physicians

A significant gap exists between patient-centered health policies and medical graduates’ practice. Medical education is not restricted to the formal curriculum. The hidden curriculum has a powerful effect on students’ learning and behavior. This study measured the patient-centeredness of the hidden curriculum in Mashhad Medical School.  The participants were medical students at Mashhad Medical School who were about to graduate. The sample size was determined 100 students based on the Morgan table and selected in a convenient method. The validated Persian version of the Haidet instrument with three content areas of “role modeling, student’s experiences and support for students’ patient-centered actions” was used to evaluate the patient-centeredness of the hidden curriculum. Descriptive indexes and Independent samples T-Test were used for analysis. The mean±SD score of patient-centeredness of the hidden curriculum was 54.9±9.4, slightly more than half of the total questionnaire score. The area of "support for students' patient-centered actions" received a higher mean±SD score (62.1±16.5) compared to role modeling (53.9±12.3) and student experiences (53.6±9.4). Additionally, medical students emphasized the professor's role in acquiring patient-centered care. Despite the formal education for patient-centeredness, students learn mainly from the practical environment and their educators’ behaviors. There was a relative dissonance between the formal and implicit curriculum regarding patient-centeredness associated with the medical student. The medical students’ experiences regarding patient-centered manners and giving encouraging feedback are two chief points for improving patient-centeredness.

The role of Muslim, Arab, and Persian scholars and physicians in shaping modern medicine and surgery practice is often overlooked in scholarly discussions and is often underappreciated in modern literature. Muslim, Arab, and Persian scholars advanced surgical techniques and knowledge. They played a pivotal and important role in translating and preserving classical Greek and Roman medical and scientific texts and knowledge, which later significantly influenced the European Renaissance. Their work laid the foundation for many modern surgical practices and techniques and continues to inspire medical professionals worldwide. This abstract aims to shed some light on the significant contributions of figures such as Rhazes, Haly Abbas, Albucasis, Avicenna, and Ibn Quff to the development of surgery and surgical specialties, including general surgery. By highlighting these contributions, we seek to rectify the historical oversight and endure the profound impact of these scholars and their contributions to the field of medicine and surgery.

Patients’ complaints against hospital staff reflect dissatisfaction with care and service, indicating gaps in the healthcare delivery system. This study investigates the causes of complaints against medical staff referred to the Kerman healthcare organization before and after the COVID-19 epidemic.

This cross-sectional study examined claims filed against medical staff during two years—2018 (before COVID-19) and 2019 (after COVID-19). The data, collected from 154 forensic medical cases (120 in 2018, 34 in 2019), included the year of complaint, complaint outcome, reasons, and defendant’s education level.

Indictments were issued for 31.2% (48 cases), prohibition of prosecution for 63.6% (98 cases), and suspension of prosecution for 8.2% (8 cases). Complaints due to complications were 61% (94 cases), mostly before COVID-19 (74 cases). Complaints due to patient death increased post-COVID-19 (8.4%, 13 cases). After the epidemic, most complaints were against physicians (70.5%) and dentists (20.6%) (p=0.001). Before COVID-19, complaints were highest among gynecologists and obstetricians (18.3%), surgical specialists (14.2%), and general practitioners (9.2%). Post-COVID-19, the highest complaints were against surgical specialists (20.6%), dentists (20.6%), and orthopedic specialists (17.6%).

Complaints against medical staff decreased post-COVID-19 compared to the previous year. The highest complaints were against gynecologists and obstetricians, surgical specialists, dentists, and orthopedic specialists. Common causes included death, complications due to lack of skill, and carelessness. Monitoring the performance of specialties with the highest complaints is necessary.

Cardiopulmonary Resuscitation (CPR) is considered as the most important skill for physicians. The practice of effective CPR depends on the quality of the CPR training, team work skills and hospital management. Because of complexity and several variables involved, the outcome of CPR may vary in the different times of day and different days of the week.   This study is a cross sectional and the data were provided from the medical records. All the patients who underwent CPR from July 2021 to Feb 2022 in the Children’s Medical Center Hospital were included. The ward, disease, gender and age, the time of the day and the day of the week in which CPR event happened and the Survival to Discharge from Hospital (SDH), had been registered. We compared The SDH rate of CPRs between different days of the week (working days and weekends) and also different working shifts (morning, afternoon and night) were compared. The rate of SDH of the patients who underwent CPR was to 21.2%. There wasn’t a significant difference between SDH during working days and weekends and during the morning, afternoon and night shifts.   The SDH rate was lower in the night shifts and during the weekends but the difference wasn’t significant. It is recommended to improve the medical team CPR skills in all shifts specially in the evening and night shifts. Also, an appropriate dissemination of health care staff in working shifts should be done to increase the success rate of CPR procedure.

The mouth is the mirror of the body and can manifest signs of underlying health issues. The oral soft and hard tissues are physically linked to the rest of the body. Therefore, the role of dentists is much greater than the dental setup. Many physicians consider dentistry as a purely practical occupation and not scientific. In recent years, the relationship between oral and systemic disease has become a leading research issue. Interventional studies focused on the relationship between dental treatment and its effect on certain systemic condition. In this regard, the aim of this study is to introduce a case of Cowden Syndrome (CS) which was first diagnosed according to their oral manifestations by a dentist. 

