shahram yazdani

This review aims to investigate the impact of economic sanctions, as a form of economic crisis, on medical education.

This research is a review of studies published between 1995 and 2023. A search was conducted in electronic sources, databases, and information repositories. The initial search yielded 313 articles. In the first screening, which involved examining the titles, 173 unrelated articles were removed, leaving 158 articles for the abstract screening stage. During this stage, 95 unrelated articles were excluded, and after accessing and reviewing the full text of the remaining 63 articles, 35 were deemed eligible for review.

Economic sanctions are defined as restrictions imposed by one country on the international trade and investment of another to force a policy change. Academic and research systems are often overlooked areas that are severely impacted by sanctions. In Sudan, for example, sanctions led foreign organizations to refrain from cooperating with academics in the country, particularly regarding the publication of articles. Importantly, the negative effects of economic sanctions on education cannot be easily remedied, even long after the sanctions are lifted.

The effects of sanctions on education and health have been proven in many countries, including Sudan, Haiti, Zimbabwe, and Iraq. There is an urgent need to specifically focus on the consequences of sanctions on medical education above all other aspects.

Synthesis studies are used for the retrieval, review, synthesis, analysis, and integration of the findings of original studies. The purpose of this review was to shed more light on how meta-ethnography works as a method of inductive and interpretative knowledge synthesis, and on its application and implementation in medical sciences.

This was a narrative review study and the statistical population included all scholarly publications on the synthesis of qualitative studies and meta-ethnography published from 1998 to 2022. The search in international and domestic databases led to the extraction of 118 books and articles. After reviewing the titles, abstracts, and full texts of these publications, we included 2 books and 8 articles in the review.

Meta-ethnography is used for synthesizing the knowledge obtained from qualitative studies to re-conceptualize their findings. There are seven phases in the process of meta-ethnography: Getting started; Deciding on what is of initial interest; Reading the studies; Determining how the studies are related; Translating the studies to each other; Synthesizing the translations; and expressing the synthesis. The number of studies required to perform meta-ethnography has been recently suggested to be 40. Strategies for updating meta-ethnography include repeating the previous strategy and reformulating the strategy according to a new objective, a revised review question, or new inclusion criteria.

Noblit and Hare introduced meta-ethnography in 1988 as a qualitative research method for the synthesis of educational ethnographies. Today, it is widely used in healthcare research.

The aims of education in any educational system reflect the essence of that system. Given that aims are in line with the fundamental purposes of education, they can determine the goals and objectives of institutions, curricula, or preparing learners for personal and civic life in the formal education system. The formal education system plays a significant role in the socialization process of individuals on one hand and reflects the values prevailing in society on the other hand. Accordingly, it seems important to address the aims of education, interpretation, and promotion. This study deals with the comparative study of the aims of health higher education systems in four Islamic countries. It is of note that Iran is the only country whose higher education system is separate from the health higher education system. As such, what has been stated as the aim in the higher education systems of other countries can be applied to their health higher education system as well.

In this comparative study the required information was extracted from the documents and articles that reviewed the education policies and analyzed them based on the four steps of Bredey’s model: description, interpretation, juxtaposition and comparison. The selected countries were Iran, Pakistan, Turkey and Malaysia.

The gathered data were firstly classified and compared at two individual and community levels in six areas of cognitive, psychological, moral, spiritual, social and economic aims and finally as an operational matrix to formulate the aims of the education system in 6 areas and two individual and social levels.

Analyzing the aims of education puts different policies adopted for education the planners and provides the possibility to make more effective decisions according to the education system of the country and its needs. This study by examining the aims of the educational system of four Islamic countries, explained and classified the aims governing the health higher education system of the countries.

Context: 

The recent growth of research and the vast amount of knowledge available highlight the necessity for synthesizing existing research in a reliable and high-quality manner. The substantial body of qualitative meta-synthesis studies on chronic diseases indicates the need for a deeper understanding of this methodology. Therefore, the purpose of this paper was to explain the process of meta-synthesis in qualitative research.

