evaluation

Evaluation is an essential and comprehensive process for all organizations. Evaluation has become very common in Iran during the past decade, and different universities assess their teachers through various methods, including various questionnaires. This research aimed to evaluate the perspectives of faculty members about the teacher evaluation process.

This qualitative observational study involved 98 faculty members from Shahid Beheshti School of Dentistry who were willing to participate. Data were collected using a researcher-made questionnaire. The questionnaire items were selected using previous research conducted in this field. After verifying their validity and reliability, 10 items were chosen. Data analysis was conducted using Pearson correlation coefficient and linear regression tests (P<0.05).

This study involved 98 university professors, with a mean teaching experience of 12.95±9.01 years. The mean score of their opinions about the evaluation system was 37.30 ± 4.75. The opinion of faculty members regarding the evaluation system had a significant inverse relationship with teaching experience (p<0.001) and male gender (p=0.025). The results showed that 80.7% of the participants believed that the evaluation process effectively improved their teaching, although 66.3% did not approve the current evaluation method.

Most faculty members believed that evaluation positively affected the quality of their teaching, although the current teaching methods were not satisfactory.

The objective structured clinical examination (OSCE) is an appropriate method for assessing clinical competency among students in universities worldwide. With nowadays technological advances, there is a growing interest in virtual OSCEs (VOSCEs).

The present study aimed to design, implement, and evaluate a VOSCE for assessing anesthesia students’ clinical competency.

This quasi-experiment study was conducted in six phases: (1) Defining the exam’s specifications and design, (2) determining validity and reliability, (3) setting up and conducting a pilot VOSCE, (4) familiarizing students with the VOSCE, (5) administering the exam, and (6) evaluating and providing feedback. Seventy-five senior anesthesia students from Abadan University of Medical Sciences were selected by census and participated in this study between 2021 and 2023. The scores of virtual and in-person OSCEs were compared, and the correlation between the two exams was investigated. At the end of each semester, students participated in a survey related to the VOSCE. The exam results and survey data were presented at the faculty’s educational development office meetings, and suggestions for amending and eliminating shortcomings were considered in the following semester. Data were analyzed using SPSS 20 by calculating means, standard deviations, and Pearson’s correlation.

The students’ mean scores in the virtual and in-person OSCEs were 17.68 and 16.75, respectively. No significant difference was observed between the scores of the two exams. The total score of the VOSCE had a direct and significant correlation with the in-person OSCE (r = 0.861, P < 0.001), and this correlation was also observed in all stations of both exams (P < 0.05). Student surveys indicated that the VOSCE fostered a sense of empowerment, self-confidence, and enhanced learning, causing students to express strong agreement with its continuation in the future.

The VOSCE can be an appropriate substitute for or an integral part of the in-person OSCE. It is recommended that educational planners and instructors develop this exam as a new assessment method. Given advances in technology and the requirement for improving the quality of virtual exams, professors need to be empowered in the field of modern electronic assessment methods.

The electronic exam is one of the foremost imperative instruments for evaluating students’ execution. Accordingly, this study aimed to identify the advantages and challenges of electronic exams based on Iranian and international studies.

The present qualitative study used meta-synthesis in the first phase. Thus, keywords such as electronic exams, online exams, electronic assessment, and online assessment in Iranianand international databases for 2005-2021 were searched. In the second phase, using the Shannon entropy technique, the advantages and challenges of electronic exams were weighted.

Challenges of e-exams were classified into seven subcategories (poor technical knowledge, security challenges, complexity and challenges in designing examination, complexityand challenges during examination, complexity and challenges after examination, lack of infrastructure, socio-cultural challenges). The advantages of e-exams were also classified into five sub-categories, including improvement of teaching and learning process, effectiveness of student performance assessment, advantages in designing exams, advantages during examinations, and advantages after examinations. In Shannon’s entropy findings, challenges (complexity and challenges after examination and poor infrastructure) and advantages (advantage after exams implementation) had the largest weight.

Considering the importance of electronic exams, especially with the outbreak of the COVID-19 epidemic, the inevitable movement of university systems, increasing concerns about student performance assessment, and improving educational performance in the current situation, decision-makers are expected to emphasize the advantages of this kind of exam and address its challenges to help improve the student assessment mechanisms.

Pre-anesthetic evaluation is the initial stage of anesthesia procedures for patients. This evaluation involves elucidating the patient's medical history, determining patient readiness, screening for undisclosed disorders, and identifying risk factors. Safety measures help mitigate patient-related risks within medical environments. The aim of this study is to investigate the role of Pre-anesthetic evaluation in patient safety.

