Today, arterial blood gas (ABG) testing is widely used in various hospital departments to support diagnosing diseases and predicting patient conditions. However, interpreting the numerical results of this test, its complex concepts continue to pose challenges for nurses and physicians. Therefore, the use of innovative educational approaches can simplify the learning of ABG interpretation. Two educational approaches that have recently received attention are the Flipped classroom and Microlearning. To evaluate and compare these approaches, we will develop a comprehensive evaluation protocol based on Kirkpatrick’s model.

This study is a quasi-experimental design that will involve 188 undergraduate nurse anaesthesia students at Tehran University of Medical Sciences, randomly allocated to a flipped classroom or microlearning groups (94 per group). The intervention will consist of one session for all registered students and three sessions for each group with their own educational approach. Two sets of educational content, according to each approach method, will be developed based on a needs assessment and will be shared via secure social media. The flipped classroom group will receive pre-session materials, followed by in-person classes. The microlearning group will engage in in-person sessions supported by micro videos, podcasts and micro games delivered via Telegram. Effectiveness will be evaluated by using Kirkpatrick’s four-level model. 1 week after the intervention concludes, participants will be invited to a meeting to complete the Training Satisfaction Rating scale (Level 1, Reaction). We will use a pre-test and a post-test for evaluating Level 2 (Learning). Level 3 (Behaviour) will be evaluated through observations of ABG interpretation at internship sites. Level 4 (Results) will be evaluated via semi-structured interviews with specialists and colleagues. Data will be analysed blind; normality will be assessed (Kolmogorov-Smirnov test), and appropriate statistical tests (t-tests, ANCOVA, ² or Fisher’s exact) will be applied.

This study received permission and ethical approval from Tehran University of Medical Sciences (IR.TUMS.SPH.REC.1404.08). Since the study is not clinical, obtaining a trial registration number is not required under Iranian research policy, and an ethical approval alone is sufficient. Informed consent will be obtained before participants are enrolled. The study’s results will ultimately be submitted as a research paper to a peer-reviewed journal.

Major depressive disorder (MDD) is a disabling disease and is recognised as a serious, public health concern. In this study, we aimed to determine the burden and trends of MDD in Iran.

Secondary data from the Global Burden of Disease study were used to analyse the time trend and geographical distribution of age-standardised rate incidence and disability-adjusted life years (DALYs) of MDD from 1990 to 2021 by sex and province, in Iran. Join point regression and ArcGIS software were used for these estimations.

Incidence and DALYs.

The trend analysis from 1990 to 2021 generally showed an increasing trend of incidence and DALYs. The highest annual percent change (APC) for incidence (6.594 95% UI: 3.727, 9.473) and DALYs (6.396 95% UI: 3.552, 9.286) of MDD in Iran was observed from 2019 to 2021 segment. Also, the geographical distribution analysis showed that the highest average annual percent change (AAPC) for incidence and DALYs of MDD in both sexes was, respectively, in Kurdistan province (0.774; [95% UI: 0.619, 0.976] and Yazd province (0.760; [95% UI: 0.601, 0.918]). Finally, the highest incidence and DALYs for MDD in 2021 were in Kerman and Fars provinces and the lowest in East Azarbayejan, Lorestan, Hamedan, Chahar Mahal and Bakhtiari, Golestan and Khorasan-e-Razavi provinces.

The findings of this study indicate an increasing trend in the burden of MDD in Iran and show the necessity of creating national policies and preventive and therapeutic measures for mental health disorders in the population.