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Background and Aim: Lack of necessary awareness and misdiagnosis can have serious consequences in dental emergencies, potentially causing irreparable harm to the patient's health. This study aimed to assess dental students' knowledge at Alborz University of Medical Sciences regarding medical emergencies in 2019. Materials and Methods:This descriptive, cross-sectional study included all dental students from the 6th to 12th semesters at Alborz University of Medical Sciences (100 students) using a census method. The data collection tool was a questionnaire consisting of three sections: demographic information, the necessity and sufficiency of learning about medical emergencies, and dental students' knowledge of medical emergencies. The collected data were analyzed using SPSS software version 21 and descriptive and analytical statistics at a significance level of P < 0.05. Results:Out of 100 students, 90 completed the questionnaire. The mean knowledge score of the students was 9.63 ± 2.73, with the highest score being 15. 71.1% of participants agreed that the method of teaching medical emergencies should be changed. Additionally, 86.7% of the students felt the need for retraining in emergencies and how to handle them. There was a statistically significant difference between knowledge scores and the academic semester (P =0.01) and the history of attending cardiopulmonary resuscitation workshops (P = 0.03). Conclusion:The knowledge of Alborz University of Medical Sciences dental students regarding medical emergencies was poor and unsatisfactory. The findings of this study, consistent with the results of other studies, highlight the necessity of reviewing and revising the curriculum related to medical emergencies in dentistry.

Abstract Introduction The preparedness of the healthcare system to address emergency situations is contingent on the inclination of healthcare personnel. Nursing students can serve as valuable resources to supplement the workforce during major incidents and disasters. This study investigated the facilitators and barriers of nursing students’ willingness to respond to disasters at the Alborz University of Medical Sciences in 2022. Methods In this cross-sectional descriptive study, 234 nursing students were recruited using convenience sampling. A deductive-inductive questionnaire was developed and distributed through an online self-administered survey comprising demographic information and questions on barriers, facilitators, various disaster scenarios, preferred activities, and reasons for pursuing a nursing career. Results The mean willingness scores of nursing students in response to various disasters were as follows: 3.15 for natural disasters, 2.60 for man-made disasters, 2.94 for pandemics, and 3.32 overall. Among the disaster scenarios, the earthquake response obtained the highest willingness score, while infectious disease epidemics received the lowest score. The most and least willingness to perform activities during disaster response were related to bedside care and participation in patients’ personal hygiene, respectively. Key determinants of participation included the possibility of immunization and concerns for family safety. Conclusion The findings indicated that nursing students are generally willing to assist as members of the healthcare team during disasters. However, the willingness to respond to infectious disease epidemics and man-made disasters was below the norm. Concerns about family health and the risk of disease transmission were identified as primary barriers. Addressing these concerns is crucial to enhance nursing students’ participation in disaster response.

Abstract Aim This study aimed to conduct a psychometric evaluation of the Persian adaptation of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ). Methods In this cross-sectional study, the validity and reliability of the EMS-SAQ were assessed among 484 Iranian pre-hospital emergency department employees between February and June 2023. Results Five factors were extracted namely safety climate, teamwork, job satisfaction, stress management, and working conditions with explained 38.75% of the total variance. The goodness of fit indexes confirmed the model (χ2 = 409.031, DF = 196, χ2 /df = 2.087, CFI = 0.900, IFI = 0.901, PCFI = 0.763 and PNFI = 0.701, and RMSEA = 0.069 [CI90% 0.059–0.078]). Conclusion The Persian version of the SAQ-EMS, comprising 22 items across five factors, demonstrated good validity and reliability. It is recommended to undertake qualitative studies focusing on the concept of patient safety in pre-hospital settings, considering diverse contexts and cultural nuances to develop more robust assessment tools.