The present study was a review conducted in the year 2024. Databases including PubMed, Direct Science, MEDLINE, Proquest, SID, Scopus, Google Scholar, Magiran, and library resources were searched using keywords such as Pre-anesthetic evaluation, pre-anesthetic visit, anesthesia clinic, patient safety, and their English equivalents. A logical combination of these keywords was performed using "OR," "AND," and "NOT" operators. The search was conducted in relevant articles from the year 2000 to January 2024.

Initially, 22,000 articles were screened, and ultimately, 16 relevant articles were used for preparing this paper. In all the reviewed articles, pre-anesthetic evaluation played a key role in patient safety.

Studies indicate that pre-anesthetic evaluation is a key improver of surgical outcomes. These measures not only mitigate potential risks but also enhance surgical outcomes. Overall, pre-anesthetic evaluation has a direct correlation with patient safety, playing a significant role in postoperative improvement and elevating the quality of medical care.

 Monitoring and evaluation are crucial in ensuring the effective implementation of health priorities. This descriptive study examined the progress towards implementing Iran’s General Health Policies (IGHP) to illustrate how countries can effectively monitor and evaluate their national plans. Additionally, the study sought to identify factors that impede the full implementation of these policies.

 Available data sources, formal reports, and studies were examined to gather data on selected indicators. Then, documentary analysis and 21 semi-structured interviews were conducted to identify measures taken to materialize IGHP and factors that hindered the full implementation of IGHP. Data were analyzed using the content analysis method.

 The results showed that several indicators improved during these years, while there was no data for some indicators. There are some barriers to implementing the IGHP, including lack of full understanding of the policies, absence of necessary mechanisms and infrastructures, lack of coherency and alignment of national health plans and policies, absence of monitoring and evaluation framework, and lack of transparency and accountability in the health system. As countries continue to develop their health plans and policies, lack of clarity regarding the progress of these plans remains a concern.

 Countries need to strengthen their health planning systems and expedite the implementation of accountability mechanisms within the health system. Enhancing capacity building is essential to establish a comprehensive monitoring and evaluation framework. By fortifying these systems, countries will be better equipped to measure and track progress toward achieving their health objectives.

 Xenogeneic graft-versus-host disease (xGvHD) is an inevitable confounder of preclinical evaluation of adoptive immunotherapies on tumor-bearing immunodeficient mouse models. This study was designed to appraise the clinical and histopathological effects caused by xGvHD in severely immunodeficient mice considering the T cell dosage.

 Fifty NOG mice underwent intraperitoneal injection of three different doses of human-derived total T cells, a high dose of CD8+T cells, or vehicle (as control). Clinical and histopathological status of the study subjects were evaluated and compared according to scoring systems.

 In mice receiving higher doses of total T cells, the clinical severity of xGvHD was greater. However, recipients of CD8+T cells developed none to mild xGvHD manifestations. Higher doses of T cells were associated with poorer outcomes including premature death and more severe histopathologic damages. Greater CD3+T cell tissue engraftment (immunohistochemical CD3 positivity) was associated with more severe xGvHD-induced histopathological damages. Clinical xGvHD scores were significantly correlated with histopathological xGvHD scores in total and in each tissue. Mice with severe cutaneous symptoms had higher scores of xGvHD-induced histopathologic changes in the skin. Lethargy was associated with higher histopathological scores in the lungs, liver and spleen.

 In preclinical evaluations, lower doses of T cell-based therapies are associated with milder xGvHD. Development of xGvHD may be averted by the use of CD4+T cell-depleted grafts. Histopathological and clinical scoring systems for evaluating xGvHD are significantly correlated. The lungs and liver are reliable organs for histopathological assessment and scoring of xGvHD.

 The integrated and comprehensive elderly care program of the Ministry of Health in the city of Asadabad has been designed to maintain and improve the health of the elderly population. The evaluation of this program using the context, input, process, and product (CIPP) model is essential to determining areas where the program may need modifications or improvements.

 The current descriptive-analytical research focused on evaluating the current elderly care program based on the CIPP evaluation model. The target population includes all employees of healthcare centers in Asadabad county. Data collection tools consisted of a two-part questionnaire, including demographic information and a researcher-developed questionnaire for evaluating the current elderly care program based on the four dimensions of the CIPP evaluation model. Participants meeting the study’s inclusion criteria were selected through a census sampling method. After completing the questionnaires, the data were analyzed using SPSS 24 for further examination and analysis.

