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Background: Burnout syndrome (BOS) is a common occupational disease amongst medical physicians; especially anesthesiologists. BOS is known to result in increased expenditure of the healthcare system and decreased patient satisfaction. In order to substitute for good conduct by its medical staff, Tehran University of Medical University established its own guidelines on professionalism as a substitute for professional conduct amongst its personnel. Learning and practicing professionalism is not only a requirement to be competent as a specialist, but also it results in increasing healthcare quality and patient satisfaction. There is a lack of studies on the relationship between BOS and professionalism. Determination of the relationships between professionalism and BOS among TUMS anesthesiology residents. Methods: In this cross-sectional study all anesthesiology residents completed three forms (demographic checklist, Maslach Burnout Inventory (MBI), and professionalism self-conduct). The results were primarily analyzed using STATA 14.0 and relationships were established via linear and binary regression. Results: About 44 percent of residents met criteria for BOS. The risk of developing BOS was significantly higher for residents who adhered to the principles of respect and altruism and for residents training in one of our surveyed hospitals; whereas the risk of developing BOS would be reduced by increasing age and adherence to the principles of justice Burnout subscales scores concerning emotional exhaustion and personal accomplishment were significantly related with higher self-reported scores of altruism and honesty-integrity respectively. Conclusion: The chances of developing BOS could be enhanced by inadequate practice in the field of professional ethics. Therefor the importance of learning and competent practice of professionalism must be acknowledged. Age and professional climate were the most important demographic variables related to BOS in anesthesiology residents.

Abstract Introduction Although paying more attention to sex education in patients with severe mental illness is recommended in the literature, the role of families has not been specifically clarified. Aim This study aims to explore family knowledge about sexual health in patients with severe mental illness in Iran. Methods We conducted a total number of 21 interviews with 4 patients, 5 families, 7 psychiatrists, 1 general practitioner, 2 nurses, and 2 psychologists through purposive sampling. The text was analyzed using conventional qualitative content analysis. Results The family knowledge about patients’ sexual health is described in three subcategories: ‘informal sources for knowledge acquisition’, ‘common myths, and ‘inappropriate reaction to the patients’ needs”. Conclusions Family sex education should be integrated into a comprehensive rehabilitation program to promote sexual health in patients with severe mental illness. Family members should be aware of the necessity of accurate information about patients’ sexual concerns.

Objective: Patients with severe mental illness may experience cognitive deficits, impaired judgment or loss of skills. Therefore, they are prone to sexual health complications. Sex education can promote sexual health, and in many countries, it is integrated into other domains of education. The educational contents taught in western countries are not necessarily appropriate for developing countries.This study aims to address sex educational content for these patients in Iran. Methods: We have conducted twenty-three face-to-face, deep and semi-structured interviews with patients, family members, psychiatrists, general practitioners, nurses and psychologists. We used the strategy of maximum diversity in selecting the participants. Results: “Improving basic knowledge,” “decreasing the risk of unsafe sex”, “empowerment” and “persuading to ask for help” should be covered in the education. Conclusions: Sexuality is not considered a priority for these patients. It is necessary to develop a training program with simple educational content for this high-risk group. Innovation: Raising awareness and knowledge about the possible risks of social media on high-risk behaviours, developing social and behavioural skills, and encouraging patients to talk about their new challenges in sexual life is recommended. Cultural, spiritual and personal beliefs should be considered in designing the educational program.

Introduction: This study aimed to emphasize the challenges in the error reporting system as one of the professionalism codes in clinical settings in hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. Materials and Methods: In total, 23 focused group discussion sessions were conducted with 85 faculty members, assistants, and interns, as well as 165 staff members in 2016. The participants were selected using a purposeful sampling method. Furthermore, the views of four faculty members were gathered again via emails in 2020 to ensure data accuracy. The extracted codes were managed using conventional content analysis through MAXQDA software. Results: Analysis of participants' discussions led to the identification of 105 codes, which were classified into six sub-categories and two main categories, including "barriers to reporting errors of peers " and "barriers to self-reporting errors". Conclusion: Most of the non-reporting errors are due to participant’s concerns. Such concerns are generally the result of poor system management or are merely misunderstandings; accordingly, errors' addressing only requires gaining a person's trust. The seriousness of the system in persuading people to report errors is one of the most important ways to gain a person's trust.

It appears that up until now, no comprehensive tool has been developed to assess medical students’ attitudes toward the different dimensions of professionalism. The present study aimed to develop a comprehensive quantitative tool to evaluate medical students’ attitudes toward professionalism. This study consisted of two phases: The first phase was item generation and questionnaire design based on literature review and a qualitative survey. The qualitative data were extracted from 49 semi-structured individual interviews and one focus group discussion. In the second phase, the questionnaire was developed and its face, content, and structure validity and reliability were evaluated. To measure the construct validity of the questionnaire, a cross-sectional study was conducted on 354 medical students at different academic levels at Isfahan University of Medical Sciences. The final questionnaire was loaded on five factors. The factors accounted for 43.5% of the total variance. Moreover, Cronbach's alpha was 0.84 for the total scale, and the interclass correlation coefficient was 0.77 for the test-retest reliability. The 17-item questionnaire measuring medical students’ professional attitude had acceptable validity and reliability and can be adopted in other studies on physicians’ and medical students’ professional attitudes.

