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Mohammad Zoladl, Abolfazl Dehbanizadeh, Esmat Nouhi,
Volume 12, Issue 2 (7-2018)
Abstract

Background and Aim: Providing safe healthcare services by medical groups, especially nurses, is a legal and human duty. Planning to prevent errors is of great importance, and the first step in this regard is to identify different types of errors and methods of error management. For this purpose, this study was conducted to examine the procedural and function errors of nurses working in Yasuj Shahid Beheshti Hospital.
Material and Methods: This study is a descriptive, cross-sectional research. The sampling method was complete enumeration and the target population included all nurses working at Yasuj Shahid Beheshti Hospital. The data collection tool was a researcher-made questionnaire. The validity and reliability (0.81) of the questionnaire were confirmed. The data were analyzed using SPSS software version 19.
Results: According to the findings of this study, 79.5% of nurses have procedural error. The most frequent error was the one made in the use of medical equipment in the ward (203 cases). Among the methods of error management, reporting and consulting with colleagues had the highest frequency (151 cases) and reporting to the patient had the lowest (8 cases).
Conclusion: The results showed that procedural and function errors by nurses were high and that nursing managers should organize training courses to identify and deal with nursing errors.
Omid Zadi Akhule, Ehsan Memarbashi, Aysan Judi, Mohammad Hossein Rafiei, Ebrahim Nasiri,
Volume 14, Issue 2 (5-2020)
Abstract

Background and Aim: The sterile technique is the basis of modern surgery. Therefore, sterile technique observance is required by the surgical team to preserve patient safety and prevent surgical site infection. This study was conducted to determine the knowledge, attitude and practice of Surgical Technologists Regarding the Sterile Techniques principles observance in the operating room.
Materials and Methods: This cross-sectional descriptive study was conducted on 198 surgical technologists working in hospitals affiliated to Mazandaran University of Medical Sciences in 2019. Surgical technologists were selected by stratified random sampling. Data collection was performed using the researcher-made questionnaire for the measurement of knowledge, attitude and practice of surgical technologists regarding the Sterile Techniques. The data was analyzed using SPSS software and applying descriptive statistics, Chi-square and t-test.
Results: The mean scores of knowledge, attitude and practice of surgical technologists regarding the sterile techniques, were 35.7±5.8, 28.3±3.7 and 38.7±6.5 respectively. The score of knowledge and practice was moderate and the score of attitude was good. Findings showed that there was a significant difference between knowledge and practice score with educational level and The mean score of knowledge and practice was significantly higher in the participants with bachelor’s degree as compared to the participants with associate degree(p<0.05).
Conclusion: According to the results, it seems necessary to promote knowledge and practice of the surgical team members by implementation of training programs, encouraging staff to upgrade their education and continuing to evaluate their knowledge and practice regarding the sterile techniques.

Omid Zadi Akhule, Mojgan Lotfi, Ebrahim Nasiri, Saba Chalangari, Yasna Torkali Pur,
Volume 14, Issue 6 (1-2021)
Abstract

Background and Aim: In order to improve patient safety, countries are seeking to monitor the safety of health systems and since surgical safety is an important part of patient safety, this study aimed to determine performance of Operating Room Personnel regarding the observance of surgical safety principles.
Materials and Methods: This cross-sectional descriptive study was conducted on operating rooms of hospitals of Mazandaran university of medical sciences in 2019. Research population included 271 personnel of operating room selected via stratified random sampling. Data were collected using demographic characteristics questionnaire and Surgical Safety Checklist of the World Health Organization. The data was analyzed using SPSS software.
Results: The mean scores of performance of surgical technologists in the circulating and scrub roles and anesthesia technologists regarding the observance of surgical safety principles, were 23.2±3.1, 18.4±3 and 28.2±3.5 respectively. The performance level of all three specialties was moderate. Findings showed that there was a significant difference between performance score with educational level. The mean score of performance was significantly higher in the technologists with bachelor’s degree as compared to the technologists with associate degree (p<0.05).
Conclusion: Considering that the performance of the participants of the study regarding the observance of surgical safety principles, it was not at a desirable level, thus it is recommended to encourage operating room personnel to upgrade their education and to continue monitoring the performance of them regarding the observance of surgical safety principles.

