Payavard Salamat

Designing a Model for Virtual Training of Information Literacy Skills on the Website of Libraries of Medical Sciences Universities in the Country

Nadjla Hariri

Background and Aim: The development of the internet and the digitalization of higher education have facilitated the possibility of online course delivery, enabling instructors and students to interact through virtual education. Virtual learning can enhance access to educational resources and services through communication technologies, regardless of time and location. Accordingly, the objective of this study is to design a virtual education model for teaching information literacy skills on the websites of medical university libraries across the country.
Materials and Methods: This research was conducted with a mixed approach (qualitative and quantitative). In the first stage, the meta-combination method and the study of previous researches were used according to the research topic and the components were extracted, and after several checks with experts, the necessary concepts and components for the design of the model were extracted. Then, using the Delphi method, experts’ opinions were applied to the output of the meta-combination stage, and the final questionnaire was designed and made available to the statistical community, and finally, in the fourth stage, modeling and validation and fitting of the model took place.
Results: The final model was developed using meta-synthesis and validated by experts, comprising 7 main categories, 14 subcategories, and 102 indicators. The main categories include technical factors, strategic factors, instructor-related components, structural factors, educational factors, content-related factors, and assessment and evaluation factors. From the users’ perspective, the content-related subcategory recorded the lowest value, with a score of 0.518 for users and 0.533 for instructors. Conversely, the assessment and evaluation subcategory achieved the highest scores, with 0.916 from the instructors’ perspective, 0.953 jointly from both users and instructors, and 0.842 for structural factors from the users’ perspective.
Conclusion: The results of the research showed that there is a significant relationship between the virtual training of information literacy skills on the website of the libraries of medical sciences universities of the country and the mentioned factors. Therefore, the model obtained in this study can be a basis for designing and compiling a framework for electronic learning of information literacy. Acquiring information literacy skills and fostering an information-literate society is a crucial necessity in the information age, particularly for graduate students whose work and activities are inherently tied to research and problem-solving.

Operating Room Nurses’ Lived Experience of the Challenges Arising after Admitting Emergency Patients: A Phenomenological Study

Behzad Imani

Background and Aim: Today, an important part of the surgeries performed in the operating room are emergency surgeries. Surgeries are generally necessary in the face of acute life-threatening conditions. Today, due to the increase in the number of emergency surgeries performed in hospitals and the challenging nature of these surgeries, several problems have arisen in the operating room. This study aimed to explain the lived experience of operating room nurses of the challenges that arise following the admission of emergency patients.
Materials and Methods: This research is a qualitative study that was conducted using descriptive phenomenology in 2023 in all hospitals affiliated with Hamadan University of Medical Sciences. The samples of this study were selected using purposeful and snowball sampling. In this research, data were collected through 10 semi-structured interviews with operating room nurses. The data obtained were analyzed to determine the main and sub-categories using Colaizzi’s method
Results: The results of this study showed that the average age of the participants was 46.2 years and their average work experience was 18.5 years. After analyzing the interviews, it was found that the challenges arising from the admission of emergency patients from the perspective of the experiences of operating room nurses are classified into three main themes and 10 subthemes. The main themes of this study include operating room supplies and infrastructure (structural limitations of the operating room, provision of human resources for emergency surgeries, provision of equipment and tools required for surgery, and negligence in providing timely medical services), clinical risks during surgery (threat to patient safety, disregard for observing the principles of sterility and the patient's unique physical condition), and coordination and communication (unconstructive interaction of the surgeon with staff, unusual behaviors of companions in the operating room, and insufficient support for the patient by others).
Conclusion: To prevent challenges, early identification is essential. By planning and implementing preventive measures, improving nurse training, improving infrastructure, and strengthening interdisciplinary collaboration, we can improve the quality of emergency surgical procedures and increase patient satisfaction.

