor technical knowledge, security challenges, complexity and challenges in designing examination, complexity
and challenges during examination, complexity and challenges after examination, lack of infrastructure, socio-cultural challenges). The advantages of e-exams were also classified into five sub-categories, including improvement of teaching and learning process, effectiveness of student performance assessment, advantages in designing exams, advantages during examinations, and advantages after examinations. In Shannon’s entropy findings, challenges (complexity and challenges after examination and poor infrastructure) and advantages (advantage after exams implementation) had the largest weight.
Conclusion: Considering the importance of electronic exams, especially with the outbreak of the COVID-19 epidemic, the inevitable movement of university systems, increasing concerns about student performance assessment, and improving educational performance in the current situation, decision-makers are expected to emphasize the advantages of this kind of exam and address its challenges to help improve the student assessment mechanisms.

Abstract Introduction: Learning Analytics (LA) has emerged as a potent tool in medical education, offering data-driven insights and personalized support to learners. This systematic review aims to provide a comprehensive overview of the current state of LA in medical education, exploring its applications, benefits, challenges, and future directions.
Methods: The study was conducted as a systematic review of learning analytics (LA) in medical education. A comprehensive search was performed in June 2023 across the following databases: ProQuest, Scopus, ERIC, Web of Science, PubMed, and ScienceDirect, with no restrictions on publication dates. The search resulted in a total of 1095 records, which were screened after removing duplicates, leaving 552 titles for review. Following the exclusion of irrelevant articles, 12 studies were selected for synthesis.
Results: Four key categories of LA applications emerged: curriculum evaluation, learner performance analysis, learner feedback and support, and learning outcome assessment. The
synthesis of findings underscores LA potential to enhance learning experiences, identify at-risk learners, and improve formative assessment practices. However, ethical and privacy concerns
warrant attention to bridge the gap between research and practice.
Conclusion: This review suggests a collaborative and mindful approach to leveraging LA in medical education. Balancing data-driven insights with effective, ethical, and human-centric
pedagogical practices is crucial. Addressing these concerns can ensure the integration of LA into medical education, fostering its transformative potential while upholding core values.

Abstract Introduction: In a regional hospital in Southern Taiwan, an average of 25 heart surgeries are performed annually, with surgical education conducted one-on-one. This indicates that
opportunities for paramedics to participate in surgical procedures are quite limited. Although 80 paramedics in the hospital can perform surgical procedures, 69 have more than two years of
experience, and only 19 are selected by surgeons to perform surgical procedures. Consequently, paramedics without hands-on experience are likely to feel panicked and helpless.
Methods: The present study employed a systematic software development approach to create a mobile application-based medical skill training system. Initially, we conducted a comprehensive
needs analysis through in-depth interviews with cardiac surgery nurses and administrators to accurately identify the key training requirements. In the system architecture design phase, we chose Windows Server as the operating system, combined PHP and Apache to handle web service requests, used MariaDB for data storage and management, and applied FastAPI to facilitate data
exchange with other services. Client-side development utilized the Flutter framework, ensuring a consistent user experience across iOS and Android platforms.
Results: We also designed complex data structures to accommodate testing and recording needs, including exam data, question types, and option records. For user flow implementation, we developed a complete process including user registration, subject management, test preparation, and evaluation. Finally, we implemented core functionalities such as the login interface, question selection, and test interface to ensure the system’s comprehensiveness and practicality. This multi-stage development approach aimed to create an efficient, user-friendly, and adaptive training platform to meet the specific needs of cardiac surgery nursing staff.
Conclusion: The development and implementation of the mobile application-based system for enhancing medical skill training has demonstrated significant potential in addressing the challenges of paramedics in cardiac surgery settings. While the initial results are promising, further long-term studies are needed to assess the impact on actual surgical outcomes and patient care quality.

Abstract Introduction: Implementing “Competency-Based Medical education” in Indian medical colleges has necessitated reengineering by the stakeholders at the institutes. Changes in the curriculum are usually inundated with challenges. The present study aimed to evaluate the implementation of the CBME curriculum for Phase II medical undergraduates in our institute.
Methods: This qualitative study involved faculty members from Pathology, Microbiology, and Pharmacology teaching Phase II medical undergraduates, who participated in three focus group
discussions (one per department) to discuss the strategies and challenges in curriculum implementation. A gap analysis followed, with individual in-depth interviews with the departmental heads to identify solutions for the challenges. A review meeting was held with the dean, curriculum committee members, and phase II faculty members to finalize the action plan.
Results: A total of 18 faculty members, predominantly females, in different age ranges (29 to 68 years) and teaching experiences (4 to 34 years) participated in this study. The faculty members have adopted various strategies for curriculum implementation such as preparing departmental planners, framing lesson plans, using interactive teaching-learning methods and e-learning, conducting self-directed learning sessions, ensuring alignment and integration, incorporating skill modules, ensuring student logbook maintenance, using appropriate assessment methods and implementing AETCOM modules. However, they faced challenges in implementing self-directed learning sessions, using e-learning platforms and recommended faculty development programs.
Conclusion: Our study reveals that the paraclinical departments at our institute have taken appreciable steps in implementing the CBME curriculum for Phase II MBBS students, despite ongoing challenges. Addressing these challenges requires careful planning and evaluation, with faculty sensitization being crucial for smooth implementation. The key outcome of the study was establishing various subcommittees within the Curriculum Committee and Medical Education Unit to facilitate the implementation of various CBME components, supported by regular feedback mechanisms. Also, the action plan was shared with the Medical Education Unit to organize appropriate faculty development programs.