 This was a narrative review with predefined inclusion and exclusion criteria, followed by a web search using relevant keywords. Initially, 980 relevant articles were selected. Subsequently, the titles, abstracts, and full texts were assessed for eligibility using the Critical Appraisal Skills Program checklist. Finally, 21 articles were included in this study.

 Various approaches have been adopted to address the meta-synthesis of qualitative studies. Common types of qualitative meta-synthesis include meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, framework synthesis, and ecological triangulation. However, concerning chronic diseases, the most commonly used methods were ethnography and Sandelowski and Barroso’s method.

 Meta-synthesis is a method for integrating the results of studies, re-understanding the findings, and ultimately interpreting them to generate new insights beyond what is obtained from individual studies. Given the extensive body of qualitative research on chronic diseases, it is recommended to conduct this type of research to develop new knowledge based on the findings of previous studies.

Evidence-informed policymaking is a complex process that requires adapting to diverse contexts characterized by varying degrees of certainty and agreement. Existing models and frameworks often lack clear guidance for dealing with such contexts. This study aimed to develop a novel contingency model to guide the context-specific use of evidence in health policymaking.  

The study conducted a meta-ethnographic synthesis of 15 existing models and frameworks on evidence-informed policymaking, integrating key factors and concepts influencing the use of evidence in policy decisions. The study also adapted the Stacey Matrix, a tool for understanding the complexity of decision-making, into a quantitative scoring system to assess the levels of certainty and agreement in a given policy context.  

The study proposed a contingency model that delineates seven modes of decision-making based on the dimensions of certainty and agreement, ranging from rational to molasses-slow collective. For each mode, the model suggests configuring four aspects: team composition, policy idea generation, problem analysis, and consensus building. The model also highlights the multifaceted influences of evidence, interests, values, and beliefs on policy decisions.  

The contingency model offers researchers and policymakers a flexible framework for aligning policymaking processes with available evidence. The model also underscores the importance of context-specific approaches to evidence-informed policymaking. The model could enhance evidence-informed policymaking capacity, improving health outcomes and system performance. Further research should validate and extend the model empirically across diverse contexts.

One of the approaches to health workforce planning is supply-based. It has been emphasized that countries should model health workforce based on evidence and their context. The objective of this study is to "design a supply health workforce planning model for specialty and subspecialty in Iran."  

This is a study using Walker and Avant’s (2018) theory synthesis framework to construct the model. This method has three steps. According to the viewpoint of the research team and the needs of the country, the focal concept is determined. Then, a literature review was done to determine related factors and their relationships. In the third step, according to the review, the viewpoint of the research team, the rationale of the connection between components, and the graphic model were presented.   

"Supply" was selected as the focal concept. In the literature review, 42 components were obtained from the systematic review, 43 components obtained from the study of other texts were combined with the opinion of the research team about the field of Iran, and the connections between them were determined. In the third step, the supply model was designed using the Stock and Flow method. Finally, by applying the "functional full-time coefficient", the number of full-time equivalent physicians was calculated.  

The presented model is an evidence-based model that follows stock and flow design. Stock is the number of specialties or subspecialties that exist in the labor market. Flow includes inflow and outflow according to the educational pathway in the context of Iran.

</strong> Community-related medical education has been defined under various terms, such as community-oriented medical education, community-based medical education, social accountability education, and community-engaged medical education. These terms have similar definitions and can be used interchangeably. The graduation of physicians who are familiar with the problems of the community is considered a necessity in modern medical education. As a result, numerous activities have been carried out worldwide, each given a different name.

</strong> This study intended to provide a more comprehensive classification of community-related medical education by examining the maximum number of educational programs and activities worldwide. The classification helps create a scientific and systematic view of this category and serves as a guide in planning and implementing such education.

