Designing a Conceptual Pattern of Medical Lecturer Professional Performance in E-Learning System Based on a Critical Review

1 PhD Student at School of Medical Education, Shahid Beheshti University of Medical Sciences and Health Services. Tehran, Iran. 2Department of Medical education, School of Medical Education, Shahid Beheshti University of Medical Sciences and Health Services. Tehran, Iran. 3Department of E-learning in Medical Education, Virtual School, Center of Excellence for E-learning in Medical Education, Tehran University of Medical Sciences,Tehran,Iran. 4Department of Medical Ethics, School of Medical Education, Shahid Beheshti University of Medical Sciences and Health Services. Tehran, Iran.

The 21st century is called the communications, information, and speed century.A century that is constantly changing so that it cannot be controlled and even its prediction is impossible (Tamlz, 2001).Creation of new educational system entitled e-learning system is derived from the same information technology.
We observe the ever-increasing trend in the demand for holding these courses in universities due to the benefits of e-learning at level of higher education (Zamir, 2010).Annually over one million people just in America receive their valid degree of education from this educational system (Hall, 2000).
A growing orientation has taken place in replacing conventional teaching with e-lessons in educating topics related to medical sciences lessons in other countries to fulfill the students' needs on ease of access to information and other technology capabilities (Song, 2008, Selwyn, 2003).Today, organizations involved in medical education are looking for utilizing this new educational method (Roach, 2003).
Therefore, the thing that is under consideration now is no longer talk on lack of entry of technology and e-learning system into higher education space, but is how it enters into the field of education and planning to utilize this phenomenon (Porter, 2003).The lecturer's role as a pivot of any change in education is very important (Ayati, 2007).
Having professional responsibility and feeling of his commitment to the students besides his specific skills and abilities are of the effective factors in effectiveness of an e-lecturer (Daniel Sun, 1996).Having knowledge of educational matters and content and type of the used technology all specify the capabilities of an e-lecturer (Wang, 2006).
On the other hand, student is the other side of education in an educational environment whether conventionally or electronically.The student should have specific features and knowledge.Having e-literacy and the way of interaction with others in this space are of the very important cases for success in such an environment (Moore, 2001) Although e-learning system is not a onedimensional system and professional performance concept in it is derived from moral issues in two fields of education and technology both in the students and lecturer, the role of the lecturer is responsible for the most gravity point.
It is demanded in today's full of change world that lecturers also learn new competencies and skills.Huntly has divided lecturers' capabilities in three contexts: professional knowledge, professional action, and professional commitment.Professional commitment includes participation, leadership, values, communications and ethics (Huntly, 2008).
Alvarez et al. have considered four roles for virtual university lecturers: design / planning, social role, educational role, and predominance in two fields of technology and managerial (Alvarez et al., 2009).
Moreno believes that professional identity of professors in the new learning system requires renewal of lecturers.
Professionalism is having knowledge and behaviors that contain scientific and moral features.Professional people seek to improve their performance and move in order to expand responsibility.They also seek to create methods through which ensure that the people of that profession are committed to competence.
The thing that is important in professionalism is having knowledge and gaining values of the profession.Topic of professionalism is a complex and multidimensional concept.Professionalism has more complex concept in e-learning system.This is because education context and learning space are encountering with new challenges that require proficient and specialized professors in two fields of education and technology.
The lecturer in e-learning in addition to professional competencies should also have other specific and special competencies to guarantee the quality of learning.
The aim of this report is that it finds a complete insight on the concept of lecturer professional performance in e-learning system based on the existing articles and according to temporal process of articles' writing; so that it utilizes all of the previous viewpoints that have dealt to this topic directly or indirectly.
Ultimately it provides a model by use of which can be claimed for having a professional and competent e-learning system, whether in the field of medical sciences or in other fields, their lecturers should have what elements to be able to gain the trust of the community's people and promote education and training system.

