jamshid bahmaei

Since medical care providers are faced with complex issues in their profession, one of the important skills in making correct clinical decisions is critical thinking. Therefore, one of the standards of medical education is to instill critical thinking in students.

The present study was a cross-sectional descriptive-analytical study. Data was collected using a demographic questionnaire and the standard California B questionnaire. Mann-Whitney test was used to make comparisons, and Spearman's correlation coefficient was used to check the correlation between the data.

The findings showed that the average critical thinking score of the participating medical students was 8.05 (± 2.6). Also, analysis and inference had the highest 2.5 (± 1.58) and lowest 2.51 (± 1.04) levels of obtainable score, respectively. Critical thinking had a significant positive correlation with all its components (P<0.001). The critical thinking of the participants was not significantly different in terms of gender or university entrance examination regions (P>0.05). The analysis showed that critical thinking has a significant positive correlation with age (r=0.159, P=0.018) but a significant negative correlation with years of education (r=-0.216, P=0.001) and grade point average in the last semester (r=-0.492, P=0.012).

The studied medical students did not have an optimal level of critical thinking, which is necessary for making appropriate and effective decisions, and this skill was found to have an inverse relationship with the grade point average and academic years. Therefore, it can be argued that the current educational system in the university has not been able to enhance this vital skill among medical students.

Critical thinking and progress orientation are effective in developing entrepreneurial traits in undergraduate students. Therefore, this study was conducted with the aim of investigating the relationship between critical thinking tendency and progress goal orientation with entrepreneurial traits among students of Abadan University of Medical Sciences.

The present study was a descriptive-analytical study. The statistical population of the study was the undergraduate students of Abadan University of Medical Sciences in 2022and 139 respondents were randomly selected. The research instruments included three questionnaires on critical thinking tendency, goal orientation of progress and measurement of entrepreneurship characteristics. To analyze the data from descriptive statistics (mean and standard deviation) and analytical statistics (two-sample t-tests (Mann-Whitney), analysis of variance (Kruskal-Wallis), correlation coefficient according to Pearson or Spearman) , the software SPSS. 26 was used with a significance level of 0.05.

A statistically significant correlation was found between the variables of entrepreneurial characteristics and goal-progress (P-value<0.001). In addition, a statistically significant correlation was found between the variables of the entrepreneurial characteristics and the tendency to think critically (P-value<0.001). The components performance avoidance (P-value <0.001) and performance-orientation (P-value = 0.002) from the variable goal-progress orientation with the components of the entrepreneurial characteristics, the components mental involvement (P-value < 0.001) and maturity (P-value < 0.001) from the variable tendency to critical thinking variable had a statistically significant correlation with the entrepreneurial characteristics.

The results of this study show that tendency to critical thinking and goal-progress orientation are significantly related to entrepreneurial traits. Therefore, students with critical thinking characteristics discover and pursue economic and social situations in a more creative way and have the ability to innovatively choose the best and most effective ways to achieve entrepreneurial goals.

Paying attention to students' growth and academic progress and the related affecting factors are among the necessary strategies to improve education. Students' social health can increase their performance in various fields, including academic motivation and academic progress. Therefore, this study was designed and implemented to investigate the role of social health in the motivation and academic progress of students at Abadan University of Medical Sciences, Abadan, Iran.

The present study was descriptive, analytical, and cross-sectional. The study samples (n=260) were the students of Abadan University of Medical Sciences. The data collection tools included a demographic characteristics form, the Social Health Questionnaire, the Academic Motivation Questionnaire, and the overall grade point average as a measure of academic progress. Data were analyzed at a significance level of 0.05 using SPSS 26 statistical software.

The results of the study showed that in general,  there was no significant correlation between social health and grade point average (academic progress) (P<0.05). It was also found that academic motivation and its components had no significant correlation with academic progress (P<0.05), except for the lack of motivation, which had a significant positive correlation with age and a significant negative correlation with academic achievement (P<0.05). A significant positive correlation was found between social health and academic motivation (r=0.457, P<0.001).

Based on the results, students considered the presence and participation in social groups, as well as their desire and motivation to attend university, independent of academic progress. According to these students, establishing social relationships and interacting with others was the motivation for attending university.