</strong> The present study is conducted using Carnwell and Daly's critical review method. The review was performed in different stages, including defining the review scope, identifying sources, reviewing, and constructing the texts. By reviewing documents and examining their similarities and differences, previous classifications are complete and updated.

</strong> Community-related medical schools are divided into socially responsible, socially responsive, and socially accountable schools, with medical curricula that are community-oriented, community-based, and community-engaged, respectively. All schools are subdivided into education, research, and service-oriented programs.

</strong> Community-related educational programs can be designed and implemented at different levels according to the context.

In this study, a comprehensive classification for supply chain risks in the pharmaceutical industry is presented using the Bailey’s classical strategy method and the four-stage Collier method. Initially, through the examination of texts related to the main hazard groups, supply chain elements, considering resources and functions, and categorizing upstream supply chain organizations, primary industry, and downstream supply chain organizations within the industrial and market environment, infrastructural environment, and external macro environment were modeled. In the next stage, criteria related to the security and safety of the supply chain were identified. In the final stage, a two-dimensional matrix classification for the identification of supply chain risk factors was proposed through the cross-tabulation of supply chain elements with security and safety criteria. Based on this classification and utilizing the exemplification method through a synthetic framework, a detailed list of risk factors was compiled. The aim of this study is to propose a comprehensive risk classification for pharmaceutical industries.

Bailey’s classical strategy method has been used to develop a comprehensive classification of supply chain risks in pharmaceutical industries. In order to review the existing knowledge about supply chain risk groups, a systematic review of literature was performed. In the first stage, to find articles related to supply chain risks in the pharmaceutical industry, different combinations of related keywords have been used to search for articles in relevant databases. The selected articles were examined in three stages: extracting and classifying the main risk groups of the supply chain (the first dimension of the conceptual framework of classification), extracting and classifying criteria for a low-risk supply chain (the second dimension of the conceptual framework of classification), and applying the two-dimensional framework of classification to identify and classify risk factors of the supply chain.

A total of 77 articles were selected for review. Based on the analysis of these articles, 83 risk groups were identified. These risk groups were arranged into a model including upstream supply organizations, the main industry, and downstream supply organizations, considering the relationships between supply chain’s resources, functions, and outcomes in the industry and market environment, infrastructural environment, and external macro environment. In the next step, 30 criteria for a safe and secure supply chain were identified. These criteria are divided into two general categories: criteria for the security of the internal supply chain environment (criteria of resistant supply chain resources and criteria of resilient supply chain functions) and criteria for the safety of the external supply chain environment (criteria of safety of market and industry, criteria of safety of infrastructural environment, and criteria of safety of external macro environment). In the last stage, through cross-tabulation of resource groups with resource resistance criteria, function groups with function resilience criteria, and peripheral environment elements with peripheral environment safety criteria, a model for identifying risk factors in the industrial environment was proposed. Based on this model, 372 risk factors of the supply chain of the pharmaceutical industry were identified.

In this study, a new classification for supply chain risks of the pharmaceutical industry has been presented. The proposed classification is highly comprehensive, and the number of risk groups counted in this study is more than all the studies that have been done in this field so far. Most existing risk taxonomies are incomplete and do not follow a specific theoretical model. The classification of risk groups identified in this study has been done based on a model that considers the relationship between assets, functions, and outcomes of the supply chain. The risk groups identified in this study cover from the upstream of the supply chain to the main industry and the downstream of the supply chain. Many risk taxonomies focus on the pharmaceutical industry and do not cover the entire supply chain from raw material production to customers. In this study, cross-tabulation of resource groups with resource resistance criteria, function groups with function resilience criteria, and peripheral environment elements with peripheral safety criteria create an ideal model for identifying risk factors in the industrial environment. The classification proposed in this study can be used to evaluate the resistance and resilience of the supply chain. This model can also provide a suitable basis for identifying and evaluating risks in the supply chain environment. In addition, results of this study provide a very practical guide for choosing supply chain risk management strategies.