Mostafa Roshanzadeh, Mina Shirvani, Ali Tajabadi, Mohammad Hossein Khalilzadeh, Somayeh Mohammadi,
Volume 16, Issue 2 (5-2022)
Abstract

Background and Aim: Clinical learning is an important part of the health field, where the student interacts with the environment and applies the learned concepts in practice. Clinical environments such as operating rooms are challenging for students due to their special complexity and can have a negative impact on their learning process. In order to identify students ‘learning challenges in the operating room environment, the present study was conducted to explain students’ experiences in the field of clinical learning challenges.
Materials and Methods: The present qualitative study was performed by contract content analysis method in 2022 in Shahrekord University of Medical Sciences. Fourteen surgical technology students were purposefully selected and data were collected using in-depth semi-structured individual and group interviews and analyzed using the Granheim and Landman approaches.
Results: The participants were interviewed over a period of 5 months. 9 face-to-face interviews were conducted with 14 participants. There were 6 individual interviews and 3 group interviews. The average duration of the interview was 30 minutes. The interviews continued until data saturation and when no new themes or categories were obtained from the interviews. The findings included a theme of “unfavorable learning environment” and three categories of “confusion in learning educational content, improper professional behavior of staff and insufficient self-confidence”. The main challenge that students faced in the field of clinical learning was the unfavorable learning environment. Conditions such as confusion in learning educational content, improper professional behavior of staff and insufficient self-confidence experienced by the students in the operating room, cause the students to find the learning atmosphere in the operating room unfavorable.
Conclusion: Improving the behavior and performance of staff and physicians in accordance with the standards of professional and ethical behavior and its regular evaluation from the perspective of students and other colleagues can play an effective role in maintaining professional conditions. Also, using experienced instructors who have the role of facilitating communication and learning of students in the operating room environment will play an effective role in reducing fear and controlling inappropriate behaviors of staff towards students. Educational officials are advised to solve the existing problems in order to improve the educational atmosphere of the operating room.

 

Omid Zadi Akhuleh, Abbas Dadashzadeh, Aysan Judi,
Volume 16, Issue 5 (12-2022)
Abstract

Background and Aim: Surgical smoke (SS), is caused by the use of high temperature devices such as electrocautery, laser and ultrasonic scalpel, which are used for cutting and coagulation of tissue during surgery, is considered as a serious threat to the health of operating room (OR) personnel. Various studies have identified the workplace safety climate as one of the main causes of the occurrence or prevention of occupational hazards. This study was conducted with the aim of Perceived Safety Climate (PSC) in ORs and its relationship with the awareness of the OR staff about the SS hazards.
Materials and Methods: This cross-sectional study was conducted from April 2021 to July 2022 in the ORs of 26 public hospitals affiliated to Tabriz University of Medical Sciences. In this research, 396 surgical and anesthesia technologists were included in the study by stratified random sampling. Data were collected using a demographic questionnaire, PSC questionnaire and awareness about the hazards of SS questionnaire and analyzed using SPSS software
Results: The knowledge of the OR staff regarding the hazards of surgical smoke was evaluated at a moderate level with a mean and standard deviation of 9.82±4.32 (range 0 to 21). The average knowledge score of surgical technologists (11.1±4.56) regarding the hazards of surgical smoke was significantly higher than the average score of anesthesia technologists (8.75±4.1)(P=0.02). The PSC in the OR was evaluated at moderate level with a mean and standard deviation of 62.15±11.1 (range 19 to 95). The results of linear regression analysis showed that the effect of PSC in increasing the awareness of OR staff about the hazards of SS was significant (P=0.001). By increasing one score to the total score of the PSC, the awareness score increases by 0.201.
Conclusion: The safety climate of the OR can predict the awareness of the hazards of SS among OR staff. It is recommended to adopt strategies such as educating personnel about the hazards of SS and how to prevent it, creating a suitable supportive environment for personnel, and providing suitable protective facilities to prevent OR staff from being exposed to SS.

