Development Strategies in Medical Education

Introduction
The goal of educational activities is to develop knowledge and potential human ability [2]. The use of appropriate educational models is one of the most important factors determining the success of the curriculum and responsive teaching. One of these models is the ASSURE model which was developed by Heinich, Molenda, Russell and Smaldino in 1999 [3] to enhance the learning environment from a constructivist perspective by integrating multimedia and technology. Providing learning opportunities is the main goal of curricula in the educational process so that students can get maximum benefit from participating in selected learning activities with maximum satisfaction [6, 7]. Using teaching methods with the active participation of students is one of the effective methods of creating motivation and increasing the level of learning [9]. Empowering medical students in the field of education and teaching and improving their skills in classrooms should be considered by professors. The present study aims to design, implement, and evaluate an empowering program for public health students based on the ASSURE model.

Methods
This is a descriptive study that was conducted based on the ASSURE model. All continuous and non-continuous undergraduate students (males and females) in public health from the Faculty of Health, Arak University of Medical Sciences in 2021 were selected for this study using a census method (n=62). The students who received the health education and communication course were included. The return of an incomplete questionnaire was the exclusion criterion. The study objectives and methods were explained to the students and their informed consent was obtained. The following steps were taken based on the ASSURE model:
1. Analyzing the learners;
2. Stating educational objectives 
3. Selecting methods, media, and materials
4. Utilizing technology, media, and materials
5. Requiring learners’ participation
6. Evaluating and revising
A researcher-made questionnaire was used for the evaluation of students’ satisfaction and attitudes. Based on the scores, their status was ranked into three levels: favorable, moderate, and poor. Data were analyzed in SPSS software, version 16 using descriptive statistics, including mean, standard deviation, frequency, and percentage.

Results
In the present study, 91% (n=53) of students were female and 9% were male. Students were able to teach 10 out of 17 classroom sessions. Production of 10 educational content titles in the field of health education was done by students. Moreover, 95% and 92% of the students answered “very high” and “high” for satisfaction with the program. The rate of interest in participating in classroom teaching was reported as 80%. Half of the students (50%) had evaluated the importance of health education for their future career as high, and only 4% reported it as very low. In terms of creating deep and lasting learning in students, 65% of students reported that the program based on the ASSURE model had a great impact on the learning.
Regarding students’ participation in teaching, their activities were: discussion in small groups and presenting reports (n=15), teaching the course materials (n=10), rethinking and sharing experiences (n=8), participating in the discussion room of university educational systems (Navid and SamaLive systems) (n=3), more than 500 questions and answers between the professors and students, and drawing a conceptual map of the course material with related images.

Conclusion
In the present study, after presenting the ASSURE model-based empowering program, the students were able to teach part of the course materials under the supervision of the professors, and a number of educational contents on the subject of health education were produced by the students. Their satisfaction level was reported as very high (95%) and high (92%). The interest rate of students to participate in teaching was reported as 80%. Moreover, 65% of the students reported that the program had a great impact on the depth of learning. A similar study reported that the educational program based on the ASSURE model had a significant effect on the components of perceived motivational climate (pursuit of progress by learners, promotion of learning by teachers, pursuit of comparisons by learners, worries about mistakes, and promotion of comparisons by teachers) and components of psychological well-being [18].
The creation of a motivating learning environment by the teacher can influence the internal motivation of students and bring positive results. In addition, getting familiar with the types of educational models and using them in teaching can turn professors into effective elements in the educational system. It is recommended that empowerment programs for faculty members in the field of teaching-learning methods and effective communication with students in the classroom be organized by the educational development centers of universities. The ASSURE model-based empowering program, which emphasizes the participation of students, can be used as an effective method to improve the teaching and learning process and strengthen self-directed learning. It is recommended to use this method in other courses and universities of Iran.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the National Agency for Strategic Research in Medical Education (NASR) of the Iranian Ministry of Health and Medicine (Code: IR.NASRME.REC.1400.185).

Funding
The present study was funded by the National Agency for Strategic Research in Medical Education (NASR) of the Iranian Ministry of Health.

Authors' contributions
Data collection and data interpretation: Raheleh Soltani; Review and data analysis: Mohsen Shamsi.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank all the students who participated in this study.

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