Research Methodology
The aim of this study is to reach degrees of innovation and synthesis and Ultimately To Provide A Model.The schematic diagram of research methodology was performed in 11 steps as the following: First Stage: Structuring the topic and cause of conducting research Scientific progress is free from moral goodness of movement in the dark.Although professional performance concept has long been posed in education, this concept needs to be redefined due to the created paradigm and creation of a modern educational system.A lecturer should pay attention to development and strengthening values, attitudes, moral norms, social skills and all the features that form an organizational behavior that is the same professional performance skill in addition to the necessary knowledge and skills.
Therefore, the aim of this research is to specify his skills in this new paradigm.
Second and Third Stages: Defining range of review and identification of the related informational sources Search of this study was done by reviewing the available published articles and books related to the concept of ethics and searching in databases and websites, Google scholar, scirus, pre quest, Scopus, IEEE, SID, magiran, Eric, Taylor and Francis, Science Direct Google.Search method was conducted in structured way (method of going back and forth) and comprehensively.
Professional performance keyword was firstly used to access the sources.It constituted the main conceptual framework.The wider key words related to the word professional performance was then used such as moral -manner -ethicsconduct disposition -netiquette -values -academic fraud and behavior in e-lecturer due to the small number of the found articles.
Also, the words related to this headword were utilized, which were distance educationmobile learning -online education -Internet based training -web based education and so on because of newness of e-learning concept and the use of other terms instead of it in articles.
58 Latin articles and 13 Persian articles were found exactly related to the topic based on extensive search since 1990 to 2015.Number of books related to the topic was also obtained 14.
Fourth Stage: Appropriate strategy to extract data related to research (related data management) The purpose of this stage is to manage data based on the balance between the studied range and texts review.The decisions that are adopted here are evaluation of quality of the related data and identifying relevant studies by using inclusion and exclusion criteria.
Studies that had the inclusion criteria were arranged and ranked based on the year of publication.These studies were reviewed carefully.All their structures and relationships with each other were specified by the researcher.On the one hand, main concepts were extracted to be used to provide in final posed model.
Process of viewpoints and opinions was being followed with regard to the type of critical review.It was necessary that the researcher to achieve all dimensions and components of professional performance in e-learning system by gathering the opinions and results of the researches and ultimately provide an operational model for designing and implementing given that the concept of professional performance in elearning was not found in any of the articles.
The texts search was continued until data saturation in this study; so that new concept and / or concepts were not found longer in new articles.
Key reliable and firm sources in which the specific topic was dealt specifically and particularly were selected for critical review after evaluating the mentioned cases.The relevant books were also utilized at the end of work to complete the initial model.

Sixth and Seven Stages: Review and Criticism of Texts
Different viewpoints are reviewed in this stage.The concept and details of it are obtained in each viewpoint.The key concepts of each viewpoint are then specified.Common points and difference of viewpoints are achieved finally.The concepts are declined and generic and overall concepts are extracted in the next step.The objective of this stage is movement from subjectivism to objectivism, so that a tangible and non-abstract model can be achieved finally.

Moral sextet areas in e-learning
Reid believed that a lot of moral riddles will be appeared in new educational conditions that require proper analysis and an appropriate response.In these cases, the way of analysis of people from the created situations depends on their moral growth.Moral growth itself also changes under some circumstances such as age, gender, professional activities experience and so on.
Moral specific skills are required in the new environment.If a lecturer shows immoral behavior in e-learning environment, the most likely cause is his trouble in lack of moral sensitivity to the situation that was not able to interpret and understand that new situation.
The lecturer who teaches in this field must find a full understanding of these situations to be able to interpret it properly since this issue is very important.It is impossible that there is an education and moral subjects are not posed in it.Therefore, any situation in which there is an opportunity for learning including distance learning is the example of this statement (Ferreira, 1982).
Hafernik Messer Schmitt believes that moral sensitivity in lecturer as a role model can also create moral sensitivities in student and can cause more secure learning system (2002).A group believes that the quality of education cannot reach to the conventional education until an interaction is not in education.This is because the values are not transmitted and the possibility of failure risk of e-courses increases (Dreyfus, 2001).
Gam Son also strongly believes this new system has a lot of deficits because of limitations in providing lessons and teaching methods (Gam Son, 1996).
Sharma considers the level of interaction and collaboration beyond the Reid's vision.He believes that student should interact with educational system.The distance learning environment is complex and intricate environment in which moral complexities are high.This environment has a lot of unknowns for student, professor, and the organizers.The highest success rate in the use of information and communication technology in learning is achieved when we go out the disorientation and consternation on information and communication technology and focus our mind and emotions with the wonders of learning.
Explaining proper educational policymaking is transparency and comprehensiveness in policies and purposefulness of administrative policy makings that provides the appropriate space to use technology capabilities.Rules and requirements that facilitate or harden the use of technologies for assumed purposes are important.Today, technology has progressed eleaning towards an interactive and transcendental education as possible.