Background: Effective stress management after unsuccessful cardiopulmonary resuscitation (CPR) requires the determination of perceived stress and identification and reinforcement of effective coping strategies. Therefore, the present study was conducted to determine perceived stress and coping strategies after unsuccessful CPR for the first time among Iranian pre-hospital emergency technicians. Methods: A cross-sectional, descriptive, correlational, multicenter study was conducted in 2022. The research population included all pre-hospital emergency technicians working in 44 urban, road, and aerial pre-hospital emergency stations in 22 counties of Ilam Province, west of Iran. A total of 374 technicians worked in these stations, which were included in the study by census method according to the inclusion criteria. The data collection tools were the Questionnaire of perceived stress after unsuccessful CPR and Brief Coping Orientation to Problems Experienced (COPE) Inventory. The collected data were analyzed with SPSS software version 27 using descriptive and analytical statistics (Pearson correlation test, multiple linear regression analysis, independent sample T-test, and ANOVA) at a significance level of p ≤ 0.05. Results: The perceived stress was at a moderate level with a mean score of 65.56 ± 14.21. Among six coping strategies, problem-focused coping had the highest (3.01 ± 0.59) and denial had the lowest mean value (1.94 ± 0.79). Perceived stress had a significant direct relationship with 5 coping strategies, including problem-focused coping, support-focused coping, emotion-focused coping, self-distraction, and religion (p

The professional quality of life of pre-hospital emergency technicians has been adversely affected during the COVID-19 pandemic. The present study was performed to investigate the professional quality of life and resilience and their relationships in pre-hospital emergency technicians of Kermanshah Province, Iran during the COVID-19 pandemic.This cross-sectional, descriptive correlational study was conducted on 412 pre-hospital emergency technicians in Kermanshah Province in 2020 using the census method. Data collection tools were the Stamm Professional Quality of Life Questionnaire and the Emergency Medical Services Resilience scale.Pre-hospital emergency technicians experienced moderate levels of the professional quality of life dimensions and high/acceptable levels of resilience. There was a significant correlation between resilience and the dimensions of the professional quality of life.The results of the regression test showed that resilience had a significant effect on all three components of the professional quality of life. Therefore, the use of resilience enhancement strategies is recommended to improve the professional quality of life of pre-hospital emergency technicians.

Background & Aim: Pre-hospital emergency staff, as the first responder group at the scene of emergencies and disasters, should be able to cope with, and maintain their physical and mental health. The aim of this study was to investigate the relationship between resilience and self-efficacy of pre-hospital emergency staff with their professional quality of life. Methods & Materials: The present study is a cross-sectional, descriptive study that was conducted in 2019. A total of 200 pre-hospital emergency operational staff from Alborz province participated in the study using proportional and convenience sampling. Data collection tools were a demographic form and three standardized questionnaires including the emergency medical services resilience scale, the Schwartz and Jerusalem self-efficacy scale, and the Stamm professional quality of life scale. Data were analyzed through the SPSS software version 20 using descriptive statistics (mean and standard deviation) and analytical statistics (Spearman correlation, one-way ANOVA and linear regression) at the significance level of P less than 0.05. Results: The mean and standard deviation of self-efficacy (29.67±5.82), resilience (123.14±17.07), compassion satisfaction (39.81±8.09), burnout (12.06±4.76), and secondary traumatic stress (23.61±7.27). There was a significant correlation between self-efficacy and three components of professional quality of life (P