 

Fardin Amiri, Arash Khajehvand, Sedigheh Hannani, Nemamali Azadi,
Volume 16, Issue 5 (12-2022)
Abstract

Background and Aim: Surgical site infection (SSI) is one of the most common health-care associated infections. Using proper antiseptic solutions for preoperative surgical site skin preparation (skin prep) is one of the methods to reduce SSIs. The purpose of this study was to compare the effect of preoperative surgical site skin preparation with povidone-iodine and chlorhexidine-gluconate on the rate of SSI in laparotomy patients.
Materials and Methods: A total of 70 Laparotomy surgery patients who referred to Firoozgar hospital in Tehran from May to September of 2021 were included in this clinical trial. Patients were randomly allocated into two groups which were treated with povidone-iodine(PVI) or chlorhexidine-gluconate (CHG) for surgical site skin prep. Skin prep was done with standard rotational method in two steps by the researcher for each group by using of PVI and CHG. SSI incidence was assessed by a researcher-made check list and also over post-surgical follow up visits by the surgeon. We used Fischer’s exact test, t-test, Chi-square and Cochrane’s Q-test to analyze the collected data.
Results: SSI was seen in five patients (14.29%) of PVI group and one patient (2.86%) of CHG group. Although the SSI incidence in PVI group was 5.54 times more than CHG group, still the difference wasn’t statistically significant (P=0.198). Comparing the incidence of SSI’s in 24 hours after surgery (0%) and 30 days after surgery (8.57%) in both groups revealed that using these antiseptics for skin prep was effective in preventing SSI (P<0.001). SSI incidence was also associated with two days of patient’s hospital admission time (P=0.001).
Conclusion: The result of this study revealed that the occurrence of SSI in PVI group was 5.54 times more than CHG group. However, the difference was not statistically significant. So both of these antiseptics can be used for surgical site skin prep.

 

Sedighe Hannani, Nazanin Sarraf Shahri, Asma Feizy Dehkharghani, Najme Samii, Azar Arab Khazaie, Azin Arab Khazaie, Kiarash Kamboozia,
Volume 17, Issue 3 (8-2023)
Abstract

Background and Aim: Virtual networks have become one of the most influential tools in people’s lives, affecting various aspects of life. In medical sciences, with numerous advancements, the use of virtual networks is increasing. However, virtual networks can lead to wastage of students’ time and a reduction in study hours, which negatively impacts their knowledge and practical skills. Therefore, this study aimed to investigate the impact of using virtual networks on the knowledge and practical skills of surgical technologist students.
Materials and Methods: This descriptive-analytical study was conducted on 60 students in the 6th and 8th semester of operating room technology at Iran University of Medical Sciences in 2020-2021. At the end of the semester, the students underwent a comprehensive 40-question theoretical exam to assess their theoretical knowledge. To evaluate the level of virtual network usage, the students filled out a researcher-designed questionnaire. The practical skills of the students were measured based on their internship grades. Normality of the data was assessed using the Kolmogorov-Smirnov, and Pearson correlation coefficient test. Data analysis was performed using SPSS software.
Results: According to the findings of this study, there was a significant negative relationship between the level of virtual network usage and theoretical knowledge (P<0.05). This means that with an increase in virtual network usage, the level of students’ knowledge decreased. On the other hand, there was a significant positive relationship between theoretical knowledge and practical skills. This means that as the scores of the comprehensive exam increased, the scores of practical skills (internship) also increased. However, no significant relationship was found between the level of virtual network usage and students’ practical skills (P>0.21).
Conclusion: Based on the findings of this study, virtual networks lead to a weakening of students’ theoretical knowledge, as evidenced by the decrease in scores on the researcher-designed questionnaire (level of virtual network usage) and the comprehensive exam scores. Another result of the study was the significant positive relationship between theoretical knowledge and practical skills, indicating that as the comprehensive exam scores increased, the scores obtained in internships also increased.