Transmission of values in virtual university
A more fundamental question was posed simultaneous with expansion of virtual education and implementation of educations in eenvironment: Whether virtual universities can and / or should have the same role of conventional universities in promoting public good and values in community?
Clarck (1983) believed that three values should be considered in higher education: 1.
Competency that means the same acquisition of knowledge, attitude and skill in universities.

2.
Social justice that means to treat all people equally and fairly regardless of race, gender, and so on.

3.
Academic freedom in a way that institutions have so much domination and independence to do some measures inside and / or outside of university to improve the community (Clarck, 1983) He believes in discussion of competency that the individual must acquire the knowledge and skill of his discipline and be educated in such a way that be available always for the community and fulfills needs of the community.This will not be possible unless moral performances to be taught to him/her whether implicitly and/or explicitly besides transmission of knowledge and skills.
In fact, these moral performances are social behaviors that have been classified into groups.One of these categories is cultural transmission of values that appears as honesty, respect, openness, responsibility and loyalty.
In fact, education space whether conventionally or electronically must institutionalize these social behaviors in person.Another important category is transmission of academic values.Academic values are values that are taught to student during training education and are expected to be emerged in the academic position in professional life (Henslin, 1993).
These values are directly associated with the individual's profession and occur in professional interactions.Academic values are: independence, curiosity, responsibility, accuracy, trust.
It is said that these values are formed in human interactions between professor and student.If a professor acts capable in these skills, he can cause the learning system to achieve its purpose.
Barry believes that whatever virtual universities are more advanced, interaction become stronger in them.This makes it easier to achieve the goal of higher education that is transmission of fundamental values.Coiro and Dobler believe moral virtues are community spirit and interaction is the way to achieve the virtues.(Kvyrv et al, 2007).
Kress also emphasizes that interactions and communications in the field of education cause promotion of quality of learning (Kress, 2003).They like Barry emphasize on the maximum amount of interaction in this field.
Values are very important in stabilization and people's personality and community life.They are as an effective factor.
Education and promulgation of them properly is essential affair.Prosperity and health of community depends on the realization of true humanity.True humanity depends on understanding and performing authentic human values, especially moral values.One of the most important factors in education of values is discussion of true interactions between student and professional professor.

Relationship between ethics, pedagogy and technology
Extension of technology persuades education and training experts to promote elearning.However, they are encountered with issues that their numbers are increasing every day.Venn diagram well shows overlapping of technology, ethics and pedagogy (Jeffries et al.,

2003):
Ethics, technology, and pedagogy are all influenced by fundamental understanding of reality.Ontology and epistemology have strong effect on our researches' methodology.Our viewpoint of human and community and type of the individual learning determine the way of our use of the technology.
Kiran Arora (2015) states that, technology is not a white notebook that its writing is in charge of us.But it is a written book that we must criticize it.Therefore, the lecturer of this field uses it well and fitly.Levy and Hubbard emphasize that the professor who teaches in the virtual world must have expertise in the field of information and communication technology, and advance the technology in line with the topics of andragogy (Hubbard et al., 2006).

