Masumeh Saeidi Medical Education Bulletin 2783-1809 6 2 2025 12 01 Challenges and Obstacles of Clinical Medical Education in Iran: A Literature Review 1115 1126 228215 10.22034/meb.2025.544604.1122 EN Abbas Bahreini MD, Shiraz University of Medical Sciences, Shiraz, Iran. Somayeh Javan School of Paramedical Sciences, North Khorasan University of Medical Sciences, Bojnurd, Iran. 0000-0001-7155-7859 Fatemeh Araghi School of Paramedical Sciences, North Khorasan University of Medical Sciences, Bojnurd, Iran. 0009-0002-3202-7526 Khatereh Shariati Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-0243-844X Masumeh Ghazanfarpour Associate Professor of Reproductive Health, Kerman University of Medical Sciences, Kerman, Iran. 0000-0003-4639-3711 Journal Article 2025 09 01 Background: Clinical education is vital for training competent healthcare professionals. In Iran, numerous obstacles hinder quality training and practical skill development. This study aims to identify key challenges in clinical medical education and proposes practical, evidence-based strategies to improve its effectiveness and overall quality. Materials and Methods: This narrative review involved a comprehensive literature search conducted independently by two reviewers using both Persian and English keywords, including "challenges of clinical education," "medical education," and "quality of clinical education." The search covered reputable databases up to April 2025, including Scopus, PubMed, Web of Science, SID, CIVILICA, and Google Scholar. Relevant data were systematically extracted, analyzed, and categorized into key themes encompassing challenges, impacts, and solutions in clinical medical education. Results: Clinical medical education in Iran faces multiple interconnected challenges that undermine its overall quality. These challenges include overcrowded and inadequately equipped clinical environments, curricula that lack alignment with practical clinical needs, and weakened faculty-student relationships that negatively affect motivation and engagement. Insufficient educational infrastructure further impedes effective training in evidence-based medicine. Additionally, assessment methods predominantly emphasize rote memorization rather than promoting critical thinking and practical skills. The COVID-19 pandemic has also further limited clinical access. Addressing these issues calls for comprehensive reforms focused on improving infrastructure, modernizing curricula through competency-based training, enhancing faculty development with an emphasis on mentorship and psychological support, implementing structured communication tools, and strengthening academic-clinical collaborations. Conclusion: Clinical medical education in Iran faces challenges such as inadequate infrastructure, misaligned curricula, weak faculty-student communication, and outdated assessment methods. Improving infrastructure, emphasizing practical skills, enhancing support systems, and adopting competency-based assessments are essential to elevate education quality, prepare competent healthcare professionals, and promote community health.

https://www.medicaleducation-bulletin.ir/article_228215_1fd077e371350c84e7ad6dbcef654100.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 6 2 2025 12 01 The Hot Seat Method in Medical Education: A Comprehensive Narrative Review of Its Applications, Benefits, Challenges, and Enhancement Strategies 1127 1137 228923 10.22034/meb.2025.546214.1123 EN Hoda Ahmari-Tehran Associate Professor in Medical Education, Spiritual Health Research Center, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran. 0000-0001-7389-6547 Ahmad Parizad Assistant Professor, PhD in Medical Education, School of Nursing, Qom University of Medical Sciences, Qom, Iran. 0000-0002-8925-3033 Masumeh Saeidi Department of Medical Education, Faculty on Medicine, Tehran University of Medical Sciences, Tehran, Iran. 0000-0001-5601-9876 Journal Article 2025 09 09 Background: Medical education requires innovative approaches to enhance critical thinking, decision-making, and ethical reasoning. The "hot seat" method simulates real-time clinical and ethical scenarios, promoting rapid analysis. This study aims to review its applications, benefits, limitations, and challenges to improve educational quality and clinical skill development. Materials and Methods: This narrative review conducted a comprehensive literature search using English and Persian terms such as hot seat, medical education, critical thinking, clinical decision-making, ethical reasoning, simulation-based learning, interactive teaching, problem-solving, and student engagement. Searches across Scopus, ERIC, Web of Science, PubMed, SID, CIVILICA, and Google Scholar up to April 2025 were screened by two independent reviewers. Extracted data were qualitatively analyzed to identify key themes. Results: The evidence review shows that the "hot seat" method has significant potential to enhance medical students’ critical thinking, clinical decision-making, and ethical reasoning. Its advantages include increased confidence in decision-making, enhanced active participation, improved communication skills, and bridging theory with clinical practice. However, challenges such as anxiety induction, unequal student participation, high resource requirements, and possible negative experiences exist. Implementation obstacles include insufficient faculty training, institutional limitations, and variability in facilitation quality. This method is applied across pathology, dental, allied health, and general medical education. To optimize its use, gradual introduction, creation of safe learning environments, encouragement of peer support, integration of technology, continuous feedback collection, and comprehensive facilitator training are recommended. Conclusion: The "hot seat" method enhances critical thinking, decision-making, and ethical reasoning by engaging students in realistic scenarios. It promotes active learning and bridges theory with practice but faces challenges such as student anxiety, resource demands, and faculty training. Gradual implementation and supportive strategies can optimize its effectiveness.