Context: 

Critical thinking (CT) has been recognized as a key learning outcome in health profession education (HPE). A holistic, well-defined process for initiating CT is essential to promote critical problem-solving in HPE students. Various perceptions of CT have emerged from different paradigms and disciplines. Integration of this variability into the CT process could be beneficial for medical educators to develop CT in learners. This study aimed to outline the CT process in view of the multiple conceptualizations of CT.

Evidence Acquisition: 

In this narrative review, SID, Google Scholar, and PubMed databases were searched. After studying 35 selected articles, the CT process was formulated based on the multiple conceptualizations of CT.

 Multiple perceptions of CT, emerged from disciplines and paradigms, should be incorporated into the CT process to achieve strong CT. In view of this multiplicity, not only the CT skills but also its dispositions are of key importance in the CT process. Furthermore, the essential role of the context in which the CT takes place, one’s own creativity, metacognition over the thinking process, social construction of meaning, caring to others, and seeking problems through challenging the systems should be considered.

 We outlined the CT process, grounded from multiple conceptualizations of CT, and advocated for the use of it by HPE students to promote critical problem-solving in facing complex challenges during their professional careers.

Context: 

Universities are among the best places to foster innovation and provide services, as they are in close contact with clients. In order to offer the best possible services, they need to be innovative in their respective fields. Service innovation is widely recognized as one of the three strategic research priorities of service institutions. Given the vast number and types of services available, various models are adopted to achieve this goal.

Evidence Acquisition: 

This article aims to provide a critical review of the available service innovation models and propose a comprehensive service innovation model. To achieve this objective, relevant keywords were used to conduct a literature search in databases. Initially, 1504 studies were obtained, and after a screening process, only 10 studies that were most relevant to the study's purpose were selected.

 The model proposed in this study is an integrated form of service innovation models, encompassing the process, dimensions, required infrastructures, capabilities, and the types and outcomes of service innovation, which are discussed separately in other models.

 Service innovation is a complex and resource-intensive activity with potential long-term benefits for firms in both service and manufacturing industries. If a service company aims to establish a more sustainable strategic position based on innovation, it should examine its management process for physical, organizational, and intellectual resources.

Proper transfer of professional values is an essential part of medical education. Real-life experiences in the educational process are one of the most effective methods for achieving values and assisting students in developing their value framework. This study aimed to develop and characterize the concept of value-rich exposures in medical education to bring this concept closer to the practice. In order to perform the synthesis, according to Walker and Avant, a combination of hermeneutic phenomenological method and literature review was used. At first, researchers characterized the concept of value-rich exposures based on the lived experiences of medical students who had participated in a program based on value-rich exposures at Shahid Beheshti University of Medical Sciences in Iran. After that, the literature was reviewed using an integrative review approach. Then we looked at the similarities and differences between the results of the interviews and the literature review and chose the best word to name the themes and subthemes. Finally, to describe the concept of value-rich exposures in medical education, we created a conceptual matrix. We defined the concept of value-rich exposure in medical education under five themes while implementing thesteps of Walker and Avant’s concept synthesis: probing self-inner values, value-rich program, value mentor, value-rich interactions, and value-rich environment. The elements and relationships of the themes were depicted in the form of a conceptual matrix. A value-rich exposure is a type of lived experience that occurs during a student’s professional life, a necessity that, with proper planning, can play an important role in shaping medical students’ professional identities.

To date, there is still no uniformity in forecasting models for health workforce planning (HWFP). Different countries use various HWFP models, some of which are context-specific. The objective of this systematic review is to determine approaches and components of HWFP models.

A systematic review of studies published in English and Persian between 2004 and 2021 was performed by searching PubMed Central, MEDLINE, Web of Science, Scopus, Eric, and Elmnet databases. Articles that assessed HWFP models, focused on health service delivery, used input-output models, and a clear formulation process were included. Articles that scored ≥20 points on the “strengthening the reporting of observational studies in epidemiology” checklist were considered of acceptable quality for inclusion.