Components of moral dimensions of Badrul Khan
Khan believes type of speech and writing of the lecturer in e-learning system must be morally in a way that does not create ambiguity for a group.Sometimes specific terms or abbreviated phrases can lead to misunderstandings.
A professional lecturer should act in such a way that explicitness and transparency prevails in this field.On the other hand, sometimes controversial issues in education field bring challenges with themselves.If such subjects are expressed in e-learning field, all the different viewpoints should be expressed and improper prejudice should be avoided.
Favoritism of a viewpoint and improper prejudice is itself considered a form of immorality.All of these contents are considered by a professional lecturer.Teaching should be done in virtual space along with etiquette and proper etiquette.A lecturer should know how to behave in interactions to not harming others.
However Khan has not mentioned professional development of the lecturers, but he has considered motive and supportive mechanisms to strengthen motivation in lecturers.This is considered a strong point itself.Professional promotion of e-learning lecturers Davis (2007) believes lecturers should have a true understanding of virtual learning for teaching in e-learning field; so that they can well support this system, as well as can use it efficiently.
She in her own researches has dealt with further to this topic of what kind of professional competencies are needed to perform an effective online teaching (Davis et al., 2007).Davis says the word professional development has not been still specified explicitly within online lecturers.
A lecturer who teaches in this field should be experienced both in his specialty and conventional education, as well as be specialized and proficient in technology issues and to be trained in this field.
The researcher believes that it is necessary that people who are changeable and love change teach in this system due to the changing nature of e-learning environment.
On the other hand, work of teaching in this field requires a lot of interactions and broad and extensive teamwork.Therefore, it seems necessary that the professors' personality of this field to be measured by tools like DISC or MBTI analysis before entering, and people who are consistent with this system are employed and recruited.
These people should be technologist means they should be familiar with technology, as well as be skilled in it.Since learning in such an environment is individually, students must have the necessary motivation and be self-control.These people need motivated lecturers to refresh enthusiasm in the students every moment to stay motivated.
DuBravac concluded in his research that lecturers in this field generally have low awareness of ICT.He suggested that educational courses should be held for lecturers to promote the quality of e-learning.He has formulated a practical manual for the professors about familiarity with copyright laws and awareness of moral dilemmas (DuBravac, 2012) Park also believes awareness of professors of this field on immoral cases is little.At the end he states that weak professors can never educate students who are conscious of moral cases (Park, 2012).
Melissa also says the appearance of • Monitoring findings and synthesis of evidences along with providing results

9
• Description of main concepts of model  Internet and its applied development in learning moral riddles in this field is increasing.It is necessary that the professors who employed in this system to be aware of all these dilemmas (Melissa, 2007).

Quality Literacy and Media Literacy
Ulf Daniel Ehlers (2007) believed that promotion of quality of learning is as a result of specific abilities that the Stick Holders whether student or lecturer should have it (Ehlers, 2007).In other words, having an able lecturer alone does not promote quality level of education, but student should also be able and have abilities that can totally promote the quality of learning.
He calls this competency and qualification quality literacy.Quality of literacy in e-learning system for lecturer is set of common capabilities required in conventional education system and elearning system and capabilities related to technology.They are considered specific for elearning system.It is called media literacy.Baack (1996) has divided dimensions of this media literacy into four parts as follows: 1.
Media Design It can be seen according to this division and definition that the first and second dimensions are related knowledge and attitude.The third and fourth dimensions are related to skill.This literacy is considered a kind of capability according to Millervedrleuten triangle.This is because all three fields containing knowledge, attitude, and skill.Therefore, regular and continuous updating of these dimensions is necessary.Wildt (2006) proposed the relationship of the three dimensions of knowledge, attitude, and skill with professional performance as continuous incremental steps as presented in Figure 3 asfollows: (Wildt, 2006) He has put professional performance stage after capability stage.He has stated its real meaning responsibility to students and community.
Since the quality literacy is considered a capability, it requires education, as well as experience and practice.This is the reason of this claim that any successful lecturer will not be also essentially successful in e-learning system.
Gladieux believes that digital literacy is important for both student and lecturer.He considers people's low-experience or inconvenience of using computer technology as of the problems that sometimes cause unwillingness to attend in virtual university (Gladieux, 2008).