https://www.medicaleducation-bulletin.ir/article_228923_4d7af326277bdf0d4b3394b18bfc2191.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 6 2 2025 12 01 Analysis of the Optometry Curriculum in Iran Compared to International Standards 1139 1141 229849 10.22034/meb.2025.548331.1124 EN Razieh Bahreini PhD in Vision Science, College of Optometry, Pacific University, Forest Grove, Oregon, USA. 0000-0002-0929-2623 Journal Article 2025 09 20 Dear Editor-in-Chief, Optometry education is a fundamental pillar of the eye health care system, playing an essential role in elevating service quality and improving public health outcomes. Although Iran’s optometry curriculum has made significant scientific and professional strides, targeted reforms are crucial to achieve full alignment with international standards. This article critically evaluates Iran’s optometry curriculum through the framework of global competency models, highlighting its strengths and pinpointing areas in need of enhancement. Current evidence shows that the curriculum offers a well-structured program, encompassing comprehensive basic and specialized courses that equip students with foundational knowledge. Nevertheless, urgent efforts are required to expand clinical training opportunities, enhance multicultural education, and integrate cutting-edge educational technologies. In addition, advancing competency-based assessment frameworks, increasing curriculum flexibility, and strengthening international collaborations are vital strategies to further elevate educational quality.

https://www.medicaleducation-bulletin.ir/article_229849_a3ea1c5ef44cdc12ec8f69f11f43f660.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 6 2 2025 12 01 Effectiveness of Narrative-Based Medical Ethics Education for Nursing Students in Iran: A Systematic Review 1143 1150 230006 10.22034/meb.2025.548532.1125 EN Maryam Tajadini 1Instructor of Nursing, Department of Anesthesiology, School of Allied Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; AND Student Research Committee, School of Health and Religion, Qom University of Medical Sciences, Qom, Iran. Tayebe Ilaghi Nezhad Instructor of Neonatal Intensive Care Nursing, Department of Nursing, School of Medical Sciences, Sirjan University of Medical Sciences, Sirjan, Iran; AND Student Research Committee, School of Health and Religion, Qom University of Medical Sciences, Qom, Iran. Elham Alimadadi Student Research Committee, Department of Health Philosophy and Ethics, School of Health and Religion, Qom University of Medical Sciences, Qom, Iran. Zhale Sadeghian Student Research Committee, Department of Health Philosophy and Ethics, School of Health and Religion, Qom University of Medical Sciences, Qom, Iran. Mahdieh Parhoon BSN, Bushehr Heart Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran. Hoda Ahmari Tehran Associate Professor of Medical Education School of Medicine Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran. 0000-0001-7389-6547 Journal Article 2025 09 21 Background: Nurses, both students and professionals, need strong ethical competence for patient care. Traditional ethics education lacks practical application, prompting interest in narrative ethics education using storytelling. This study systematically reviews research on narrative ethics education for nursing students and nurses in Iran to assess its effectiveness and challenges. Materials and Methods: A systematic review was conducted by searching Persian and English literature up to April 2025 in databases including Web of Science, PubMed, Scopus, Cochrane Library, CINAHL, EMBASE, SID, and CIVILICA. Search terms included “medical ethics,” “narrative,” “education,” “medical sciences,” “medicine,” “nursing,” and “Iran.” Two independent researchers screened studies. Quality was assessed with the modified JADAD scale and JBI Critical Appraisal Tool. Results: This systematic review of five studies involving 319 nursing from various Iranian cities (Yazd, Tehran, Birjand) demonstrated that narrative ethics education significantly improves ethical intelligence, sensitivity, empathy, and respect for patient privacy. The positive effects were sustained for up to two months post-intervention. Both virtual and face-to-face delivery methods were effective in enhancing students’ professional behavior, communication skills, and overall ethical competence. While some studies reported no significant differences compared to traditional lecture-based methods, narrative education consistently showed greater improvements in ethical sensitivity. By engaging students with patient stories and moral dilemmas, this educational approach fosters deeper moral insight and reflective thinking, making it a flexible and practical strategy for nursing ethics education. Conclusion: Narrative ethics education effectively boosts nursing students' ethical awareness, empathy, and professional behavior. Its flexible delivery, both virtual and in-person, prepares students to face clinical ethical challenges. Combining narrative and lecture methods enhances nurses' patient advocacy, making it a comprehensive strategy in nursing education.