Samaneh Dehghan Abnavi, Afshin Karami Varnamkhasti , Mostafa Roshanzadeh, Fatemeh Kazemi Najafabadi,
Volume 17, Issue 3 (8-2023)
Abstract

Background and Aim: Communication skills are considered as the most important feature required for health care workers and provide the basis for the development of professional ethics. Since working in the operating room requires team effort and establishing communication between team members, the importance of communication skills in operating room nurses is more visible. Therefore, in the present study was performed, with the aim of determining the effect of virtual training on the principles of professional ethics on communication skills of operating room staff of Ayatollah Kashani and Hajar hospitals of Shahrekord University of Medical Sciences.
Materials and Methods: A quasi-experimental study with a single-group plan before and after in 2020 was performed on 35 operating room staff of Kashani and Hajar teaching hospitals in Shahrekord who were selected by random sampling. Demographic information questionnaire and Queen Dam communication skills questionnaire were used to collect the data. Data analysis was performed by SPSS software using independent t test, Analysis of variance, paired t-test and ANOVA statistics.
Results: Paired t-test showed that the mean of communication skills after the intervention was significantly different from before (P<0.001). The mean of communication skills before the intervention was 65.85±24.52 and after the intervention was 139.77±5.70. No significant relationship was reported between communication skills and age, service history and number of working hours (P>.0.05). Also, there was no significant difference in the average of communication skills according to the variables of gender, marital status, field of study and degree (P>0.05).
Conclusion: The present study showed that professional ethics training was able to improve the communication skills of employees. Therefore, it seems necessary to compile virtual professional ethics training for health care providers and other groups providing health services who do not have enough time to participate in face-to-face classes. According to the results obtained, managers of health systems are recommended to use strategies such as holding workshops on the principles of professional ethics to develop communication skills in their employees.



Maryam Bahrami, Somayeh Mohammadi, Mostafa Roshanzadeh, Samaneh Dehghan Abnavi, Ali Taj, Fatemeh Maraki,
Volume 17, Issue 4 (10-2023)
Abstract

Background and Aim: Operating room students have experienced anxiety for various reasons that affect their educational process such as stitching. Due to the effective role of simulation in improving the education of students, this study was conducted with the aim of the effect of animal skin suturing simulation on the skill level and anxiety level of operating room students.
Materials and Methods: In this study, 30 people (75%) of the samples were aged 18-25 and 10 people (25%) of them were 26-35. 10 people (25%) were men and 30 people (75%) were women. Also, in terms of marriage, 7 people (17.5%) were married and 33 people (82.5%) were single. The present quasi-experimental study was performed with a two-group plan before and after with 40 operating room students of Shahrekord University of Medical Sciences (Shahrekord, Broujen) in 2020. The samples were randomly assigned to two test and control groups using the method based on the purpose of selection. Data were collected before and after the intervention by Spielberger Anxiety Tool and Suturing Skills Questionnaire and analyzed by SPSS software and descriptive and analytical statistical tests (Chi-square test, t-test, paired t-test).
Results: The t-test test showed that the mean of obvious anxiety in the intervention group (36.35±10.22) and the control group (41.15±7.92) after the intervention was not significant (P=0.346). Also, the mean hidden anxiety in the intervention group (36.65±10.47) and the control group (38.65±6.13) had no significant difference (P=0.089). The t-test test showed that there was a significant difference in sewing skills after the intervention in the two intervention groups (28.2±58.22) and the control group (23.42±3.12) (P=0.04).
Conclusion: The texture of suture mannequins is very different from human skin in terms of consistency, and it does not convey the same feeling of sutures on natural skin to students. On the other hand, it is easier to enter and exit and move the needle and thread in the sheepskin, and this provides the students with the possibility of stitching more easily. Therefore, it is suggested to buy and prepare sheep skin for training students and teach them stitches on it.