Twenty articles were included for qualitative synthesis based on the inclusion and exclusion criteria. Most studies used the mixed method approach “supply and demand”, whereas target- and needs-based approaches were used less frequently. The number of components used to estimate supply, demand, needs, and targets were 42, 32, 11, and 6, respectively. In addition, several unique factors used in the various HWFP models were identified.

Different approaches are used in HWFP models, which is indicative of the lack of consensus on this topic. High diversity in the identified factors is related to the approach used and the context in which the model is applied.

Over the past three decades, the supply chain of leading industries has become increasingly manifold. Along with this complexity, there has been a significant increase in related research. The existence of a formal ontology is one of the necessities of development in a area of knowledge. This terminological structure in the ideal situation should be based on a semantic model of the key concepts of this area of knowledge. Despite, the development of literature on supply chain risk management, there is no consensus among researchers on the terms, concepts and definitions of the field and researchers have used their own definitions to refer to the key concepts of the field. The purpose of this study is to develop a conceptual model based on ontology for supply chain risk management. In this study, the critical review method was used to achieve a conceptual model and model-based ontology for supply chain risk management. Based on a systematicl review of 60 related articles, four conceptual frameworks : "effect of risk factors on supply chain", "supply chain resilience", "severe or serious supply chain risk" and "supply chain risk management" were developed and based on these frameworks, analytical definitions for 47 related concepts were presented in the form of a thematic ontology. The ontology presented in this research, can provide a platform for communication and cooperation of researchers, publication of research results and indexing of literature related to supply chain risk management.

Socioeconomic status (SES) is a criterion consisting of several components that encompass socioeconomic and cultural dimensions. This study aimed to design and develop a methodological guideline for calculating a single summary index (SSI) using the contributing variables of SES in a family unit. The data consisted of 18 700 urban and 19 200 rural households. Effective components of SES were extracted using two-step factor analysis and the structural equational modeling (SEM) method for both populations separately with AMOS software. Then, in order to customize and validate the weight of each component, the analytic hierarchy process (AHP) method was performed by a panel of experts. Finally, the SES index computational tool was developed as an SSI using all effective components by Excel software. Statistical analysis was done with SPSS software version 21. In rural areas, the four wealth components of education, job, income, and family size were recognized as effective socioeconomic factors. Yet, in urban areas, family size was disregarded as an effective factor. In both rural and urban communities the three welfare components of appropriate nutrition, appropriate home appliance, and appropriate housing were similarly effective. The SES of rural population had a homogeneous distribution, while urban population did not follow a particular trend. The SES index impacts all aspects of life, especially health status. The introduced method is comprehensive and applicable to both rural and urban populations. Due to ever-changing lifestyles, constant technological advances, and socio-political changes in each society, the tool requires modification in a specific time intervals.

Identifying and developing superior talents doubles the importanceof educational planning.The purpose of this plan is to find laws in the field of superior talent that are incompatible with the logic of following educational justice in academic environments and to suggestfor reform have been presented.

This qualitative study was conducted in 2022using the content analysis method. Targeted interview sessions were held with assistants and students who were members and non-members of gifted students offices as well as the heads of these offices in major universities of medical sciences. Primary conceptual codes were extracted after data analysis, and after continuous review and assessing similar codes, summarization, and removal of duplicate codes, four main categories and 14 subcategories were identified.

Students emphasized the need to change the conditions of membership in gifted students offices and to identify talents during their studies according to their efforts and scientific and research abilities.While requesting coordination between the educational and executive institutions of the country, they inquired forcreatinga stronger foundation for the officials of the ministries, so that they could have a greater impact on the scientific and cultural promotion of the country.