Background There is no specific tool for measuring the professional resilience of emergency nurses. Therefore, the present study aimed to design and psychometrically evaluate a new tool named the emergency nurses’ professional resilience tool. Method This mixed-method sequential exploratory study was conducted in two phases: (1) item generation using literature review and evaluation of the results of a qualitative study and (2) psychometric evaluation of the developed scale. The face, content, and construct validity (exploratory and confirmatory factor analysis), reliability (internal consistency, relative, and absolute), and accountability were assessed in the population of Iranian nurses (N = 465) during March 2019-June 2020. Results The tool designed for assessing the professional resilience of Iranian nurses included 37 items. The average scale content validity index (S-CVI/Ave) was equal to 0.94. The exploratory factor analysis revealed five factors, including professional competencies, emotional-cognitive characteristics, external support, in addition to behavioral and cognitive strategies, and explained 75.59% of the whole variance. Cronbach’s alpha and intraclass correlation were 0.915 and 0.888, respectively. Construct validity for five factors was established with acceptable model fit indices [Chi–square/df = 1336.56/619, p < .001]; [Comparative Fit Index [CFI] = 0.96]; [Non-Normed Fit Index [NNFI] = 0.96]; [Root Mean Square Error of Approximation (RMSEA) = 0.074 and 90 Percent Confidence Interval = (0.069; 0.080)]; and [SRMR = 0.095]. Conclusions According to the findings of the current study, the emergency nurses’ professional resilience tool can be used by healthcare managers as a valid and reliable scale to evaluate the professional resilience of nurses to designate them as nurses working in emergency and disaster situations.

Introduction: Increase of the human capital and the quality of human resources due to the development of health level is one of the important factors in economic growth, which leads to productivity increase at constant levels of inputs. Methods: In this study the panel data of 30 provinces was used in 2005 -2013. These data were obtained from the regional data of statistics center of Iran using the estimates of Mankiw, Romer, and Weil models by data panel method and generalized method of moments. Data analysis was performed using Spss22 and Eviews 8 software. Results: The results showed that public health expenditures had a greater effect on the labor productivity than the private health expenditures. In this regard, per 100 rials increase in private and public health expenditures, the productivity increases by 0.75 rials and 27.4 rial, respectively. Conclusion: The private health expenditures has treatment applications and public health expenditure has sanitary applications. Furthermore, the heath expenditure has high cost for some families. SO, the government must reduce the total cost of health to increase the labor productivity.

Introduction: Nuring is an intensive course which may cause stress and, in turn, decrease learning abilities. Given the important role of nursing graduates, efficient teaching methods should be used. Acting is one of the new simulation methods that improve learning. Hence, the effect of acting along with lecturing was compared with pure lecturing of basic immunology on student's learning. Methods: Two separate classes of nursing students were selected. For one class, the course was taught only through lecturing and for the other, through lecturing plus acting. In the latter, each student played as an immune response element taught in that session. At the final session, all of the students were involved and played the role of immune system elements against an infectious agent. At the end of the semester, a final exam was given to the students containing 40questions with similar difficulty and discrimination index. The results were analyzed, and the students' satisfaction was evaluated using a questionnaire Results: There was a significant increase in the average satisfaction of the class which was taught through lecturing and acting. Of course, the mean score for the female students was significantly higher. However, males did not show a significant difference. Results of the questionnaire showed that 100% of the students enjoyed this teaching method and believed their knowledge had increased. Conclusion: Acting helps deeper learning of immunology and changes the learning from a boring process to a pleasant one. More importantly, the students could be asked conceptual questions during the performances. Citation: Pouragha B, Norouzinia R, Ghazivakili Z, Pakravan N. Immune system on the stage: The effect of teaching basic immunology using students’ theater on the nursing students' academic performance and satisfaction. Journal of Development Strategies in Medical Education 2018; 5(2): 63-74.