Sedigheh Hannani, Parsa Farmahin Farahany, Fardin Amiri,
Volume 18, Issue 3 (7-2024)
Abstract

Background and Aim: The usual trainings are not enough to acquire the knowledge and skills of operating room students to play the role of scrub and mobile person, especially in complex and specialized surgeries. This research was conducted with the aim of determining the effect of designing, implementing and evaluating the protocol before, during and after Whipple surgery and its effect on the knowledge, attitude and clinical skills of surgical technology students of Iran University of Medical Sciences.
Materials and Methods: This research was a semi-experimental study of pre- and post-intervention type, during which 50, fifth and seventh semester undergraduate students of surgical technology were selected and trained using the designed protocol.  The content of the protocol included the latest principles of Whipple surgery technology in the field of surgical anatomy, pathology of the digestive system and pancreas, diagnostic procedures and preparations before Whipple surgery, the procedure of Whipple surgery and the post-surgery phase and the recovery period of Whipple surgery.  Before and after the training, the amount of knowledge, attitude and clinical skills of the students were evaluated and compared using a questionnaire and an observational checklist.  The data were analyzed using paired t-test, non-parametric Wilcoxon test and analysis of covariance test in SPSS software.
Results: The results of this study showed that after using the designed educational protocol, the knowledge, attitude and clinical skills of surgical technology students increased. That is, the use of the designed educational protocol was effective on the level of knowledge, attitude and especially the clinical skills of the students. So that a statistically significant difference was observed in the average scores of the knowledge, attitude and clinical skill test of the students before and after training (P<0.05).
Conclusion: Based on the results of this study, designing and using educational protocols is an effective method in the process of teaching and evaluating the level of knowledge, attitude and clinical skills of students in complex and specialized surgeries such as Whipple surgery. Therefore, the use of educational protocols designed in the process of teaching students is recommended to all professors and educational officials of surgical technology.

Alireza Jafarkhani, Behzad Imani, Sina Ghasemi,
Volume 18, Issue 4 (10-2024)
Abstract

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.

Mohammad Ghasembandi, Samaneh Dehghan Abnavi, Negin Larti, Foziye Hamoole Tahmasbi, Jaber Zabihirad,
Volume 19, Issue 1 (4-2025)
Abstract

Background and Aim: Low back pain (LBP) is one of the most common musculoskeletal disorders among operating room nurses, and numerous studies have well explained its causes and factors. However, studies focusing on the characteristics and dimensions of low back pain and its relationship with influencing factors have not been conducted. Therefore, the aim of this study was to investigate the prevalence of the type of LBP, duration of back pain, and severity of back pain, and their relationship with the demographic characteristics of operating room nurses.
Materials and Methods: This cross-sectional study was conducted on 350 operating room nurses at Ahvaz teaching hospitals in Iran in 2023. Data were collected using a questionnaire that included demographic information and LBP characteristics. Data were analyzed using IBM SPSS.
Results: 64.8% of the subjects were female, 63.5% were married, and their mean age was 33.83±7.02 years. The prevalence of LBP among operating room nurses was 74.3%. In 60.7% of participant who have LBP, the first experience of back pain was in the past 5 years. The most common diagnosis of LBP was muscular disorders (29.9%). Also, 57.3% of them had pain only in the lower back and 42.7% of them had LBP radiating to the legs. We found no statistically significant relationship between the duration and severity of LBP and demographic characteristics (P<0.05). A statistically significant relationship was found between the type of LBP and gender and level of education, as well as between the duration of LBP and severity of LBP (P<0.05).
Conclusion: The findings of this study showed a high prevalence of LBP among operating room nurses, and differences in the type of LBP were observed based on gender and educational level, which may be attributed to individual factors. Additionally, the significant relationship between the duration of LBP and its severity may indicate the effect of the long duration of LBP on its severity, which suggests that providing counseling and treatment programs for nurses who are in the early stages of LBP.

