The impact of a computerized decision aid on empowering pregnant women for choosing vaginal versus cesarean section delivery: study protocol for a randomized controlled trial

Cesarean delivery on maternal request (CDMR) is one of the main reasons for cesarean delivery in Iran, and women often need help in making a decision about the delivery options available to them. The main objective of this study is to evaluate the effect of a computerized decision aid (CDA) system on empowering pregnant women in choosing an appropriate mode of delivery. This CDA contrasts the advantages and disadvantages of vaginal versus cesarean section delivery in terms of their value to the individual woman. The protocol concerns a randomized trial study that will be performed among Iranian women. Four hundred pregnant women will be recruited from two private and two public prenatal centers in Mashhad, Iran. They will be randomly assigned to either an intervention or a control group. The designed CDA will be provided to the intervention group, whereas the control group will only receive routine care. The CDA provides educational contents as well as some recommendations. The CDA's knowledge base is obtained from the results of studies on predictors of cesarean delivery. The CDA's software will be installed on women's computers for use at home. The two primary outcomes for the study are O'Connor's Decisional Conflict Scale and knowledge as measured by true/false questions. Actual mode of delivery (vaginal versus cesarean) will be compared in the two groups. We investigate the effect of a CDA on empowering pregnant women in terms of reducing their decisional conflict as well as on improving their clinical knowledge pertaining to mode of delivery. This trial is registered with the Iran Trial Registrar under registration number IRCT2015093010777N4 and registration date 26 October 201

Measurement of Geographical Dispersion in Virtual Project Teams

RÉSUMÉ : Le contexte actuel de mondialisation et de développement rapide des technologies de communication incite les organisations à mettre en place des équipes de projets dispersées. À mesure que se généralise ce mode d’organisation, plusieurs chercheurs s’y intéressent et tentent de mieux comprendre les facteurs, processus et conditions qui favorisent son implantation. Bien qu’un corpus de connaissances se soit bien développé au cours de la dernière décennie, plusieurs dimensions de ce phénomène restent peu explorées, et c’est précisément le cas de la mesure de dispersion des équipes. La littérature suggère en effet un manque de rigueur et d’homogénéité à ce niveau. L'objectif global de cette étude consiste justement à analyser un certain nombre de propositions de mesure de dispersion appliquées à des équipes de projet réelles. Après avoir examiné les principales définitions de la dispersion des équipes dans la littérature, certaines mesures sont sélectionnées. Le potentiel de ces mesures est ensuite analysé à partir d’une base de données contenant plusieurs informations fournies par des professionnels de la gestion de projet. La comparaison de ces mesures s’appuie sur un modèle théorique mettant en relation la dispersion, l’efficacité des équipes de projets, et certains facteurs contextuels dont l’impact sur le fonctionnement des équipes est établi dans la littérature. Au terme de l’analyse, il est possible d’identifier une mesure simple et deux mesures combinées présentant un plus grand potentiel d’applicabilité que les sept mesures simples et 56 mesures combinées considérées initialement. Parmi toutes les mesures de dispersion simple, les résultats des analyses effectuées rapportent que l'indice appelé Member Index est la meilleure solution pour cerner la dispersion. Parmi les mesures combinées, les résultats des analyses révèlent que les deux meilleurs types de mesures de dispersion sont 1) celle qui combine la distance, le temps, et l’indice de voyage, et 2) celle qui combine la distance, le nombre de sites et l’indice de voyage.Outre la contribution sur la plan méthodologique (analyse des mesures de dispersion), cette recherche fournit également des résultats intéressants tant sur le plan théorique que pratique. Plusieurs implications managériales sont identifiées notamment en ce qui concerne l’effet de l’expérience du chef de projet et la fréquence de réunions entre les membres des équipes dispersées. Au plan théorique, cette étude contribue à l’avancement de l’état actuel des connaissances portant sur le thème de la dispersion dont le degré est rarement étudié dans des projets concrets. En effet, bien que certains auteurs aient proposé diverses structures pour cerner cette dimension, les mesures théoriques sont rarement étudiées dans des projets concrets. Afin de pallier cette limite, cette étude explore les mesures proposées, sur la base d'un échantillon de 149 projets réels de la diversité considérable en termes de distance géographique, les fuseaux horaires et les caractéristiques organisationnelles.----------ABSTRACT : The current context of globalization and the fast development of communication technologies encourages organizations to use virtual project teams. As this organizational form is becoming more demanded, many researchers are interested in and try to better understand the factors, processes and conditions that favor its implementation. Although a body of knowledge is well developed over the last decade, several aspects of this phenomenon remain poorly explored, and this is precisely what the measurement of dispersed teams experienced. Indeed, the literature suggests a lack of rigor and consistency at this level. The overall objective of this study is precisely to analyze a number of proposals for measuring dispersion applied to real project teams. After reviewing the main definitions of virtual teams in the literature, some measures are selected. The potential of these dispersion measures is then analyzed from a database containing information provided by several project management professionals. The comparison of these measures is based on a theoretical model linking the virtual teamwork effectiveness of project teams, and certain characteristics of the organization whose impact on the functioning of the teams were established in the literature. After the analysis, a simple measure and two combined measures were identified with greater potential applicability of the seven (7) simple measures and fifty six (56) combined measures initially considered. Among all the simple dispersion measures, member index is the best fit to capture dispersion. Among combined measures, the combined measures of spatial, temporal, and travel indices and spatial, number of sites and travel indices are proved to be the best. Besides the methodological contribution (analysis of measures of dispersion), this research also provides interesting results both in theory and practice. Several managerial implications are identified in particular as regards the effect of the experience of the project manager and the frequency of meetings between members of virtual teams. The current study provides several theoretical contributions to virtual dispersion research community. First of all, the degree of dispersion is rarely studied in real-life projects. Many authors have provided different structures to capture this dimension. However, theoretical measures are rarely studied in ongoing real projects. The present study looks at the proposed measures using a sample of 149 real projects of considerable diversity in terms of geographic distance, time zones and organizational characteristics. The results are of practical use to both researchers and managers of virtual teams. The concept of creating combined measures to capture the multi-dimensional nature of dispersion is another contribution of this thesis. The combined measures capture the various aspects of dispersion simultaneously. Among the managerial implications of the thesis, the importance of project manager experience and managerial skills is revealed. The technological support is also a essential factor to consider for project managers