Abstract Introduction: Case-based learning (CBL) is widely used in medical education to bridge theory and practice, but traditional methods often struggle to sustain student engagement and promote critical thinking. To address these challenges, Case-Based Integrated Learning (CBIL) was developed as a novel approach combining immersive and interactive learning techniques. This study aimed to evaluate the effectiveness of CBIL in enhancing engagement, critical thinking, and clinical reasoning among medical students, and explore faculty experiences regarding the pedagogy.
Methods: An explanatory-sequential mixed-methods study was conducted in a private medical college in Pakistan. Quantitative data were collected through faculty (n=35) and student (n=122) evaluation surveys, and analyzed using descriptive statistics (mean, standard deviation, frequencies, and percentages). Qualitative data from focused group discussions (FGD) with faculty were analyzed thematically. A committee of clinical faculty and medical educationists developed
four CBIL prototypes. Faculty from various clinical specialties were trained on CBIL concepts and lesson planning, and the prototypes were used to develop engaging cases for subsequent sessions. Participants included faculty from diverse disciplines and students in
their third and fourth years of medical school.
Results: The faculty considered the training very effective (overall satisfaction: 5.17±0.89 out of 6), with a vast majority being very satisfied with its relevance (86%, n=30) and structure (91%, n=32).
Among students, 95% (n=116) were satisfied with the developed cases. Most of them were also satisfied with the clarity (92%, n=112) and applicability of the cases (96%, n=117). In FGD, facilitators expressed satisfaction with CBIL formats as it provided opportunities for engagement, in-depth analyses, and discussions.
Conclusion: Interactive formats like CBIL can engage students by allowing opportunities for interaction, discussion, and peer-learning. This promotes improved understanding and critical thinking. Further exploration of the effectiveness and impacts on the learning of various interactive formats of case-based learning is essential.

Abstract Introduction: The quality of nursing education depends on the availability of faculty members with great professional knowledge and clinical work experience. Thus, novice faculty may face challenges in providing quality education. The aim of this study was to explore the experience of transition to a faculty role among a sample of Iranian nursing faculty.
Methods: This qualitative study was conducted in 2022. A total of fifteen faculty members of the nursing and midwifery schools participated in this study. Participants were recruited through purposeful sampling. Data were collected through semistructured interviews and analyzed through Graneheim and Lundman’s conventional content analysis approach.
Results: 704 primary codes were generated and grouped into 35 subcategories, nine main categories, and three main themes, namely unpreparedness for the faculty role, abandonment in a
non-empathetic workplace, and a road to resilience.
Conclusion: Nursing faculty members with limited work experience are unprepared for the transition to faculty roles, receive limited support at work, and rely on personal resources and support networks to facilitate their transition to the faculty role. Further studies are needed to assess the effects of preparation and support programs on the transition to faculty roles among the faculty members with no previous clinical work experience.

Abstract Introduction: Educational procrastination is a pervasive issue among students, influenced by a range of demographic, psychological, and behavioral factors. This study aimed to assess
the prevalence and determinants of educational procrastination among medical students at Shahid Beheshti University of Medical Sciences, focusing on the unique challenges posed by remote learning and Internet use.
Methods: A quantitative, cross-sectional study was conducted involving 200 medical students who had completed the basic sciences courses. Data were collected using a demographic
questionnaire, Solomon and Rothbloom’s academic procrastination questionnaire, and a researcher-made questionnaire assessing the factors contributing to procrastination. Statistical analyses, including t-tests, chi-square tests, and regression analyses, were performed using SPSS version 24.
Results: The study found a high prevalence of severe procrastination among medical students. Age, gender, and Internet addiction emerged as significant predictors of procrastination,
with younger students, females, and those with higher levels of Internet addiction exhibiting greater procrastination tendencies. Other factors, including educational status, second job, work
experience, marital status, living arrangements, socioeconomic status, GPA, psychological issues, self-confidence, stress during tests, and motivation, did not significantly predict procrastination.
These findings underscore the complexity of academic procrastination and its multifaceted determinants.
Conclusion: Interventions to reduce procrastination should consider key demographic and psychological factors, especially focusing on younger students, females, and those with high levels
of Internet addiction. Further research is required to explore causal relationships and develop targeted strategies for addressing procrastination in medical education.

Abstract The emergence of the Internet of Behaviors (IoB) has created new opportunities for influencing and guiding human decisionmaking. IoB refers to the collection, analysis, and application of
data generated by individuals’ online activities, behaviors, and interactions. This concept integrates data from various sources, including social media, wearable devices, smartphones, and
other digital platforms, to gain insights into human behavior patterns. This technology can profoundly affect various areas of our lives, such as healthcare, education, and transportation. This
paper explores the transformative potential of IoB in educational businesses, where it enables personalized learning, real-time feedback, and improved student retention. By analyzing data on
student engagement and performance, IoB supports differentiated instruction, enhances collaborative learning, and drives datadriven curriculum development. Additionally, IoB contributes to students’ health and safety through wearable technology and promotes smart, resource-efficient classrooms. However, the implementation of IoB in education poses significant challenges, including privacy concerns, technical complexities, and access disparities. The paper identifies key areas for future research, such as the integration of IoB with traditional pedagogical approaches, equitable access to IoB technologies, and development of ethical standards to safeguard student privacy. This commentary underscores IoB’s potential to revolutionize education while emphasizing the need for careful consideration of its challenges to ensure broad and equitable benefits.