Fatemeh Najafi, Hooman Shahsavari, Golnar Ghane, Zahra Zare,
Volume 19, Issue 3 (9-2025)
Abstract

Background and Aim: Ensuring the quality of care and maintaining patient safety are fundamental challenges within the nursing profession. Having a culturally relevant and valid tool to assess the phenomenon of “missed nursing care” can significantly assist in identifying actions and conditions that result in negative patient outcomes or situations where care is inadequately provided. Therefore, the aim of the present study was to culturally adapt and validate the Iranian version of the Missed Care Survey tool.
Materials and Methods: The translation and psychometric testing were carried out in six stages: 1) translation from the original language to the target language, 2) comparison of the two translated versions, 3) back-translation, 4) comparison of the back-translated versions with the original, 5) pilot testing of the pre-final version with a monolingual sample, and 6) full psychometric validation of the pre-final version. These stages were conducted with a sample of 330 nursing staff from hospitals affiliated with Tehran University of Medical Sciences.
Results: A total of 330 participants were included in the present study, the majority of whom were female and worked rotating shifts. Approximately half of the participants were aged between 25 and 34 years, and the longest duration of employment in the nursing profession was more than ten years (100 participants, 30.3%). In addition, more than half of the participants held a bachelor’s degree in nursing, and the majority worked more than 30 hours per week (316 participants, 95.8%).The Cronbach’s alpha for the entire instrument was 0.89, and for the subscales of Part B it ranged from 0.79 to 0.93. Moreover, the test–retest correlation coefficients for Part A (missed nursing care, including a list of nursing activities) and Part B (reasons for missed nursing care) were 0.83 and 0.80, respectively. The results of confirmatory factor analysis indicated an acceptable and satisfactory model fit for the three-factor structure of Part B based on overall goodness-of-fit indices. Collectively, these findings provide evidence for the instrument’s robust construct validity and reliability, supporting its suitability for assessing missed nursing care in clinical settings.
Conclusion: Given the critical role of nurses in the healthcare system, providing high-quality and safe nursing care becomes increasingly important. The growing diversity of populations worldwide highlights the pressing need for researchers and healthcare providers to access valid tools across different cultural groups and languages. The Iranian version of the “Missed Nursing Care Survey” is a reliable tool with acceptable internal consistency, good test-retest reliability, and sufficient validity due to its correlation with the original version. Therefore, this tool can be utilized in studies aimed at generating deeper insights into the factors influencing or moderating this complex phenomenon. 

Zahra Ataei Barazandeh, Behzad Imani, Erfan Aubi, Elham Soltani, Mohamadreza Ebadian,
Volume 19, Issue 3 (9-2025)
Abstract

Background and Aim: Cataract surgery is one of the most common eye surgeries worldwide. Most individuals undergoing this surgery are elderly patients, and the use of general anesthesia and additional medications can lead to complications during and after the surgery, as well as increased costs for patients. Therefore, the present study aimed to investigate the effects of intravenous Dexmedetomidine and Fentanyl, as well as Midazolam and intravenous Sufentanil, on pain intensity, hemodynamic status, surgeon satisfaction, and the level of sedation in patients undergoing cataract surgery.
Materials and Methods: This double-blind clinical trial was conducted on 80 patients who were candidates for cataract surgery at Farshchian Sina Hospital in Hamadan. Sampling was carried out from March 10, 2023 to August 21, 2024. The intervention group received Dexmedetomidine and intravenous fentanyl, while the control group received midazolam and Sufentanil. Blood pressure, heart rate, and oxygen saturation level, were measured. Pain intensity, surgeon satisfaction, and the level of sedation in patients were measured and recorded. The results of the research utilized qualitative and quantitative variables based on the study groups, using counts (percentages) and means (standard deviations). For the statistical analysis of these variables at baseline, chi-square tests and independent t-tests were employed. To assess the impact of treatment groups on pain throughout the study, repeated measures ANOVA was used, and the interaction between time and group was evaluated. In cases where the outcome variable under study was not normally distributed, non-parametric equivalents such as the Mann-Whitney test were applied. A significance level of P-Value<0.05 was considered. All statistical tests were conducted using Stata software.  
Results: In the intervention group, heart rate and blood pressure decreased over time. Changes in heart rate and blood pressure had no effect on the patients’ recovery process. Oxygen saturation level in the intervention group did not change compared to the control group over time. The medication used in the intervention group did not cause shortness of breath or a decrease in oxygen saturation levels. Additionally, there was no significant difference in pain levels between the two groups. The level of sedation in patients and surgeon satisfaction in the intervention group was higher than the control group.
Conclusion: Based on the results of the research, it is recommended to use Dexmedetomidine in cataract surgery and other surgeries that require sedation.