Evaluation the Status of Patient Safety Culture from the Perspective of Healthcare Personnel of Teaching Hospitals Affiliated to Alborz University of Medical Sciences Norouzinia Roohangiz1,2, Aghabarary Maryam3, Mirzaei Samaneh4, Rahimi Fatemeh5, Nouri Khaneghah Zahra6* 1. Lecturer, School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran 2. PhD Student, Management and Health Economic Research Center, School of Management and Medical Information Sciences, Isfahan university of Medical Sciences, Isfahan, Iran 3. Assistant Professor, School of Nursing, Alborz University of Medical Sciences, Karaj, Iran 4. PhD Student, Department of Health in Emergency and Disaster, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 5. MSc, Shahid Rajaee Center, Alborz University of Medical Sciences, Karaj, Iran 6. Lecturer, Department of Operating Room, School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran *Correspondence: School of Paramedical, Golestan 6, Baghestan st, Karaj, Iran Tel: 00982634349807 Email: z_noori86@yahoo.com Abstract: Background & Objectives: Patient safety culture is one of the effective factors in the prevention of medical errors and keeping patient safety, therefore, its assessment will lead to the identification of improvable factors and provision of corrective action solutions for the weaknesses. This study aimed to evaluate patient safety culture from the perspective of healthcare personnel of teaching hospitals affiliated to Alborz University of Medical Sciences. Methods: This cross-sectional descriptive-analytical study was conducted in 2018. The study samples were 168 personnel who were selected from two teaching hospitals affiliated to Alborz University of Medical Sciences, using simple random sampling. Data were collected using Hospital Survey on Patient Safety Culture (HSOPSC) with 12 dimensions. Data were analyzed using descriptive statistics and independent t-test by SPSS version 20. Results: The total mean score of patient safety culture was 3.21. Of 12 dimensions, teamwork in units had the highest mean score (3.5), and non-punitive response to errors had the lowest mean score (2.7). There was no significant difference between total mean scores of organizational learning and continuous improvement; supervisor expectations and actions promoting patient safety; relationships and feedback of errors; and teamwork in the unites of two hospitals. Conclusion: Development of an encouragement culture instead of punishment/blame culture is one of the issues that politicians need to pay attention to. In addition, continuous training of staff at all levels and occupations in terms of patient safety culture will be effective. Key­words: Patient safety, Patient safety culture, Teaching hospital, Nurse, Healthcare personnel ­Citation: Norouzinia R, Aghabarary M, Mirzaei S, Rahimi F, Nouri Khaneghah Z. Evaluation the Status of Patient Safety Culture from the Perspective of Healthcare Personnel of Teaching Hospitals Affiliated to Alborz University of Medical Sciences. Journal of Health Based Research 2018; 4(2): 123-34. [In Persian]

Background Medical education is viewed as a challenging phenomenon, which can cause stress in learners and affect the learning quality. Considering the importance of basic sciences education, development of new pedagogical approaches is necessary to improve medical education. Role-play is an efficient simulation-based approach, which can improve the students’ perception and imagination. In basic sciences, immunology is of high relevance in clinical situations, as immunological disorders are becoming increasingly prevalent. Objectives Given the importance of deep learning in immunology, we integrated role-play in teaching immunology to medical students in order to promote deep and durable learning. Methods In this study, two independent classes of medical students were evaluated in two consecutive academic semesters in 2014 - 2015. In one class, only lectures were conducted, while in the other class, lectures, along with role-play, were integrated. Pretest and posttest scores were determined at the beginning and end of the semesters in both classes, and the scores were compared. Also, the students’ point of view was studied using a questionnaire. Results The pretest score, which indicated the students’ general knowledge of immunology, was not significantly different between the two classes. However, there was an increase in the score of students participating in the class, which integrated lecture and role-play. In addition, the score obtained by female students, who participated in the class with lecture and role-play, was significantly higher than that of female students in the lecture-based class. The results of the questionnaire revealed that the students were satisfied with the integrated teaching method and believed that their knowledge had improved. Conclusions Based on the findings, dramatization can make learning an exciting process and improve the students’ understanding of immunology concepts.