Presenting a Simulation Model to Optimize the Patient’s Movement Flow and Length of Stay (Study Case: In the Emergency Department of a Selected Specialized Hospital in Zahedan City)

Farzad Firouzi Jahantigh

Background and Aim: The emergency department of the hospital is considered one of its main entrances; which has provided health care and treatment for critical and non-critical patients and faces various health and treatment restrictions, but the main emphasis is always on resource limitations. Many simulation projects were implemented in hospitals and first in emergency departments with the aim of increasing productivity. The present research is a general description of the patient’s movement flow and length of stay in the emergency department of a selected specialized hospital in Zahedan city. The aim of the current research is to prevent care complications, reduce waiting time and patient stay in the emergency department, present a simulation model and improve it based on discrete-event simulation.
Materials and Methods: Using the data bank of the emergency department system based on the required data and also through the in-person observation of the data related to the duration of the patient’s stay in the emergency department, including the arrival time, waiting time, The type of services provided to the patient, the time of service and the time of departure were collected and checked and confirmed by experts related to this field so that it has the highest level of reliability with the facts. The data were designed in Excel software, and then data analysis and simulation model creation were done using Aren V14 software, and according to the results, the effect of the proposed solutions was evaluated.
Results: The findings of the present research showed that the longest queue created in the emergency department of the selected specialized hospital in Zahedan city is related to medical examination and additional tests. By implementing the simulation model and testing different solutions, solution 3, which means adding one nurse to nursing consultation and one person to radiology, has the most optimizing effect on the performance of the system at different levels of the patient admission process. and the cost of its implementation is more than solutions 1 and 2. This solution created a 14% decrease in the average length of stay and a 28% decrease in the average duration of additional tests.
Conclusion: The use of queuing models and simulation techniques improve the performance of the system and their implementation has significant effects on reducing the waiting time and length of stay of patients in the emergency department, increasing the quality level of the process of monitoring patients. It leads to optimal management of resources and increased productivity.

Body Identity in Women with Breast Cancer

Narges Nikkhah Ghamsari

Background and Aim: Breast cancer treatment is associated with changes in women’s bodies. Changes that are related to their femininity in addition to the appearance aspect and can face challenges in the part of women’s identity that is related to their body. This research deals with the process of changes in women’s physical identity in the context of culture and society
Materials and Methods: A qualitative method was used for the research, and in this regard, in-depth and semi-structured interviews were conducted with 15 women from Tehran who had undergone treatment for breast cancer, along with 5 companions who were alongside the patients during their illness, and 3 surgical doctors. The interviews focused on the experiences, emotions, and actions of the women in response to bodily changes. Sampling was conducted through purposive and snowball sampling methods. The thematic analysis technique developed by Braun and Clarke was employed for analyzing the interviews.
Results: The participating women were aged 27 to 65 years, with 8 holding bachelor’s degrees or higher. Seven women were housewives, 8 were employed, and 13 had undergone mastectomies. The main themes identified include changes in the female body, societal challenges, disruption of body image, support and companionship, economic constraints, and the redefinition of body image. These themes explain the process of women’s coping with bodily changes. Following bodily changes, women face challenges from society. Society judges women’s bodies after these changes and views them negatively. Furthermore, women experience dissatisfaction with their bodies, perceiving them as inadequate for fulfilling feminine roles and responsibilities as wives and mothers. However, over time, through acceptance of the changes and body management, women strive to reconstruct their body image. In addition, the women’s economic situation and the support and companionship of those around them—manifesting as acceptance of the bodily changes and emotional support—can facilitate the acceptance of these changes.
Conclusion: Given the importance of the body in defining femininity, women, after experiencing breast cancer, face not only the suffering of the disease but also identity challenges. Therefore, breast cancer treatment, alongside clinical interventions, requires societal awareness of how to interact with affected women.

