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J Educ Health Promot. 2019 Jul 29;8:131. doi: 10.4103/jehp.jehp_22_18. eCollection 2019.

Designing a blended training program and its effects on clinical practice and clinical reasoning in midwifery students.

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Medical Education Development Center, Jahrom University of Medical Sciences, Jahrom, Iran.
Medical Education Development Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Obstetrics and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran.



Proper empowerment of medical students in encounter with the complexities of the clinical environment is one of the requirements for health services. In this regard, the development of problem-solving skills, critical thinking is essential for medical education. The purpose of this study was to investigate the effect of designing a blended training program on the practice and clinical reasoning of midwifery students.


In a quasi-experimental study with control group, 41 undergraduate midwifery students were randomly assigned to two intervention and control groups by four blocking. In the first group, the 15-h workshop was held in the traditional teaching method and in the second group in the blended method, about three emergency aspects of midwifery. Data were collected and analyzed through objective structured clinical examination and clinical assessment evaluation before and after the educational intervention.


The mean and standard deviation of the age of participants were 23.54 ± 2.19 years. The mean score of clinical practice before the beginning of the study in the integrated training group was 16.68 ± 5.49 and at the end of the study was increased to 35.75 ± 4.54, which was significant between the two groups (P = 0.035). The clinical reasoning score was changed at the beginning of the study in the blended training group of 6.77 ± 3.57 and at the end of the intervention was 11.58 ± 2.83. There was no significant difference between the two groups (P = 0.81).


The results showed that the use of blended methods in comparison with conventional education can improve clinical practice, but the improvement of students' ability in clinical reasoning requires more effort.


Blended education; clinical practice; clinical reasoning; traditional education

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