Senior educational managers should pay attention to solving the structural problems of the units and revising the regulations, motivational inducers, and the social and cultural needs of talented students. While requesting the generalization and changes of the statements mentioned in related regulations, the students agreed with establishment of elite assessment centers in metropolitan areas with the same guideline. It is suggested that the Office of Elites and Talented Students of the relevant ministry, be in charge of forming specialized groups of talented students from medical sciences universitiesin cooperation with one of the leading educational institutions in the country; so that these students have closer contact with the relevant ministryofficials and participate more actively in solving educational, research-related and executive problems.

The capacity of self‑authoring one’s own beliefs, identity, and relationships is core to many expected outcomes of future health‑care professionals. Students’ personal and professional development for self‑authorship can be promoted by the variety of developmentally effective “crossroads” experiences that they encounter. Identifying the characteristics of the crossroads experiences in clinical rotations can provide a foundation for medical educators to provide an environment that can foster self‑authorship.

A cross‑sectional qualitative survey was conducted using a researcher developed semi‑structured questionnaire which had three open questions and asked medical interns to describe their internship experiences that stimulated their thinking along the self‑authorship dimensions of identity, relationships, and ways of knowledge acquisition. Data were analyzed using Braun and Clarkes’ thematic analysis method.

The survey was completed by 167 medical interns (response rate: 83%). The key features of significant crossroads experiences and their effects were created into six themes: Experiences by being respected and validated; experiences by involvement in patient management; experiences by participation in interactive learning environments; experiences by participation in authentic clinical work environments; experiences by the observation of professional behaviors; experiences through the uniqueness of different specialties.

Authentic experiences of patient management in the real world of clinical settings with a high interactive environment have the potential to promote interns’ self‑authorship development. Educators can support learners by respecting and validating their capacities and by role modeling of professional behaviors.

The complexity of today's world is constantly creating new challenges for higher education institutions, and they must continually be consistent and accountable to maintain standards of excellence and compete in international education markets. Being or becoming an entrepreneurial higher education institution is a response to these challenges. There is no "unique" approach, but there are different ways in which higher education institutions behave in an entrepreneurial and creative way. The purpose of this article was to explain how universities can become more entrepreneurial by changing how they provide knowledge. This article is based on the results of a literature review in the fall and winter of 2020 and is in line with the doctoral dissertation that is currently being done in the "Virtual School, Medical Education and Management, Shahid Beheshti University of Medical Sciences." After 1989, a review of the limited, focused literature on service innovation, with an emphasis on knowledge-based service innovation, was done. Service innovation is multidimensional and interactive in nature and can be examined from both technological (information and communication technology developments) and non-technological (organizational innovations) aspects. Accordingly, knowledge-based services include services based on professional knowledge and technology knowledge. Universities need to focus on innovation in both aspects of knowledge-based services. If universities are to become entrepreneurial universities, it is important to explain the comprehensive model of entrepreneurial universities by focusing on the dimensions, concepts, opportunities, challenges, and requirements for knowledge service innovation and then apply it to medical universities to fits their needs.

The training and education of competent and qualified surgeons have been one of the challenges of the surgical profession. The concept of surgical competence has been affected widely due to a series of developments in the new disease emergence, various surgical techniques and the introduction of advanced tools and equipment into the operating. The development of surgical competence and achieving this goal requires accurate identification and analysis of the dimensions of competence. This study was done to explain the concept of surgical competence using the 8-step Walker and Avant approach.

This study is a qualitative study that was conducted from May- October 2016 at Shahid Beheshti University of Medical Sciences. The present study is a qualitative and conceptual analysis study, which is done with Walker&Avant's eight-step approach to determine the defining characteristics of the concept of surgical competence. A systematic search was conducted between 1990 and 2020 by keywords search such as surgery, surgical, operation OR laparoscopy AND competence competency development competency proficient, proficiency, expertise, clinical, in the database like Google Scholar, PubMed, SID, Magiran, Scopus, Web of Science. Twenty articles were included in the study based on inclusion and exclusion criteria. Moreover, the defining features of the concept were extracted from it.

