Introduction: the increasing growth of science and as a result the necessity of using new educational methods, tools and systems, beside critical situation of the corona epidemic and the closure of universities, despite the inevitability of the use of e-learning methods, it raises many concerns, such as the decline in the quality of education and the effectiveness of such training methods, as a major challenge for students. The purpose of this study was to determine the effect of virtual clinical education on the academic achievement of Shiraz medical assistants during the Corona pandemic period. Virtual education and its effectiveness on the level of learning and performance of medical students in a virtual way was a big challenge that educational centers of medical sciences universities will face in the future. With the onset of the Corona crisis and the adoption of strict rules regarding social distancing all over the world and the recommendation of educational guidelines that students should not have direct contact with patients, the importance and necessity of virtual education became more obvious. The crisis caused by the epidemic of Covid-19 has affected the educational systems in all countries all over the world like here in Iran, and has led to the closure of face-to-face courses, and on the other hand, the role and importance of non-face-to-face education has become more colorful. The covid-19 epidemic at the beginning of 2020 has forced people to observe social distancing and not be present in all areas of social life, including cultural and educational centers. Accordingly, an issue that faced a tough challenge to education in general and traditional education in particular and opened a new horizon towards paying more attention to virtual space.
Method: The present study was a descriptive cross-sectional study. This research seeked to determine the impact of virtual clinical training on the academic progress of the third and fourth year assistants of Shiraz Medical School based on Kirkpatrick's model during the Corona era in the academic year 2020-2021.The statistical population of this study was all third and fourth year medical assistants that the sample size was selected based on Cochran's formula, consequently, the number of 186 assistants were participated randomly. The tool for collecting information was a questionnaire measuring the attitude of medical assistants about e-learning, which was designed and used by Kian, Zarif Sanyaani and Karimian in 2022. This questionnaire has been prepared by using reliable and relevant scientific sources in addition to the respondent's personal characteristics in three emotional, cognitive and behavioral areas based on the Crickpatrick model in the form of 21 items. Then the assistants expressed their level of their agreement with each of the questions of this scale. They stated on a 6-point Likert scale.  Scores from 1 to 6 were assigned to options from completely disagree to completely agree, respectively. In addiotn, after the content validity of this questionnaire was confirmed by the designers, the obtained coefficients for each question were 8 that meant up to 1. The reliability of this questionnaire was also determined by the designers through Cronbach's alpha test calculated of 0/80. Next, the GPA of the previous semester was used to determine the academic performance of assistants. SPSS version 23 software was used for statistical analysis. After testing the normality of the data and as a result of the non-normality of the data distribution, the non-parametric, Spearman correlation test was used. The significance level was considered equal to 0.05. The entry criteria in this study were the third and fourth year of residency and the consent of the medical assistants to participate in the research, and those student's  with lack of consent were exited.
Results and discussion: The results of the present study indicated that the general average of the attitude and willingness of the assistants participating in this research to virtual clinical training based on the scale of Kirkpatrick model seemed higher than the average and desirable value. Assistants' general attitude towards virtual education had a positive and significant correlation with their academic performance. In other words, in parallel with the increase in the positive attitude and desire of the assistants for virtual clinical training, their academic performance had also improved. In line with the results of the present study, Wu determined that there is a significant difference in the test scores of the students by examining the average test difference in the two groups of traditional and virtual education. The emotional and cognitive aspects of Shiraz medical school assistants' attitude to virtual clinical training also had a positive and significant correlation with their academic performance. However, the level of residents' behavioral attitude towards virtual clinical training had no significant correlation with their academic performance. Therefore, in spite of the high sense and emotional desire as well as the relative understanding and knowledge of clinical virtual training, the assistants had not implemented a favorable behavioral attitude and evaluation in line with the implementation of clinical virtual training. This research finding was consistent with the results of the studies of Haji Khajelu et al. (2013), Khadivar and Rahmani (2014) regarding the practical obstacles of providing virtual education.
Conclusion: To conclude, the virtual education had a significant effect on the learning rate of medical assistants, which demonstrated the effectiveness and usefulness of this educational method. These findings were consistent with the research conducted in other countries such as Cyprus (Uzgur and Uzgur, 2010), Tanili (2009), Thailand (Noy Tim, 2010), and Czechoslovakia (Hebakova, 2010).