Background and Aim: Lack of attention to curriculum planning or reliance on traditional methods will limit the opportunity to use different methods of educational planning. The aim of this study was to evaluate the three–semester planning for the academic year in the nursing course and finding out its weaknesses and strengths in medical universities. Materials and Methods: In this descriptive-comparative study, nursing undergraduate course planning base on its educational curriculum was compared in two different (two versus three semester) scenarios. In both scenarios, the educational time per week was 40 hours. According to the distribution of the number of weeks of education, the average educational hours of students in both scenarios were equal and were about 5 hours. Results: The number of teaching days, exams, and inter-term holidays in the two-semester scenario is lower than the three-semester scenario and direct education of students in both scenarios accounts for only 50% of the year's day. In the trimester scenario, the number of course units were less and the teaching hours per unit was higher. The teaching staff activities in trimester planning had more balanced distribution versus semester planning. Conclusion: Recommendation of two or three semester planning has advantages and disadvantages that can be beneficial or inadequate for different academic disciplines and curricula on the basis of education and training potential of the universities.

Introduction: Basic immunology is one of the basic sciences in which deep understanding and link between the contents is essential. Teaching using small group is one of the student-centered approaches that have not been used to teach basic immunology. Concept map, as one of the educational methods that helps deep understanding of the content and link between concepts, was also considered. This study aimed to investigate the effect of teaching using the methods of "small group and concept maps" on the students' performance and satisfaction. Methods: The study was performed on the students who had taken the course of immunology during two consecutive semesters at the Paramedical Faculty of Alborz University of Medical Sciences. Basic immunology was taught to both groups through lecturing. In one class, group discussions were also performed on concept maps. Final exam was given, the students' satisfaction was evaluated using a questionnaire, and the results were analyzed. Results: Final score of the two groups did not differ significantly. Noteworthy, GPA of the lecture group was significantly higher than that of the lecturing for the small group-taught group. Comparison of final scores between boys of the two groups suggests that small group plus lecturing is more efficient for boys than girls. Results of the questionnaire showed that lecturing for small groups increases motivation (84%), passion (92%), and intimacy between students and instructors (92%). Conclusion: Utilizing concept map for small groups did not improve academic performance but creates enthusiasm, motivation, and establishes better communication between students and the teachers.. Citation: Pouragha B, Norouzinia R Ghazivakili Z, Pakravan N. Effect of Conceptual Mapping in Small Groups on Academic Performance and Student Satisfaction in Basic Immunology. Journal of Development Strategies in Medical Education 2018; 5(1): 54-69

Introduction: Since pre-hospital care is the first line of trauma care, its right and accurate implementation can reduce problems such as long-term disabilities and mortality due to trauma. Therefore, the present study aimed to evaluate knowledge and clinical competence of bachelor of medical emergencies students in facing trauma. Methods: The present study is a cross-sectional one. All the students of medical emergencies in Alborz University of Medical Sciences were included using convenience sampling. To gather data a demographic questionnaire, “clinical competence checklist” including 9 skills, and an oral test were used. Face and content validity, and reliability of the tool were evaluated and approved by 10 experts. In addition, reliability coefficient was calculated to be 0.82 for all the skills. Data gathering was done by taking oral and OSCE tests and observation of skill performance and filling the checklists. Data analysis was done using SPSS version 20 and using univariate t-test and Pearson’s correlation coefficient. Results: The findings of the study showed that 6.5% of the students had poor knowledge, 82.6% had fair, and 10.9% had good knowledge regarding trauma. In addition, 89.1% of the studied student had good clinical competences, and 10.9% had fair competence regarding trauma. In comparing the competence with an ideal state, there was a significant gap in all sub scales. There was a significant correlation between clinical competence level and work experience (p < 0.001, r = 0.595). However, no significant correlation existed between theoretical knowledge and clinical competence (p = 0.646, r = 0.07) or work experience (p = 0.478, r = -0.107). Conclusion: The results of this study showed that most bachelor of medical emergencies students in Alborz University of Medical Sciences had acceptable knowledge and competence regarding taking care of trauma patients in a pre-hospital setting. However, considering the significant gap between the acquired points and ideal state, continuous training in this regard seems necessary.