Goal orientation is one of the determining variables in the quality of the learning process and academic progress of people. Therefore, this study was designed and implemented to investigate the relationship between goal orientation and academic achievement among the students of Abadan University of Medical Sciences, Abadan, Iran.

The present study was a descriptive-analytical correlational research that was conducted cross-sectionally in 2022-2023. The sampling method was stratified and clustered. The study sample consisted of 259 students from Abadan University of Medical Sciences. The data collection tool was the Academic Goal Orientation Questionnaire of Buffard et al. (1998), and the students' grade point average (GPA) in the last semester was used as the measure of their academic status. Data were analyzed using SPSS 26 and AMOS 24 software.

The average age of the students was 24.3 (±2.4) years and their average last semester GPA was 16.57 (±1.25). The average score of the failure avoidance component was 20.32 (± 4.11), performance 14.08 (± 5.58), and goal-mastery 9.43 (± 3.82). The correlation coefficient showed that although there was a positive relationship between goal orientation components and academic achievement, it was not significant. The correlation coefficient also showed that the academic semester had a positive and significant relationship with the components of performance orientation and mastery orientation; however, it had a negative relationship with failure avoidance.

According to the results of this study, no significant relationship was found between the three components of goal orientation and academic achievement. It can be suggested that educational planners provide and improve educational conditions in such a way that students move towards mastery and performance goals and move away from avoidance orientation.

The quality of life of the elderly is endangered by their special needs. The present study aimed to investigate the relationship between social support and health-related quality of life among the elderly in Abadan.

This study was conducted based on a descriptive cross-sectional analytical design. The study sample included 138 elderly people in Abadan. Data collection instruments were the SF36 standard quality of life questionnaire and social support questionnaire. Data were analyzed in SPSS software (version 21) using descriptive statistics, independent t-test, Pearson correlation, and regression at a significance level of 0.05.

The results demonstrated that the quality of life of men (91.29±6.2) was higher than women (46.47±22.58), and the difference was significant (P<0.05). The mean score of social support and all three dimensions (support of family, friends, and acquaintances) in older men was higher than in older women. Social support had a significant and direct correlation with health-related quality of life (P=0.01). Social support predicted a 31.8% variance in the quality of life among the elderly.

The elderly had moderate quality of life and social support. The use of counseling, training, and support methods by the family and the community can be effective in improving their health.

As economic resistance is largely defined as the capacity of an economy to improve or adapt to the effects of unexpected, exterior shocks such as COVID-19 pandemic for health systems, the purpose of this study was to identify the economic resistance components of the Iranian health system during COVID-19 pandemic.

This qualitative study was conducted using the content analysis method from 2020 to 2021. The statistical population of the study consisted of health system experts who are familiar with the subject of resistance economy. Using the snowball sampling method, semi-structured interviews with 30 selected participants were done. The reliability and transparency were determined by Guba and Linkon criteria such as credibility, transferability, confirmability, and consistency, or dependability. Data were analyzed using the Clarke and Braun thematic six-step method.

It was found that economic growth, economic stability, justice, and economic resilience, as fourmain components, affected the economic resistance of the health system in COVID-19 pandemic. Each of these components encompasses a number of subcomponents that can help reinforce the health system in two restorative and resilient categories.

To the best of our knowledge, a comprehensive study with an exploratory approach was not retrieved to find the main determinants of economic resistance components in COVID-19 pandemic. The present study can greatly contribute to the available knowledge to guide the policymakers for better understanding of the system during unexpected situations and applying the most applied solutions as well. Itmay help the health systems particularly those who encounter unpleasantmacro-trends and unplanned crises, to keep their preparedness and readiness and improve their resilience.

Accreditation is a process in which a foreign institution systematically measures and evaluates the credibility of an organization in terms of process, outcome, and structural indicators. This study aimed to identify the effective challenges in the implementation of the accreditation process and achieve a comprehensive model to improve and enhance the accreditation process.

This study was performed in two stages. In the first stage, a review of studies was conducted to identify the challenges affecting the implementation of hospital accreditation in Iran. In the second stage, the content validity method was used to recognize the most important challenges affecting the implementation of accreditation. Subsequently, to investigate the relationships among factors and determine the most effective and impressionable variables, quantitative interpretive structural modeling technique was used.