 The means±standard deviations (SD) of the age of the participants was 34.84±7.31 years, and 140 people (84.3%) were women. The mean±of work experience was 10.75±7.07 years. Based on the results of the field evaluation, the highest average score was related to the item “the need of the target group for the program”, while the lowest average score belonged to “identifying the potential of other influential organizations in the implementation of the program”. In the evaluation of the input field, the highest average score was associated with the item “asking questions of the target group during the implementation of the program to ensure learning”, whereas the lowest average score was attributed to “budget and credit necessary for the program”. In evaluating the scope of the process, the highest average score was related to the “evaluation of the program by the officials and executive personnel”, while the lowest average score belonged to the item “updating the program according to the needs assessment and problems encountered”. Based on output area evaluation, the highest and lowest average scores were associated with items “satisfaction with interest in work and commitment and work conscience” and “responsiveness of the program to the needs of the elderly”, respectively. In the overall evaluation of the program, the highest average score belonged to “necessity of the program” and the lowest average score was related to “quality of program presentation”.

 Based on the current study results, the evaluation of the integrated and comprehensive elderly care program of the Ministry of Health using the CIPP model focuses on identifying the strengths and weaknesses of the program, taking into account the opinions of healthcare center staff in Asadabad province. Therefore, policymakers and officials can use these findings to improve the implementation of this program further.

Evaluating the effectiveness of educational courses is essential for ensuring high-quality healthcare.

This study assessed the effectiveness of current in-service training courses on infection prevention and control for nurses, using the Kirkpatrick evaluation model.

This evaluative study was conducted at Shiraz Army Hospital in 2024, involving 40 nurses and 10 supervisors. The educational program consisted of interactive workshops held over two days, covering topics such as standard precautions, isolation procedures, and hand hygiene. The evaluation followed Kirkpatrick’s four levels: Reaction, learning, behavior, and impact. Nurses' reactions and knowledge were measured using validated questionnaires, while supervisors assessed behavioral changes. Data were analyzed with SPSS 26, using descriptive statistics and a one-sample t -test.

All four levels of the Kirkpatrick model were evaluated. Nurses reported a mean reaction score of 3.73 (SD = 0.80), reflecting positive feedback on the training. Knowledge scores significantly increased from a pre-test mean of 2.39 (SD = 0.74) to a post-test mean of 3.72 (SD = 0.74) (P < 0.001). Supervisors observed a behavioral improvement, with scores increasing from 2.34 (SD = 0.94) to 3.72 (SD = 0.74) (P = 0.004). Furthermore, the nosocomial infection index decreased from 0.7 to 0.5 (P = 0.002) following the training.

The findings demonstrate the effectiveness of current in-service training courses on infection prevention and control for nurses. The Kirkpatrick model proved to be a valuable evaluation tool, underscoring the importance of ongoing assessment of nurses’ competencies to enhance infection prevention practices.

  The best approach for defining and measuring community healthcare (CHC) resilience in times of crisis remains elusive. We aimed to synthesise definitions and indicators of resilience from countries who had recently undergone shocks (ie, outbreaks and natural disasters). 

We purposively selected four countries that had recently or were currently experiencing a shock: Nepal, Ethiopia, Sierra Leone, and Liberia. Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with participants at the community, facility, district, sub-national, national, and international levels. Interviews and discussions were translated and transcribed verbatim. Data were open coded in ATLAS.ti using a grounded theory approach and were thematically collated to a pre-specified framework. 

  A total of 486 people participated in the study (n = 378 community members, n = 108 non-community members). Emergent themes defining CHC resilience included: the importance of communities, health system characteristics, learning from shocks, preventing and preparing for shocks, and considerations for sustainability and intersectoral engagement. Participants identified 193 potential indicators for measuring resilience, which fell into the domains of: (1) preparedness, (2) response and recovery, (3) communities, (4) health systems, and (5) intersectoral engagement.

  Despite varying definitions and understanding of the concept of resilience, community-centred responses to shocks were key in building resilience. Further insight is needed into how the definitions and indicators identified in this study compare to other shocks and contexts and can be used to further our understanding of health system resilience. Metrics and definitions could assist policy-makers, researchers, and practitioners in evaluating the readiness of systems to respond to shocks and to allow comparability across health systems. We must build health systems that can continue to function and ensure quality, equity, community-focused care, and engagement, regardless of the pressures put upon them and ensure they are linked to strong primary healthcare.

Research impact assessment is already being institutionalized in health research and innovation systems. In developing countries, there are many different research assessment models which have focused more on research output in academic levels and less on impact.

The aim of this study is designing an Iranian impact‑oriented model of research and technology evaluation.