OBJECTIVES: This study discussed about challenges and opportunities of institutional accreditation in Iranian medical universities. The lesson learned of the first round of the accreditation would direct initiatives and solutions for future accreditation. METHODOLOGY: This research is a qualitative content analysis research that studied the experience of the survey visit teams. Semistructured interviews with a purposive sampling approach were done to reach data saturation. Constant comparative method was used to analyze the data. RESULTS: The emergent themes were incompatible scheduling with accreditation workload, accreditation sustainability, the weakness of the survey instrument, advantage of the survey instrument, the quality of evaluators' survey, the opportunity of progress for universities, accreditation perspective, defendable cost opportunity, perceived injustice, and the leading strategies. In this study, the relationship between categories and themes was shown with a systematic approach. CONCLUSION: In medical education systems, it is necessary to continue the research and development studies using the findings in each accreditation period to achieve the prospect of international accreditation.

مقدمه: ارزشیابی توان علمی و عملی دانشجویان دوره کارشناسی گروه فوریت­های پزشکی به عنوان کارکنان حال حاضر و یا آینده مراکز اورژانس کشور و در خط مقدم برخورد با بیمار، می­تواند بازتابی مناسب از عملکرد آموزش آنان در دوره کاردانی و نیز دوره جدید تحصیل را فراهم نماید. این پژوهش با هدف ارزشیابی میزان دانش و مهارتهای یالینی دانشجویان دوره کارشناسی فوریت­های پزشکی دانشگاه علوم پزشکی البرز در مواجهه با تروما انجام شد. روش­ کار: مطالعه حاضر از نوع مقطعی است. کلیه دانشجویان دوره کارشناسی فوریت­های پزشکی دانشگاه علوم پزشکی البرز به صورت سرشماری وارد مطالعه شدند. ابزار جمع­آوری اطلاعات، پرسشنامه جمعیت­شناختی و "چک لیست مهارتهای بالینی" شامل 9 مهارت، و آزمون تئوری بود. اعتبار صوری و محتوایی ابزار توسط 10 نفر از مدرسین و صاحبنظران مورد بررسی و تایید قرار گرفت. همچنین ضریب پایایی برای مجموع مهارت­ها 82/0 محاسبه گردید. جمع­آوری داده­ها با برگزاری آزمون تئوری و نیز آزمون آسکی و مشاهده انجام مهارت­ها و تکمیل چک لیست­ها انجام شد. تجزیه و تحلیل داده­ها با نرم­افزار SPSS نسخه 20 و با استفاده از آزمون­های آماری تی تک نمونه ای و ضریب همبستگی پیرسون انجام شد. نتایج: نتایج مطالعه نشان داد که در زمینه تروما 5/6 درصد دانشجویان از سطح دانش ضعیف، 6/82 درصد از دانش بالینی متوسط و 9/10 درصد نیز از سطح دانش خوبی برخوردار بودند. همچنین، در رابطه با سنجش میزان مهارت بالینی افراد مورد مطالعه در زمینه تروما ، یافته‌ها حاکی از آن بود که 1/89 درصد از سطح مهارت خوب و 9/10 درصد نیز از مهارت بالینی متوسط برخوردار بودند. در مقایسه میزان مهارتها با سطح ایده آل نتاج نشان داد که در همه زیر مقیاس ها یک شکاف مهارتی معنی دار در سطح 01/0 وجود داشت. نتایج آزمون همبستگی پیرسون نیز نشان داد که در این مطالعه بین دانش تئوری و مهارت بالینی موارد پژوهش رابطه معنی‌داری وجود نداشت. نتیجه­گیری: با توجه به فاصله معنی دار بین امتیازات کسب شده و سطح مطلوب و نیز اهمیت کار کارکنان اورژانس به عنوان اولین پاسخ دهندگان، انتظار می رود که با آموزش با کیفیت تر کلیه ارائه دهندگان خدمات اورژانس 115 قادر باشند خدمات خوب و با کیفیت در حد مطلوب به مددجویان ارائه نمایند.