The most effective variables with a driving power of 11 and dependence power of 4 were found to be the lack of necessary infrastructure, nurses, clinical staff, and other personnel; limited resources and capital; not considering the appropriate budget for the implementation of the accreditation program; and non-compliance of some standards with national and provincial conditions. On the other hand, the least influential variables on challenges affecting the implementation of hospital accreditation with a driving power of 1 were reported to be the challenge in the degree of independence, impartiality, personal judgments, and differences of evaluatorschr('39') tastes, as well as the poor patient-medical team communication.

 It is necessary to find the main and effective factors in accreditation and establish a relationship between them to achieve the more effective implementation of accreditation. Therefore, it would be possible to provide a clear framework for determining the best policies to control and manage accreditation and ultimately prevent the waste of resources in the health sector. This research provided new insights into the challenges affecting the implementation of accreditation, which identify the priorities for action in decision-making and policy-making.

Induced demand is an important challenge in national healthcare systems, and can waste their resources. The likelihood of induced demand and the intensity of its effects are the results of an interaction between a wide range of factors. Therefore, this study was designed for structural modeling of the factors affecting induced demand.
This applied study was carried out using a descriptive-analytic design. First, the factors affecting induced demand were identified by a thorough literature review. Then, using interpretive structural modeling (ISM), the relationship between the factors was determined and categorized, and the final model  developed. In addition, using MICMAC analysis, the types of variables have been identified with respect to their driving and dependency power.
Lack of clinical guidelines, increased number of providers, weakness of education system, weakness of Health Supervisory System, poor supervision of insurance companies, improper payment system, providers' insufficient knowledge, skills and clinical uncertainty, defensive medicine, patient preferences, information asymmetry, the collusion of service providers, and their incentives to earn more income were identified as the most important factors affecting management and control of induced demand.
Induced demand reduction requires finding the relationships between the key factors to provide a clear framework for determining the best controlling policies, thereby preventing the loss of healthcare resources. This study provided a new insight into the factors affecting induced demand leading to prioritization of decision-making and policymaking measures.

Accreditation is a method used for the improvement of the quality of hospital services. It refers to the systematic evaluation of the health centers based on specific standards. The present study aimed to critically review the implementation of accreditation standards in hospitals.

This critical review investigated all the articles that were published during 1993-2019. In order to find the sources, the authors referred to various databases, namely ISC, DOAJ, PubMed, ProQuest, Embase, Science Direct, Scopus, and Web of Science. The keywords used for the search included Mesh terms and common keywords related to the subject of the study, including challenges, barriers, hospital management, accreditation, hospital, or accreditation hospital. Finally, the full texts of 16 articles were reviewed for the purposes of the study. 

According to the results, various issues, such as the accreditation organization independence, staff and physician participation, number, structure, and content of standards, structural and contextual problems, importance of human resources, financial and capital resources, organizational and management issues, other plans, role of evaluators and their evaluation methods, role of stakeholders, and impact of accreditation on the patients and teaching atmosphere of the hospital were executive challenges of hospital accreditation.

In order to increase the impact of accredition and significantly address its challenges, there should be emphasis on performance indicators, preparation by training and raising awareness of the personnel, budget allocation, and development of plans on accreditation.

One of the health sector evolution plan's goals is to reduce the rate of cesarean section (C-section) and increase the natural childbirth rate. Therefore, this study aimed to evaluate the rate of C-sections before and after the implementation of the health sector evolution plan in the hospitals affiliated to Abadan School of Medical Sciences, Abadan, Iran.

The study population of this descriptive-analytical study included all hospitals with a maternity ward affiliated to Abadan School of Medical Sciences. The samples were selected using a census method.
The C-section rates were evaluated in 2013 and 2018 to calculate the baseline C-section rate at the beginning and five-year after the implementation of the plan, respectively. In order to investigate the effect of the health sector evolution plan on the mean cost spent by mothers, it was studied in one hospital. The data were analyzed in SPSS  software (version 18) using the Chi-square test, and Paired t-test.

The total C-section rate was 45% as the baseline cesarean rate in 2013, which decreased by 24.44% to 34% during the 5 years after the plan. The mean cost spent by each hospitalized mother was 103342.175 Rials prior to the implementation of the health sector evolution plan which was reduced to 96689.4347 Rials after the implementation of the plan.