Moral ASIE educational design model
E-learning valuable results were appeared from 2009 onwards.This educational system proved how technology could support the educational processes.But moral dilemmas of this field were the thing that appeared in this time more than ever.Therefore, the researchers attempted to provide an educational design model that considers moral issues in all phases (Kurria et al., 2008).
Manuela Sarmento suggested in 2009 that educational design should use combination of Jeffries theory and ADDIE model in e-learning field to be able to consider all moral dimensions in all fields (Manuela Sarmento et al., 2009).His model is presented in Figure 4.
He showed that whatever the professors of this field can implement moral criteria in design and performance in specialized way; they more guarantee e-learning system.Sang Keun Shin also says better designs are done and value riddles less appeared when trained professors are used to design this system (Sang Keun Shin, 2015).
Alison Higgs believes only professors should not be involved in the design of e-learning programs.He proved in his research on medical students that once the design is perfored with the participation of professors and students both consider themselves involved in the educational system.Therefore, they try to create a safe environment and be committed to its ethics aspects (Alison Higgs, 2012).

Communication ethics
Educational institutions must teach so that to institutionalize moral responsibility inside the individual, the kind of education does not matter.Toprak concluded that ethics is divided into two categories in field of online learning (Toprak, 2007): Moral issues common with conventional education that have sometimes appeared as moral codes and every lecturer is required to implement it.
The researcher proves that the discussion of etiquette that is named in the other articles as netiquette is very important in this field.It is among the important moral issues.It is on how people talk or how they write so that not harming others.
The researcher has stated over the research that redlines should be drawn for student and professor explicitly and clearly from the very first.Then in continue he has provided strategies as preventive approaches and executive approaches.
The researcher believes that moral issues in the field of e-learning should be considered in both interactions and preparation of courses.Professor morally is obliged to offer high-quality lessons that are consistent with the objectives of the course.Katz like Toprak emphasizes on familiarizing people with legal cases of ethics in computer (Katz, 2012).

Interrelation of ethics and technology in education
Current world and global community encounter with new challenges and conflicts that did not exist previously (Toprak, 2010).New moral challenges have been created because of predominance of technology over all aspects.
The main challenge in e-learning system is also quality of educational process.Although process of accreditation to institutions somehow determines the quality level in this system, accreditation is a complex subject and does not indicate only educational quality.
Arora believes students often do not know the concept of collegiate ethics and academic integrity, especially in e-learning environment.They do not know how to implement it.It is better that the professors of this field make the students familiar with these concepts.But such a work will be possible when they themselves are capable, cautious, and responsible in this area.
Eighth stage: Monitoring findings and synthesis of evidences along with provision of results As we observed, each of the researchers in global articles and texts have paid attention to the topic of professional performance of the lecturer in e-learning system from a specific angle.
It was attempted in the present research to extract the main dimensions and components of professionalism in this field by reviewing articles and texts with critical look.Finally, a model can be created for professional performance of e-lecturer by combining and modifying them; so that the present model can involve all dimensions and components, and have the necessary comprehensiveness.
A lecturer who has full view and holistic attitude, and is master and has full knowledge in the specialized field is considered professional.On the other hand, he should adhere to principles in addition of wisdom.Accordingly, professionalism in this environment needs to be based on two topics: expertise and organizational commitment.
The conceptual pattern model of professional performance in e-learning system was classified in the following main dimension by using the studied components in several researches.Each of these dimensions has some components: Introduction of such a pattern has not been provided yet in an integrated form and in comprehensive taxonomy format.The Figure 5 shows the conceptual pattern model of professional performance of E-lecturer.The Ninth stage: Description of the main concepts of model 1.
Professional performance of E-lecturer Having experienced and specialized professors in any educational system is considered its success key.Although modern technologies have given more responsibility to students to be participated in their own learning, this factor takes place depending on a good teaching by professional professors (Bigs, 1991).
Harden believes the issue of devaluation of the role of lecturer in new methods is not correct, because teaching and learning have deep connection with each other.The thing that has been changed is only the roles of lecturers in these systems (Harden et al., 2000).They considered different roles in the context of the frameworks for a lecturer.
Bawan claims that the multi-dimensional role should be assumed for lecturers in eenvironments.The acquisition of wide range of different and several competencies is emphasized (Bawan, 2009).New educational methods are created in e-learning environment that improve learning methods, especially social teaching (Baran et al., 2011).
Professor is one of the most important factors affecting qualitative e-learning, because learning is provided through him / her.Many studies have been conducted on making transparent and clarifying the tasks and roles of electurers to provide qualitative virtual courses (Lim et al., 2003 andMavr, 2003).
Institutions and organizations have tried based on their experiences to explain the roles and qualifications required for e-lecturers' roles.Thereby they ensure quality of e-learning system.We classified professional performance of electurer into four categories according to various studies.They are described, respectively as: 1.
Although the professor does not teach student in modern educational systems in other words, the transfer of information, knowledge and understanding in a particular topic is not merely his responsibility, he plays a fundamental role in the teaching and learning process.
Teaching and learning process is the result of interaction of three elements of professor, student, and content.This process is not so different in real and virtual environments.
The most important of these activities according to the conducted studies are: 2.
Professor is an individual who has expertise in a particular field in a knowledge field that provides his knowledge as a teaching method.Every professor should have knowledge management to be able to provide scientific and updated services to students.A person who is professional in teaching should act as a knowledge manager and being able to be knowledge appraiser, knowledge synthesizer and adapting it to the various needs and conditions (Knowledge customizer) (Yazdani et al., 2012).