Challenges and Obstacles in Providing Healthcare Services to the Nomadic Populations, with a Focus on Strengthening the Network System in Khouzestan Province, Iran: A Qualitative Approach Addressing Internal and External Factors

Nayeb Fadaei Dehcheshmeh

Background and Aim: The fundamental right and most valuable asset for all strata of society is the enjoyment of health. Individuals residing in nomadic settings face geographical, social, cultural, and linguistic barriers when seeking access to essential services. The provision of healthcare services to nomads has become a complex issue due to the nature of the lifestyle. The aim of this study was to assess the challenges in the provision of healthcare services among the nomads in the Khuzestan province.
Materials and Methods: This study uses a qualitative approach, involving seventeen managers and staff from health centers affiliated with Ahvaz University of Medical Sciences. The data collection approach was inductive. Data were gathered through individual interviews, and participants’ opinions were recorded. The data were analyzed using the conventional content analysis method with a mixed approach (deductive and inductive). The credibility and quality of the data were assessed using the Guba and Lincoln method.
Results: The challenges in providing healthcare services in nomads were identified in nine categories and three overarching themes. The themes encompassed the nature and characteristics of the non-sedentary populations, the healthcare system, and the responsibilities of other sectors. The nature and characteristics of the nomads were categorized into five categories: demographic, cultural, climatic-geographic, socio-ethnic-tribal, and lifestyle. The healthcare delivery comprises of two aspects: structural and procedural. Additionally, the duties of other development sectors were categorized into two categories: infrastructures and inter-sectoral collaborations. The results showed that nomads face barriers to receiving healthcare due to the inherent characteristics of them, the healthcare system, and the performance of other organizations. The unstable population, cultural diversity, scattered distribution of the population, and their ethnic and migration-based lifestyle are among the inherent characteristics of nomads that impact the provision of services.
Conclusion: The provision of health services to nomads is influenced by recipients’ and providers’ characteristics. Decision-makers and managers, considering the unique conditions of life in the design and implementation of health programs, decision-makers and managers should prioritize strengthening healthcare networks in hard-to-reach areas. Given the limited resources and infrastructure weaknesses in settlements, inter-sectoral collaboration and the development of resources and infrastructure (applying the One Health approach) are important.

Mapping of Iran’s Red Crescent Society Research Problems based on Synonym Analysis of Scientific Outputs

Reza Dehkhodaei

Background and Aim: The Iranian Red Crescent Society (IRCS) is recognized as one of the ten most powerful national societies among the Red Cross and Red Crescent societies globally in responding to disasters and emergencies. The purpose of this study is to outline the research topics of the Iranian Red Crescent Society by analyzing its scientific outputs over the past years.
Materials and Methods: The research is of an applied type with a scientometric approach and bibliometric analysis, which uses event network visualization techniques and synonym analysis. The statistical population of the study included all research conducted by the Iranian Red Crescent Society and articles indexed in the Scopus database since the 1990s. The synonym analysis of research titles conducted in the organization and article abstract information and data visualization techniques were used with VOSviewer, NVIVO, WordCloud and iThoughts software.
Results: The trend of publishing research outputs has been upward. Analysis of outputs showed that Shiraz University of Medical Sciences had the highest output and the Gastroenterology and Liver Research Center and Isfahan University of Medical Sciences had the lowest output among the 10 most active institutions. Also, the Iranian Red Crescent Medical Journal had the highest output, and among the topics related to outputs, the field of medicine was ranked first and the field of Multidisciplinary was ranked lowest. Among the frequently used words, “human” was ranked first. Identifying and drawing a map of research issues for this organization showed that the problem-oriented research topics of the Red Crescent Society were categorized into nine main areas, among which relief and rescue was ranked first with 21.4% and technology and innovation was ranked lowest with 4.6%.
Conclusion: The study of the scientific and research outputs of the Iranian Red Crescent indicates the breadth and diversity of research issues in the subject areas raised. The status of research conducted in the map of Iranian Red Crescent issues by comparing the keywords showed that the research performance of this organization is higher in the fields of health services, relief and rescue, and education. Given the breadth of issues commensurate with its missions, it needs balanced growth in research and knowledge production in other areas.