According to the results, there was a reduction in the rate of C-sections after the implementation of the health sector evolution plan in hospitals under study. However, regarding the global rate of C-sections, the mean C-section rate is still high in these hospitals.

The learning environment affects the development and growth of a learner in an educational institution. Academic vitality and motivation are among the determining factors of success in the educational system. Consequently, the purpose of this study was to evaluate the academic vitality and motivation of students based on their perception of the learning environment in Abadan School of Medical Sciences, Iran.

This descriptive-analytical study was performed on the study population of all students of Abadan School of Medical Sciences. The sample size was calculated as 283 people and the samples were selected through simple random sampling method. The data were collected by the researchers using the questionnaires of learning environment evaluation and academic vitality and motivation. All the data were statistically analyzed by Pearson’s correlation test and regression test utilizing the SPSS software version 18.

Our findings demonstrated that there was a positive correlation between learning vitality and the perception of students of the learning environment. Moreover, the perceptions of students of the learning environment could be predictive of their educational vitality and academic motivation. All the components of the perception of students of the learning environment were able to predict the vitality of students. It should be noted that among the components of perception of the learning environment, only the aspect of the perception of the educational environment had a significant role in predicting academic motivation.

According to the results of the present study, a better understanding of students of the learning environment leads to higher motivation toward academic achievement in diverse educational and research fields. Furthermore, the improvement of the learning environment enhances the academic vitality of students in terms of responding to the confronted challenges and obstacles in educational environments.

Intellectual capital is the key factor in value creation for organizations. Social responsibility means taking some measures for the improvement of  the community welfare beyond the interests of the organization and legal requirements. To researchers, ethical behavior in the organization means acting in ways consistent with the ethical values of the organization. In this regard, this study was conducted to determine the relationship between intellectual capital and social responsibility and its relationship with the professional ethics of faculty members of the Faculty of Medical Sciences of Abadan, Iran. This research was descriptive-correlational. The required data were collected from 78 people using census method. To this end, information was collected by researchers using intellectual capital, social responsibility, and ethical behavior questionnaires. Finally, the data were analyzed using SPSS software, Pearson correlation coefficient, and regression tests. There was a positive and significant relationship between intellectual capital and all its subscales with the ethical behavior of the faculty members (P<0/05). According to the results, all components of intellectual capital were able to predict ethical behavior. Furthermore, a positive and significant relationship was found between social responsibility and all its subscales with the ethical behavior of faculty members and all components of social responsibility were able to predict ethical behavior. The faculty members with high intellectual capital and social responsibility will show more ethical behavior in educational and research activities. Therefore, they will improve the level of the university and the scientific community of the country.

The hospital is a significant part of health systems that presents a complex and vital services. Therefore, performance management of hospitals should be considered especially. BSC model is so helpful and popular for performance management. In using BSC, cause and effect relations is very important, since it helps to apply non-financial to forecast financial performance.
This study aims to analysis systematic relations between key indicators of hospital performance evaluation, identifying causal relations and prioritizing indicators.
Based on the 4 perspectives described by the balanced scorecard (BSC), the evaluation indicators of hospital performance and key performance indicators (KPIs) were adopted from the related literature and selected by experts’ panel, respectively. Then, the decision making trial and evaluation laboratory (DEMATEL) method was employed for the determination of the cause-and-effect relationships between the indicators, differentiation of the effective and significant factors, and construction of the strategy map to ameliorate hospital performance.
According to the BSC perspectives, 21 KPIs were selected for evaluation of hospital performance. The highest relationship was found between bed occupancy having the largest R D value and other indicators, thus illustrating its fundamental role among the indicators. Clinical errors with the greatest value of R - D showed the strongest impacts on the other indicators and was thus named as the “main cause factor” among the indicators. In contrast, the percentage of patient satisfaction with the smallest R - D value was most strongly influenced by the other indicators and therefore, it was known as the “main effect factor” among the indicators.
Assessment and improvement of the hospital performance is a complex and multi-dimensional activity. In order to have a powerful assessment system and success in improving hospital performance, instead of a single-dimension, it should be paying attention to all dimensions of performance.