This study was conducted to develop and validate an instrument to measure the medical professionalism climate in clinical settings. The item pool was developed based on the Tehran University of Medical Sciences Guideline for Professional Conduct. The items were distributed between two questionnaires, one for health-care providers and the other for patients. To assess the construct validity of the questionnaires, 350 health-care providers and 88 patients were enrolled in the study. The reliability of the questionnaires was evaluated by calculating Cronbach’s alpha and ICC. At first a 74-item pool was generated. After assessing and confirming face and content validity, 41 items remained in the final version of the scale. Exploratory factor analysis revealed the three factors of “personal behavior”, “collegiality” and “respect for patient autonomy” in a 25-item questionnaire for service providers and a single factor of “professional behavior” in a 6-item questionnaire for patients. The three factors explained 51.775% of the variance for service providers’ questionnaire and the single factor explained 63.9% of the variance for patients’ questionnaire. The findings demonstrated that from the viewpoints of patients and service providers, this instrument could be applied to assess the medical professionalism climate in hospital clinical settings.

Professional behavior with patients and interactions with colleagues, the institution and professional bodies are influenced by many factors. The purpose of this manuscript is to clarify those personal factors affecting medical professionalism in clinical settings affiliated with Tehran University of Medical Sciences. For this purpose, a qualitative study was carried out. One hundred and eighty-two participants were recruited through purposive sampling of clinical staff, physicians, and medical students in Tehran. Data were collected through 22 focus group discussions, and conventional content analysis was used to analyze the data. The results were reported in five categories to present the participants’ views. Categories were extracted from 103 codes and consisted of 1) people's belief in professionalism, 2) personality traits, 3) problems in family, 4) mental or physical health status, and 5) communication skills. The results showed that despite the facilitator roles of some personal factors, others act as barriers to professional behaviors. In order to control their impact, it is crucial to pay attention to them at the time of student/staff selection. Strengthening support systems in the organization is also essential for decreasing the effect of family problems or physical and mental health problems.

Many studies have attempted to analyze the concept of professionalism in nursing. Prior to this study, however, there had been no experience of empowering nurses to train their peers. The context of nursing is different from other professions in the health system. In comparison to physicians, nurses’ exposure to patients is not only more frequent, but also of a kind that urges them to behave in a professional manner that differs from physicians and medical students.

BACKGROUND: Observing professional behavior in clinical settings encounters many obstacles. In this research, the effect of defects of the educational system in observing professional behavior in clinical settings of Tehran University of Medical Sciences (TUMS) has been investigated. MATERIALS AND METHODS: This qualitative content analysis study was conducted using focused group discussions in TUMS. Twenty-two focused group discussions with 182 faculty members, medical students, and clinical staff were conducted. Conventional content analysis was used to analyze the data. RESULTS: One hundred and sixty codes (90 codes from the viewpoint of clinical staff and 70 codes from the viewpoint of faculty members and medical students) were extracted. The codes are categorized into 4 categories and 17 subcategories. The categories include “educators' imperfections,” “inadequate initial training,” “lack of attention to continuous professional education,” and “lack of passion for professionalism education.” CONCLUSION: Greater efforts to empower educators, planning for the effectiveness of initial education, and motivating employees might play a role in promoting the observance of professional behavior in clinical settings. Professional behavior training should be considered at the entrance into the system. This education should be strengthened by continuing theoretical and practical training and addressed by proper supervision. It is also important to focus on attracting the attention of teachers to their own model role in observing professional behavior by others.

INTRODUCTION: Despite all efforts that have been made to promote professional behavior among medical trainees, unfortunately, reports from medical schools around the world confirm the prevalence of nonprofessional behaviors by medical students. Experts in the field of medical ethics and medical education in different countries have suggested several reasons for failing to minimize unprofessional performance among medical students. MATERIALS AND METHODS: This qualitative study aimed to promote our understanding from the challenges faced by Iranian medical students in providing professional behavior. The study was first conducted in the form of a semi-structured face-to-face interview with medical students and then completed with a focus group discussion (FGD) session. Forty-nine medical students participated in the interviews and 11 students participated in the FGD session. Qualitative conventional content analysis was used for examining the data. RESULTS: The participants classified the obstacles of professional behavior into the following three main categories: problems related to educational system, problems related to the society, and problems related to students themselves. CONCLUSION: Regarding the impact of various personal, social, and educational factors on the creation and expansion of unprofessional behaviors among medical students, it is essential to have a comprehensive approach for solving the problem.