Background Flipped learning excessively boosts the conceptual understanding of students through the reversed arrangement of pre-learning and in classroom learning events and challenges students to independently achieve learning objectives. Using a gamification method in flipped classrooms can help students stay motivated and achieve their goals.  Methods This study adopted a randomized controlled study design with a pre-test and post-test and involved 128 nursing students at Mansoura University. This study randomly divided the students into the study and control groups. Data were collected at three time points using six tools. In the intervention group, Moodle was gamified for 6 weeks.  Results A significant difference in the students’ self-confidence (p = 0.021), skills knowledge (p < 0.001), intensity of preparation (p < 0.001), and motivation (p < 0.001) was observed between the two groups; however, no difference in the students’ skills performance (p = 0.163) was observed between the two groups after using gamified flipped classrooms. Conclusions Compared with the traditional flipped classrooms, gamified flipped classrooms improved nursing students’ motivation, intensity of preparation, skills knowledge, and self-confidence during laboratory clinical practice. Thus, gamification is a learning approach that can be implemented in conjunction with the flipped classroom model to motivate students to participate in the learning process. Trial registration. Prospectively registered with ClinicalTrials.gov on 26/04/2021; registration number NCT04859192.

Atrial fibrillation (AF) is the most prevalent clinical arrhythmia found in clinical practice. Patients with AF have greater activity impairment which affects daily life, leading to a more sedentary lifestyle. Exercise training have various benefits for AF patients including improvements in frequency control, functional capability, activities of daily living and a lower resting pulse rate. Pedometers have recently gained recognition as a useful intervention in the promotion of physical activity (PA). Therefore, the aim of the study was to examine the effect of pedometer based aerobic walking program on steps count and resting heart rate among Patients with AF. Methods Quasi-experimental research design was carried out in outpatient cardiovascular clinic of the Specialized-Medical Hospital, at Mansoura University. Purposive sample of this study composed of 60 adult patients of both sexes who met inclusion criteria and divided alternatively into two equal groups study and experimental. Results the result shows significant improvement in step count by 2814 step \ day and drop in resting heart rate by 4 beat / minute in study group after program. Conclusion positive effect of pedometer based aerobic walking program on exercise parameters of AF patients.

Atrial fibrillation is a major risk factor of stroke. Stroke prevention in atrial fibrillation (AF), most commonly with warfarin, requires maintenance of a narrow therapeutic target (INR 2.0 to 3.0). To ensure safe and effective use, it is vital that patients have a sound understanding of warfarin. Therefore, the aim of the study was to determine AF patient's knowledge about using warfarin. Methods descriptive correlational cross sectional research design was conducted in the cardiovascular outpatient clinics of Specialized Medical Hospital at Mansoura University. Sociodemographic data sheet & Warfarin knowledge questionnaire was designed after an extensive literature review. It contains 24 questions related to warfarin use and international normalized ratio (INR) test. Convenient sample of this study composed of 104 adult patients of both sexes who met inclusion criteria and faceto-face interviews using standard questionnaires were administered to determine the demographic characteristics, medical history and the patient's knowledge of warfarin therapy. Results the result revealed that Patients' warfarin knowledge was poor, with an overall score of 9.9±6.32 (range 0-24). Knowledge deficits were greater in female subjects, older subjects, subjects with less formal education, subjects live in rural, subjects don't work and subjects with long duration of warfarin use. Conclusion There is an increasing need to introduce effective education programs to current patients in order to enhance and update their knowledge with regard to warfarin therapy and INR test.

Background: Higher education has faced numerous challenges due to the COVID 19 outbreak, and written exams conduction with strict precautionary measures is one of them. Study aims were to evaluate adherence to preventive measures and factors affecting suspected COVID-19 symptoms development during exams. Subjects and method: a repeated cross sectional study was conducted at Mansoura University Nursing Faculty. The participants were nursing students at the fourth level and the calculated sample size was 215. Students were videotaped to assess their adherence during the exam hours using observation checklist and suspected COVID 19 symptoms were measured using the baseline questionnaire and were measured for 6 weeks every two weeks. Results: One or more suspected symptoms of COVID 19 had formed among 60.4% of students who were significantly higher at the first two weeks of exams. The mean hourly contact of the T zone was (13±11.3) and only (42.4%) of students wear the mask all exam time. Conclusion: Higher T zone touch, less adherence to mask wearing all exam time and less reported adherence directly predicting suspected COVID 19 symptoms occurrence. Recommendations: Raising students' awareness and finding new strategies to improve students' adherence to preventive measures during written exams is of great value during this epidemic.

Background Hypertension diagnosis, treatment, and follow-up depend on accurate blood pressure measurement; however, inaccurate measurement techniques are common among healthcare providers. To improve professional performance, continuous education is necessary. Distance education through virtual social network can be used as it is easy to use and accessible. Methods This study adopted a randomized controlled trial design and was conducted at two hospitals in Mansoura, Egypt. The subjects were selected from two hospitals using Stratified random sampling method in proportion to the total number of nurses. Seventy nurses were included in this study and were randomly divided into the intervention (n = 35) and control (n = 35) groups using block randomization. Data were gathered before and after intervention using a blood pressure measurement knowledge questionnaire and a blood pressure measurement observation checklist. The blood pressure measurement error (the difference between the BP determined by each observer and the reference BP) was calculated for the randomly selected recordings in both groups. The intervention group received 24 blood pressure measurement education sessions using WhatsApp, while the control group received only routine education using traditional lecture. Results No statistically significant differences in pretest knowledge scores, performance scores, and range of error were found between both groups, whereas, after intervention, knowledge scores were higher in the intervention group than those in the control group (p < 0.001). The range of error of systolic and diastolic blood pressure values significantly reduced after the intervention in the intervention group, and the posttest performance scores were higher than the pretest performance scores; however, the difference was not statistically significant. Conclusions The blood pressure measurement education program via WhatsApp was effective in increasing nurses’ knowledge and reducing the range of error; however, a multimodal approach may be required to improve performance scores. Trial registration Prospectively registered with ClinicalTrials.gov on 09/03/2021; registration number NCT04789642.