Assessment of the Quality of Smartphone-Based Applications and Games for Teaching Medical Terminology Using the Mobile Application Rating Scale (MARS)

Khalil Kimiafar

Background and Aim: Proficiency in medical terminology is a basic competency of most medical students, which ensures communication with other healthcare providers. Facing the lack of motivation and involvement of students, applications, and games based on smartphones are considered as a possible educational option. Due to the rapid expansion of these applications, a correct evaluation of their quality is often not provided. This study investigated and evaluated the quality of smartphone applications and games for teaching medical terminology.
Materials and Methods: A systematic review was conducted in August 2024, in the official stores of Bazaar and Google Play applications. The two main keywords “medical terminology” and “medical vocabulary” were searched in Persian and English. Two evaluators independently downloaded and evaluated smartphone-based applications and games for teaching medical terminology. The same checklist was used for data extraction. The quality of apps was measured using the Mobile App Rating Scale (MARS). The points of each section, the final score of the retrieved applications, and the mean and standard deviation were obtained.
Results: In total, eighteen programs were included in this study, four of which were games. The average quality of the programs was between 2.70 and 4.30 (average 3.80) on a scale from 1 (inadequate) to 5 (excellent). The best scores are in performance (mean: 3.91), followed by information quality (mean: 3.15). Aesthetics (mean: 2.56) and mental quality of the program (mean: 2.58) had the lowest scores. Two applications offered data privacy, and four had privacy statements. The game ‘Dean Vaughn’ and the application ‘MediTerm’ received the highest overall scores.
Conclusion: This study provides an analysis and description of smartphone-based applications and games for teaching medical terminology to help students and users choose high-quality applications that suit their needs and tastes, and on the other hand, it provides the possibility of identifying research and operational gaps to strengthen and design more effective and better applications for the developers of these applications. The applications evaluated were generally of good overall quality, particularly in terms of functionality and information. However, some applications need to improve aspects such as aesthetics and subjective quality to increase their impact on users and ensure better security and privacy.

Effect of Educational Intervention of Clinical Librarian on Ophthalmology Assistants Skill in Usage of Evidence Based Medicine Information

Fatemeh Sheikhshoaei

Background and Aim: Health librarians can play an important role in meeting the information needs of the clinical team and improving the quality of medical cares. Increasing clinical health literacy and use of Evidence-based medicine among ophthalmology residents is of great importance due to the importance of patients’ health in this field and appropriate decision-making about the individual’s health status. The present study aimed to evaluate the effect of an educational intervention by clinical librarians on the skills of ophthalmology residents in using of evidence-based information at Zahedan University of Medical Sciences.
Materials and Methods: This was a semi-experimental applied study. The research population was ophthalmology residents of Al-Zahra Eye Hospital, Zahedan University of Medical Sciences during the years 2020-2023, who were selected through a census. During a three-month period, 17 combined training sessions (face-to-face and virtual using the Navid system) were held for 18 ophthalmology residents regarding correct search methods from different databases and appropriate use of evidence-based information. To collect data before and after training, a clinical information literacy questionnaire derived from previous studies was used, and data analysis was performed using SPSS software and ANOVA and ANCOVA statistical tests to compare scores before and after training in the intervention group.
Results: The majority of participating residents (55.6%) were female. Before the intervention, 33.3% of the study population had moderate to high levels of knowledge about evidence-based medicine. There was a statistically significant relationship between the total level of knowledge of residents after training and gender (P-value<0.05). Clinical librarian training was effective on the level of basic knowledge of evidence-based medicine, designing clinical questions, searching for clinical evidence, critical evaluation of clinical evidence, and dissemination of evidence-based medical information of residents (P-value<0.05).
Conclusion: Considering the positive impact of clinical librarians’ intervention in improving the level of clinical decision-making knowledge of ophthalmology residents, it is suggested that evidence-based medicine training workshops or courses be held for residents of different disciplines using a variety of educational methods. In addition, it is suggested that evidence-based units be included in the residents’ curriculum and that training be conducted as a team consisting of medical librarians and specialists and ophthalmologist.