https://www.medicaleducation-bulletin.ir/article_230006_465a5b31c10e496a32e8ad3c3315cad4.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 6 2 2025 12 01 A Review of Student Feedback Literacy in Higher Education: Theoretical Foundations, Challenges, and the Role of Training and Technology in Improving Learning Quality 1151 1162 232674 10.22034/meb.2025.554750.1126 EN Rahim Vakili Professor, Pediatric Endocrinologist, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0001-5601-9876 Maryam Ajilian Abbasi MSc of Clinical Psychology, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0003-4921-976X Khatereh Shariati Department of Medical Education, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-0243-844X Mansoure Alipour-Anbarani PhD in Health Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran. 0000-0002-9563-7383 Journal Article 2025 10 21 Background: Feedback is essential for advancing learning, educational quality, and student achievement. As higher education continues to expand, students’ ability to interpret and apply feedback—referred to as Student Feedback Literacy (SFL)—has become increasingly critical. This study reviews and synthesizes national and international research on SFL, examining its theoretical foundations, key challenges, and implications for enhancing learning quality through training and technology. Materials and Methods: This narrative review synthesizes studies on student feedback literacy in higher education. Relevant literature published up to April 2025 was searched in Web of Science, ERIC, PubMed, Scopus, and Google Scholar, covering both English and Persian sources. Data collection and screening were independently performed by two researchers in two stages. Empirical studies with full-text availability were selected for qualitative synthesis and thematic analysis. Results: Findings demonstrate that student feedback literacy (SFL) integrates interrelated knowledge, skills, and attitudes that empower learners to interpret, evaluate, and apply feedback effectively for continuous improvement. Four core dimensions—valuing feedback, critical judgment, emotional regulation, and purposeful action—collectively foster learner autonomy and engagement. Consistent, dialogic, and formative feedback enhances self-regulation, motivation, and academic achievement. Yet, inadequate training, inconsistent quality, and cultural or institutional constraints limit full development. Strengthening teachers’ feedback literacy, employing digital tools that support interactive and traceable feedback, and implementing structured peer-feedback systems are critical strategies for advancing sustainable feedback cultures in higher education. Conclusion: Feedback literacy enhances students’ ability to interpret and utilize feedback, leading to improved learning outcomes. Integrating targeted training programs, institutional support, and digital technologies—alongside teacher and peer contributions—can cultivate a robust feedback culture that supports continuous learning improvement across higher education contexts.

https://www.medicaleducation-bulletin.ir/article_232674_b8f3c88317e68ce15f52e59d1f6e891c.pdf

Masumeh Saeidi Medical Education Bulletin 2783-1809 6 2 2025 12 01 Managing Unexpected Classroom Challenges: The Role of Teacher-Student Interaction in Promoting Engagement and Learning 1163 1175 235703 10.22034/meb.2025.564852.1127 EN Amin Hoseini Shavoun PhD in Medical Education, Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 0000-0001-6168-781X Ahmad Parizad Assistant Professor, PhD in Medical Education, School of Nursing, Qom University of Medical Sciences, Qom, Iran. 0000-0002-8925-3033 Hoda Ahmari-Tehran Associate Professor in Medical Education, Spiritual Health Research Center, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran. 0000-0001-7389-6547 Journal Article 2025 12 07 Background: Managing unexpected classroom situations—sudden questions, sensitive discussions, behavioral disruptions—is a fundamental challenge in modern education, transforming controlled classrooms into dynamic, unpredictable spaces. This review examines management strategies, emphasizing effective teacher-student interaction's key role in enhancing learning processes. Materials and Methods: This narrative review systematically searched Persian and English literature up to March 2025. Keywords focused on unexpected classroom situations, classroom management, teacher skills, teacher-student interaction, and active learning. The databases searched included SID, Magiran, CIVILICA, PubMed, ERIC, Scopus, and Web of Science. Screening involved two phases—title/abstract and full-text—conducted independently by two researchers. Study quality was assessed using the STROBE checklist. Results: This review demonstrated that managing unexpected classroom situations is essential, as teachers' rapid, flexible responses preserve student focus and motivation. Challenges—disruptive behaviors, diverse needs, sudden questions, sensitive topics—are effectively managed through enhanced emotional intelligence, strengthening communication, alleviating stress, and fostering psychological safety. Key strategies include active interaction, clear behavioral rules, interactive teaching methods, positive reinforcement, and time management. Paired with cognitive flexibility and specialized training, these prepare teachers for complex conditions, boosting intrinsic motivation, active participation, and effective learning environments. Emotional skills training and organizational support further enhance classroom management. Conclusion: Managing unexpected classroom situations like sudden questions or disruptions is vital for maintaining focus and learning quality. Quick, flexible teacher responses transform challenges into opportunities, boosting motivation. Active interaction, clear rules, interactive teaching, positive feedback, and time management enhance classroom environments. Emotional intelligence facilitates emotion control and better stress decisions. Training with psychological/organizational support creates safe, effective learning spaces.

https://www.medicaleducation-bulletin.ir/article_235703_e7e5daea2d515edafa24655563595fad.pdf