Based on the results of this study, the concept of surgical competence was defined and the four dimensions of elements, goals, components and the process of developing surgical competence were identified. Then, by clarifying the characteristics of surgical competence, a model of surgical competence development was drawn. Surgical competence development depends on the acquisition of specialized knowledge and numerous skills that are acquired through experience and deliberated practice under the supervision of others in the surgical community of practice and over time.

Surgical competence is a set of observable and measurable skills that allows a surgeon to manage the surgical process independently pbt while maintaining the patient's safety. It includes specialized knowledge, communication skills, cognitive and technical skills, and basic surgical skills.

The value framework governing the health system can guide the policymaking. This study presents a set of values governing the health policies for adopting policies that are in harmony with the ideology of Iran.

This study was conducted in two phases. In the first phase, using the qualitative approach, Shams et al. framework was adopted to identify values. Identification of health‑related national documents (nine documents) was performed purposefully. In the next phase, semi‑structured interviews on individual experts in the health system were carried out. The key question was “What values and principles govern the health policy system?” Participants included 15 individuals. Both phases were analyzed based on qualitative content analysis.

In this study, a taxonomy of values governing policymaking is presented. Results show that equity in different dimensions, comprehensive health and a healthy human being, pioneering in health in the region, and accountability are the most important terminal values. Individual responsibility, government responsibility for health, endogenous and extrinsic economics, fair access, transparency, efficiency, quality and integrity in the supply, development and fair allocation of public health resources, and professional commitment are the most important instrumental values in Iran. Participants believed that, despite the many higher‑order documents available, the health system policymaking was not based on a predetermined value.

It is not enough to provide a set of values in upstream documents for implementation. It is necessary to specify the relative weight of the reference values in policymaking and their relation to each other in order to apply them in policymaking

Purpose of the review: 

The aim of this paper is to review Iran’s activities on resilience during home quarantine of outbreak of COVID-19 disease.

Governmental activities were included; closing of all schools and universities, changes in office hours, closing shrines, delay in repayment of loans until three months, electricity and water costs were reduced for a month, and urging people not to visit each other, and do not take a trip during the Iranian new year. Also, the municipality and the Islamic Republic's army began to disinfect public passages.

Medical activities:

 All medical staff and health providers provided care and treatment of patients in hospitals. Furthermore, midwives and other public health workers continued work in the health center. Also, physicians and other health workers such as midwives began setting up systems to answer questions from the public. Telephone counseling with women on any issues related to pregnancy, lactation, sex issues and other problems were provided by midwives. Staff of pharmacology schools started to prepare alcoholic sanitizer. Public activities were included; various groups of people have begun collecting public assistance to provide masks and disposable clothing for the health workers. Some groups started to disinfect the ATMs.

Numerous factors and elements are effective in the professional development of any field of study, including the educational structure, the individual characteristics of learners, and the educational atmosphere prevalent in the educational environment. Understanding each of these factors and elements and the relationships among them can guide educational system administrators in the direction of professional development. Surgical residents’ professional development is no exception to this rule. As a consequence, the present research sought to explain and suggest a model for surgical assistant professional growth in Iranian operating rooms. The present research was a grounded theory study based on a post-positivist approach, in which data analysis was performed using Clark’s situational analysis methodology by drawing three maps, situational map, social worlds/arenas map, and positional map.
In the presence of human and non-human factors, cultural, political, historical, and social components, the ordered situational map demonstrated the complexity of the operating room learning environment. The social worlds/arenas map confirmed the existence of several communities of practice wherein surgical residents were present with different power roles, and the positional map showed role of the educational level in the acquisition of thecompetence in the professional development pathway. Finally, the Triple Helix model of professional development was extracted, which has three components: psychological identity, social identity, and surgical competency. The surgical residents’ professional development in operating rooms occurs due to the acquisition of surgicalcompetency along with the growth of individuals and socialization. As a result, all factors and components impacting the residents’ competence development process in this learning environment must be identified and their linkages clarified.