Evaluating Neonatal Resuscitation Skills of Nursing and Midwifery Students Using Objective Structured Clinical Examination (OSCE)

Background & aim: Neonatal resuscitation training is mandatory for the staff providing maternity and neonatal services in order to ensure competence during the academic period. This study was conducted to assess the neonatal resuscitation skills of nursing and midwifery students. Methods:In this study, the skills of 48 nursing and midwifery students  were assessed, using Objective Structured Clinical Examination (OSCE), which consists of seven “stations”, lasting 28 minutes. In station 1, students’ knowledge was assessed. In stations 2-7, students’ skills in the initial steps of resuscitation, positive pressure ventilation, intubation, chest compression, medication prescription and management of cardiopulmonary resuscitation were assessed. Time management and students’ re-evaluation of the infant were also assessed. The total score of OSCE was calculated to be 236. Also, students’ self-evaluation regarding their competence in neonatal resuscitation and their satisfaction with OSCE were evaluated, using two self-structured questionnaires. Results: The mean score of students’ skills in neonatal resuscitation was 97.85±23.15 out of 236. On average, students obtained 38%, 49%, 20% and 72% of the total score in the initial steps of resuscitation, positive pressure ventilation, intubation and chest compression, respectively. Also, the students obtained 45%, 29% and 56% of the total score in prescribing medications (drug dosage and route of administration), management skills in advanced resuscitation and knowledge on neonatal resuscitation, respectively. Students’ self-confidence was lower than half of the optimal score, and their satisfaction with OSCE was high. Conclusion: The students’ skills in neonatal resuscitation were lower than expected. As competence in this area is of high significance for the improvement of neonatal outcomes, holding training workshops through applying novel training methods is recommended

The Impact of a High-risk Sexual Behavior Prevention Program via Mobile Application on Sexual Knowledge and Attitude of Female Students