E-learning Technical Mastery
Teaching-learning environment is changing ecologic deeply and is widely.Professors who experience creative and exploratory changes can pass these changes successfully.Considerations such as low-ability to communicate with student, unclear expectations of e-learning student can easily make inefficient the virtual class.
On the contrary there are professors in this field who identify their students' needs and respond to it.a list of these technical masteries to work in e-learning environment according to the conducted articles and researches include: Infrastructures' knowledge and skills, Material Production, Hard ware ownership, Education Tech Conversant, Online support, Students Surveillance, Online Evaluation, Linguistic Strategies, Writing and Verbal skills, Safe communication, Real time Communication.

Ethical Mastery
Ethical knowledge, especially ethics philosophy plays a role as a basis for selecting patterns and methods.Ethics has close relationship and is fitted with a part of existing knowledge.One of these sciences is Educational Sciences.Ethics is the result of part of training.This is important that a lecturer at any educational space (real or virtual space) should be cautious and responsible for what ethical points in education and training.

Cyber ethics
Cyber space is a space in which physical reality and virtual reality interact with each other through Internet.It is necessary in such a space that its own related ethics to be implemented to promote the ethical and professional quality and performance.

Netiquette
A set of dos and don'ts that exist in virtual networks and online communications are called netiquette.This etiquette or behaviors are driven by the dominant values that if they are not implemented, they have legal penalty (Value Based e-learning behavior).Or they are ethical customs and good deeds that are referred as good methods in social communications, and if they are not implemented, they are not followed by legal penalty, but are considered of popular virtues (Etiquette).

Tenth and Eleventh Stages: Conclusions and suggestions for future studies
New communicational technologies entry into education stage has changed the nature of academic teaching and learning process and has led to the creation of new learning environments.E-learning is one of these new methods (Raschk et al., 2003).It is necessary firstly all individuals in this field observe professional behavior and be cautious and responsible for all ethical issues to have a professional e-learning system.
To create a moral atmosphere and to fill the gap between the student, coach and university a moral relationship is necessary to be created between these three vertices.
All dimensions of lecturer professionalism, including ethical and technical aspect must be known and all its components must be examined to design and implement a qualitative e-learning system.
On the other hand, such an educational system can facilitate movement towards the civilization-making and culture-making university.Review of most of dimensions separately and determination of policy dimensions to implement them step by step in e-learning universities are important issues which are suggested for future researches.

10 , 11 •Figure 1 .
Figure 1.The steps of research methodology of the present study.

Fig. 2 .Fig. 3 .
Fig. 2. The Venn diagram of the E-learning on overlapping of technology, ethics and pedagogy

Fig. 4 .Fig. 5 .
Fig. 4. The educational model of Sarmento in 2009 for considering the moral dimensions of E-learning Therefore It Is Necessary To Use Critical Review Methodology.Since The Researcher's Intent At This Stage Is To Provide The Model, Various Concepts Of The Topic Need To Be Combined With Each Other And A Kind Of Conceptualization To Be Taken Place Again.Combined structure of Carn Well and Randolph has been used to do critical review methodology.

Table 1 .
The conceptual pattern model of professional performance and their elements proposed in this study