Mahnaz Moghadari Koosha, Iraj Salehi, Elaheh Mousavi, Mohammad Reza Safari, Nasim Alipour, Hossein Vakili Mofrad,
Volume 19, Issue 4 (11-2025)
Abstract

Background and Aim: The hidden curriculum is considered the most powerful means of transmitting professional values. Given the critical importance of managing the hidden curriculum to institutionalize professional ethics and professionalism within health higher education institutions, the present study was conducted to explore the perceptions of operating room and anesthesia students and instructors regarding the impact of the hidden curriculum on the promotion of professional ethics.
Materials and Methods: This study was conducted using a qualitative approach based on conventional content analysis. The study population included final-year students and instructors from the operating room and anesthesia disciplines at Hamadan University of Medical Sciences. Participants were selected through purposive and theoretical sampling methods. Data were collected via in-depth, semi-structured interviews. Data saturation was achieved after conducting 24 interviews. The data analysis followed the qualitative content analysis approach proposed by Graneheim and Lundman (2004), and was carried out in seven steps: 1. familiarization with the data, 2. identification of meaning units, 3. initial coding, 4. formation of subcategories, 5. development of categories, 6. extraction of themes, and 7. final review.
Results: The content analysis of the interviews resulted in the identification of 456 initial codes. Following refinement and consolidation, these codes were organized into four overarching categories and ten subcategories. The main categories comprised: ‘Components of the hidden curriculum in professional ethics education’, ‘Mechanisms through which the hidden curriculum exerts influence’, ‘Consequences of the hidden curriculum’, and ‘Strategies for enhancing professional ethics’. The findings indicated that the hidden curriculum, manifested through the behavioral patterns of faculty members and instructors, organizational culture, and interpersonal interactions, plays a pivotal role in shaping students’ ethical attitudes and behaviors. Furthermore, the hidden curriculum, through processes of unconscious learning, reinforcement or erosion of formal values, and the manner in which rules are implemented, can yield both positive outcomes—such as the development of ethical decision-making skills—and negative outcomes, including diminished ethical sensitivity.
Conclusion: This study revealed that the hidden curriculum in operating room and anesthesia education functions as a dual-force phenomenon. On one hand, it fosters the development of professional ethics through constructive role modeling and authentic clinical experiences. On the other hand, it can contribute to ethical erosion by conveying contradictory messages and unhealthy norms. Achieving sustainable ethical learning requires active management of the hidden curriculum through three key strategies: aligning the formal and hidden curricula, empowering instructors as agents of ethical value transmission, and shifting the organizational culture paradigm toward learning from error.