Background & aim: The prevalence of high-risk sexual behaviors among different social groups has been considered as a serious health-related threat in recent years. Given the importance of raising awareness and health among the youth and preventing high-risk behaviors, the present study was conducted to investigate the effect of a high-risk sexual behavior prevention program via mobile application on sexual knowledge and attitude in undergraduate female students. Methods: This quasi-experimental study was conducted among two groups of female students with a pretest-posttest design. A total number of 200 undergraduate eligible female students of Mashhad University of Medical Sciences, Mashhad, Iran were recruited in 2016. The subjects were randomly assigned to an intervention group receiving education through a mobile application (N=100) and a control group (N=100). To collect data a self-structured demographic questionnaire as well as sexual knowledge and attitude questionnaires were used. In the intervention group, the participants received a prevention program through a mobile application. Knowledge and attitude towards high-risk sexual behaviors were assessed and compared before and two weeks after the intervention. To analyze the data, paired t-test, independent t-test, Mann-Whitney U test, Wilcoxon signed-rank test, and Chi-square test were run in SPSS, version 16. Results: The mean scores of sexual knowledge and attitude after education increased compared to the pre-intervention stage (p0.05). Conclusion: The study results reflected the favorable effect of education via mobile application. The implementation of high-risk sexual behavior prevention programs using mobile applications could enhance sexual knowledge and attitude in students and promote community healt

The Effect of Teaching by Role Playing on Students\' Counseling and Screening Skills toward IUD Clients

Introduction: One of the most important barriers for using IUD (Intra Uterine Device) is inadequate provision of appropriate counseling. Since, employing new training methods is necessary for enhancing midwives` roles in providing appropriate counseling, this study was performed to compare the effect of two methods of traditional training and role playing on students’ skills in counseling. Methods: In this experimental study, 62 midwifery students were randomly allocated in role playing and traditional training groups to participate in a 4 hour workshop about counseling skills for IUD clients. Before and after the workshop students' skills in counseling were assessed. The data gathering tools included a self evaluation form and evaluation checklists for assessing students’ performance in counseling before and after IUD insertion. Comparisons were made using Chi square, Fisher exact text, t-student, Man-Whitney, paired t-test, and Wilcoxon by SPSS software. Results: The mean of students' score in counseling before and after IUD insertion was not different between the two groups in pretest, but the post-tests of the 2 groups in both skills were significantly different. There was a significant difference between pretest and posttest scores in both groups regarding the two skills. Conclusion: Teaching by role playing leads to a better learning of counseling skills. Employing this educational method is recommended for training counseling skills to students

Comparison of Structured Clinical Instruction Module and Video-Assisted Instructor -Led Training in Accelerating and Retention of Nursing and Midwifery Students’ Skill in Neonatal Resuscitation

Background & aim: Some studies have called into question medical students' competency in neonatal resuscitation. Therefore applying standard training methods has been recommended. This study compared the effect of Structured Clinical Instruction Module (SCIM) and video-assisted Instructor -led training (ILT) in accelerating and retention of students’ knowledge and skill in neonatal resuscitation.Methods: In this experimental study 48 nursing and midwifery students of Mashhad University of Medical Sciences, Mashhad Iran, who did not attended in any related education, were allocated in SCIM, VT and control group through stratified randomization. In SCIM group, after lecture, six groups of students rotated through six stations, trained and practiced under supervision of six instructors.  In VT group after lecture an instructional video presented then students repeated the video and discussed its content with each other and instructor. Before, after and one month following workshops all students participated in an OSCE to assess their cognitive, technical and behavioral skills. Paired t-test and One-way ANOVA were used for data analysis.Results: In post-test, both groups of SCIM and VT had better performance than control group (p<.001, p<.001, respectively). But SCIM group demonstrated a marked improvement compared with VT group (202.97±16.6 vs 173.6±15.3 (P<0.001). There was a significant difference between students’ comfort and confidence in both SCIM and VT groups (P<0/001). In retention test total score between three groups showed significant difference (P<0.001); whilst the SCIM group had significantly better performance (P<0.001).Conclusion: SCIM is an effective method in acquisition and retention of neonatal resuscitation skill. So its application is recommended in the neonatal resuscitation training