 Need and demand modeling is one of the conceptual approaches of health workforce planning. In many models of this field, “need” is not considered. Each country should model according to its context.

 The present study aimed to design a need adjusted with demand model of the health workforce in the fields of specialties and subspecialties.

 Walker and Avant’s synthesis theory method was used for modeling in this study. The concepts of need and demand were chosen as the focal concepts. In addition, to find the components related to the concepts and the relationships between these components, the result of a previous systematic review and a supplementary study of viewpoints of research teams were used. In the last step, the graphic form of the model was presented.

 The need-adjusted demand model was presented in this study. In this model, the types of flows were headcounts. Actual need, willingness, and ability to use health services were considered. Finally, the number of full-time equivalents of physicians was estimated.

 In this model, a series of main components that are headcounts and a series of influential factors that affect the main factors through rates were considered.

One of the critical needs of governmental agencies and educational institutions is meeting community needs. Organizations and governmental systems that rely on social capital are considered inefficient and vulnerable if they are unable to meet the needs of society. Thus, accountability is a critical pillar of government management that leads to effective actions and better service delivery.

Critical review methodology was used in the first phase to review texts and documents available in the field of social accountability and to collect items used to develop the social accountability assessment tool. The Delphi method was then used to finalize and approve the model and assessment tool. University processes were investigated and evaluated based on the social accountability tool in the second phase.

In all, 422 university processes were investigated and evaluated to determine their accountability in different fields. The mean score of the evaluated processes was 11.9 out of 100.

The results show that social accountability is a relatively new topic that has received considerable attention in medical education in Iran. Given the relative newness of this topic, these results could be expected; social accountability should try and be expected to improve in the coming years.

Phenomenology of practice is a useful method for deeply understanding human phenomena and is fundamentally practical. Its ultimate goal is to nurture thoughtfulness and tact in the practice of professions. Pathic knowledge is a type of non-cognitive knowledge which is obtained through phenomenology of practice and can provide a lens for teachers and students to reflect on their teaching and learning experiences through their relationships, their situations, and their acts. From Van Manen’s point of view, what distinguishes practice from theory is not that practice exerts thought and concepts in the real world; rather, phenomenology of practice involves a different path of recognizing the world. It is very important in medical education due to the importance of communication and human interactions. In this letter, the author highlighted the importance of pathic knowledge in medical education as a part of professional knowledge.

We aimed to explain the roadmap to supremacy in the country's medical universities. Expanding this path in all higher education institutes would improve supremacy.

In this project, local competitive advantages and the strengths of medical universities were initially identified. Three methods were used for measuring and quantifying, as follows: determining the index based on total citations of the top ten researchers in each field and the ratio of these people to the top ten in the country, SciVal analysis, evaluation and internal evaluation of universities and institutions were used.

The data collected from the previous two stages during 2020-2021 led us to potential areas of differentiation. Strategic placement took place with an emphasis on the division of national duties and special missions, and we paid attention to the articulated diferentiated. All competitive advantages were classified into four levels (internal, weak, strong, and exclusive competitive advantage) based on characteristics such as infrastructure, capital and resources, access, reputation, staff, processes, and various functions of universities. The way of moving between the start point, and the destination was also done by formulating strategies.

In formulating a strategic plan for achieving supremacy, a strategic timeline, a strategic roadmap, and a strategic plan were developed. Supremacy is a high goal for universities. However, universities must also consider other goals, such as: creating knowledge-based economic value addition, interdisciplinary development, social accountability, and the institutionalization of different levels of academic hubs in universities. In this path, identifying and encouraging talented individuals and making full use of their scientific capacities is also very important