Maryam Amirshekari, Seyyedeh Maryam Seyyedi, Faeze Fakhri, Mohsen Yaghmaei,
Volume 19, Issue 4 (11-2025)
Abstract

Background and Aim: Shift handover is one of the key processes in clinical settings, during which patient care is transferred from one healthcare team to the next. Weaknesses in this process—particularly in high-pressure environments such as operating rooms—may lead to reduced quality of information transfer and staff dissatisfaction. This study aimed to determine the effect of the standard SBAR communication model on the quality of the shift handover process and the satisfaction of operating room personnel.
Materials and Methods: This quasi-experimental study with a pretest–posttest design was conducted in 2023 at Imam Khomeini Hospital in Jiroft. Sampling was performed using a census method, and a total of 66 operating room staff members participated in the study. The intervention consisted of a two-hour training session (including theoretical and practical components) on the SBAR model. Data were collected using the standard CEX checklist to assess handover quality and a modified version of the Petrovic questionnaire to evaluate staff satisfaction. The validity and reliability of the instruments were confirmed. Data analysis was performed using SPSS and paired t-tests. A significance level of less than 0.05 was considered.
Results: The study participants included 66 operating room staff members, comprising 39 women and 27 men, with a mean age of 30.2±2.45 years. The mean score of shift handover quality significantly increased after SBAR training, rising from 73.80±13.99 before the training to 102.18±10.69 after the training, which corresponds to an improvement of approximately 20.9% relative to the total score range of the instrument (P<0.001). Furthermore, staff satisfaction with the shift handover process also improved, increasing from 37.85±4.77 to 42.41±4.76, representing an improvement of approximately 11.4% relative to the total instrument score range (P<0.001). These changes indicate the positive impact of SBAR training on both the shift handover process and the staff experience.
Conclusion: The findings indicated that training and implementation of the SBAR model were associated with significant improvements in handover quality and staff satisfaction. These results suggest that using structured communication tools may help improve certain aspects of the handover process. However, due to the lack of a control group and the short follow-up period, it is not possible to draw firm conclusions about the long-term effects of the intervention. Therefore, SBAR-based training may be considered as a recommended option; however, further studies with stronger designs and in diverse clinical settings are needed to more accurately evaluate its outcomes.

Parsa Farmahin Farahany, Maryam Amirshekari, Mohsen Yaghmaie,
Volume 19, Issue 5 (12-2025)
Abstract

Background and Aim: Designing a standard surgical preference card and implementing it in the operating room environment can partially solve the problems related to the variety of surgical procedures and the preparation of tools and equipment required for each surgical procedure. The present study aimed to determine the effect of designing and implementing surgical preference card software on the clinical skills of operating room students at Jiroft University of Medical Sciences.
Materials and Methods: This study was a semi-experimental intervention study in which 70 operating room students from the 4th, 6th, and 8th semesters of the undergraduate operating room program were selected through a census method and were trained using educational software designed by the researcher. Before and after the training, their clinical skills were assessed using a researcher-made questionnaire and checklist. To confirm the validity of the questionnaires and the researcher-made checklist, the opinion of an expert panel (12 expert faculty members) and the consensus of peer reviewers were used. Then, the data were analyzed in SPSS software using descriptive statistics, paired t-test, nonparametric Wilcoxon test, and analysis of covariance test.
Results: According to the research findings, the use of the designed software was effective on the clinical skills of operating room students. Based on the results of the Willcocson tests, a significant difference was observed in the mean scores of the students’ clinical skills test before and after implementing the designed software. The results of the study showed that the clinical skill scores of the students increased after using the software. The maximum scores of the samples are calculated from 100 points. The average clinical skill score of the subjects in the study increased from 40.98 before the educational intervention to 92.36 after the intervention, and the students had a higher level of skill in preparing the items and tools needed by the surgical team in all three stages before, during, and after surgery. Also, in the study, no relationship was found between any of the demographic variables studied, such as age, gender, and academic semester, and the clinical skills of the study members (P<0/05).
Conclusion: Based on the results of the present study, the design and use of surgical preference card software in training procedure of operating room students has had an impact on improve their clinical skills. Therefore, the design and use of educational software in the field of anticipating the needs and preparing the requirements of each surgical procedure is recommended to all professors and officials in the operating room field. 


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