This is a mixed study. In the quantitative part, by reviewing the literature, a list of research impact indicators that existed were gathered, reviewed, and scored by participants on importance, relevance, and measurability via a 5‑point Likert scale. All indicators with a mean score equal to or greater than 3.5 entered the qualitative part, which were discussed in depth by engaging key stakeholders regarding their validity and feasibility through focus groups, interviews, and expert panels.

The Iranian research impact evaluation model was developed with four main pillars (including input and process, output, outcome, and impact), four areas (stewardship, advancing knowledge and translation, technology, and impact), and 30 indicators through key stakeholders participation in the Iranian health research system.

This model has been introduced as the first model designed to evaluate the impact of health research and can be one of the most important tools for allocating limited funding resources while maximizing the desired impact of research in the community

Evaluating the academic performance and competencies of medical students is essential in the medical field. Written tests play a big part in this situation. This study's primary goal was to comprehend medical students' experiences with their exams.

The study was carried out from 2020 to 2022 at the Fasa University of Medical Sciences in the Iranian province of Fars, using a qualitative research methodology using a phenomenological approach. In-depth one-on-one interviews with the investigators were conducted with twenty-three medical students from a variety of professions, including health, medicine, nursing, operating room technology, anesthesiology technology, and medical emergencies. The interpretive phenomenological approach was used to analyze the data, including observations made during written exams and in-depth interviews.

The results of the study revealed four general themes that reflected the views of the medical students about their exam experiences. The themes that emerged were emotional fluctuations, stressful difficulty, coping strategies, and blessings in disguise.

Despite the participants' initial uncertainty, the study participants saw the exams as a blessing in disguise. They saw exams as essential learning resources and a means of gaining access to stable job chances. However, because of the psychological strain and scoring direction, the exam also presented a hard challenge. Furthermore, students experienced a range of positive and negative emotional changes as a result of the test. In order to manage their test anxiety, the students used both positive and negative strategies for coping. These results have substantial implications for policies that might be implemented in the field of education

Lack of clinical competence can endanger the patient’s safety and reduce the quality of providing health care services. The aim of this study was to examine the impact of formative Objective Structured Clinical Examinations (OSCEs) with immediate verbal and visual feedback on the clinical competence of fourth-year nurse anesthesia students. This was a single blind quasi-experimental study with a pre-test/post-test design in compliance with the CONSORT (Consolidated Standards of Reporting Trials) statement. Fortyeightstudents were allocated to intervention (n=24) and control (n=24) groups. During the academic semester, the students of the intervention group attended 3 sessions of formative OSCE (5 stations) with immediate verbal and visual feedback. In the control group, however, the students received in-person feedback according to curricular routine. The data collection tool includedtwo sections. The first section included a questionnaire to collect demographic information such as age, sex, grade point average and marital status. In the second section, clinical competenceof students was measured by Common Clinical Assessment Tool (CCAT). The collected data were analyzed by Analysis of Covariance, paired T-test, Chi-square, and Fischer’s exact test inSPSS, version 16.
Comparing post-test scores by ANCOVA showed a significant difference between groups (P=0.001) because there was a significant positive change in the overall clinical competencescore in the intervention group after receiving formative OSCE.
This study showed that regular implementation of formative OSCEs in nurse anesthesia education fosters learning and has a positive effect on improving students’ educationalbehaviors and helps them learn more efficiently. However, it is recommended to conduct more studies with a larger number of participants to confirm this conclusion.

The development of mobile apps in healthcare facilities helps users perform self-care effectively.

This study aimed to evaluate the quality, functionality, and features of Persian language diabetes mobile apps.

Persian language diabetes self-management mobile apps were searched in the Android and iOS App Stores using relevant keywords such as "diabetes" and "blood sugar." Twelve apps met the inclusion criteria. Nine evaluators assessed the apps' quality based on the Mobile App Rating Scale (MARS), their functionality according to the IMS institute for healthcare informatics app functionality scoring system, and their features and content using a checklist.

The mean MARS score of the apps was 3.02 out of 5. Among the four dimensions of engagement, aesthetics, functionality, and information quality, functionality had the highest mean ± SD score (3.64 ± 1.13). Most of the apps used 5 - 7 out of the 11 defined functionalities. All self-management apps included the functionality of monitoring blood glucose levels, and the majority had health status monitoring features.

The mobile apps had several drawbacks, including a lack of engagement strategies, insufficient evidence-based information for patients, limited guideline-based self-management functionalities, failure to evaluate clinical effectiveness in trials, and an absence of mutual communication with healthcare providers.