Case report: 

A 37-year-old woman was referred to the Department of Oral Medicine, Shahid Beheshti University of Medical Sciences complaining of aesthetic problems. Intra-oral examinations showed grooves and papillomatosis. Examination of the oral cavity showed a high- arched palate, hypoplasia of the maxilla and jaw. According to the patient’s oral presentation, we asked for a consultation with gastroenterologist, gynecologist and endocrinologist. Finally, based on clinical and paraclinical findings, the clinicians put the final diagnosis of CS.

According to the review of literature, less than 500 cases have been reported worldwide, many of which have been diagnosed by dental surgeons, or oral pathology and medicine specialists by recognition of mucocutaneous lesions. There is a close association of CS with the development of several malignant neoplasms. This point emphasizes the importance of the early recognition of these lesions, which facilitates an early diagnosis of CS. Oral lesions can be the first sign of the disease, because they develop in 90 to 99% of cases. The diagnosis of CS in this case was made based on criteria proposed by the International Cowden Syndrome Consortium.

Since the patients can have a variety of clinical manifestations, the diagnosis can be mistaken and delayed. Therefore, it seems that there is a need for awareness of this entity in the dental community.

Considering the increasing use of decision support systems, specifically artificial intelligence (AI), in the field of medicine, our goal in this study was to identify, from the perspective of physicians working in AJA medical centers, the obstacles hindering the adoption and use of AI in the treatment and diagnosis of patients.

This study investigated the obstacles faced by specialist physicians working in AJA medical centers regarding the implementation of AI in their professional practice.

A qualitative approach using contractual content analysis was employed. Data were collected through semi-structured, in-depth interviews and analyzed using the qualitative analysis method of Granheim and Lundman (2004) from May to July 2022. The study included 20 physicians working in selected AJA medical centers in Tehran. Sampling was conducted based on entry criteria and targeted to ensure maximum diversity.

The study involved 20 specialist physicians (15 men and 5 women) from selected AJA medical centers in Tehran, with an average age of 42 years and an average work experience of 14 years. The identified obstacles to the development of AI in these medical centers were categorized into three main groups: Extra-organizational and organizational factors, individual factors, and educational factors. These categories included 10 subcategories: Sanctions and economic issues, organizational attitudes, rules and regulations, available facilities, quality of facilities, knowledge and attitude, individual resistance to change, education quality, educational curriculum, and clinical professors.

Iran's unique conditions pose challenges to the development and implementation of AI in its medical centers. This study highlights the need to address these obstacles by revising organizational rules and regulations and educating stakeholders on the benefits of AI. These measures could promote the use of AI in military medical centers and improve the quality of care.

The awareness of the Emergency Department (ED) workforce about the department’s operational guidelines and metrics is essential to optimize the workflow and reduce workload and patient revisits to the ED. Therefore, this study aimed to evaluate the knowledge of the ED workforce regarding operational metrics.

We conducted a national cross-sectional study using an online survey in the Kingdom of Saudi Arabia between September and December 2020. ED personnel were studied regarding the ED operational metrics like laboratory/imaging turnaround times, ED length of stay, and patient revisits, linking them to quality care. Data was summarized and analyzed using the Jamovi statistical package.

One hundred sixty-six participants responded to our online survey. Ministry of Health hospitals represented the largest section (n=90, 54.2%), followed by academic hospitals (n=40, 24.1%). The frequencies of an exit block in the ED were reported as 2-3 days per week (29.5%), most days (24.7%), or daily (18.1%). 41% of the respondents did not know the metrics of lab and imaging turnaround time, while 21.7% did not know about the length of stay. Most respondents agreed that the principles of ED operation should be implemented in the training programs (88.6%) and reported their satisfaction with the productivity of their department in practicing effective operations (70.9%).

About one-third of the ED workers were unaware of the key operational metrics of the ED. However, the respondents believe that implementing operational metrics for ED increases the quality of medical care and should be part of the training programs.

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths with high mortality rates worldwide. Accessible screening methods have facilitated its early diagnosis. In Iran, as in many Asian countries, an important barrier to CRC screening is the insufficient knowledge of healthcare providers, including physicians, and the lack of advice from them. Available data on this subject are insufficient, and more surveys are needed in this country.

This study aimed to investigate Iranian physicians' knowledge about CRC signs and symptoms, risk factors, and screening. Additionally, the association between their knowledge and their characteristics was assessed to provide more data for further interventions.

This cross-sectional study was conducted on 150 family physicians selected by convenience sampling from rural areas in Hamadan province, Iran, from June to September 2017. A self-administered, semi-structured questionnaire was used. Data were analyzed using SPSS 21, with a significance level set at P < 0.05.

The mean total knowledge score about CRC was 25.11 ± 4.64 (64.3%) out of 38 questions. The average scores for knowledge about CRC signs and symptoms, risk factors, and the screening program were 7.1 ± 0.81 (out of 8), 10.29 ± 1.83 (out of 13), and 7.77 ± 3.43 (out of 18), respectively. Family physicians had the highest accuracy in answering questions about CRC signs and symptoms (88.7%) and the lowest accuracy in answering questions about the screening program (43%). Since the Kolmogorov-Smirnov test rejected the normal distribution of the data, nonparametric tests were used to compare physicians' knowledge scores according to different variables. The study revealed a statistically significant reverse correlation between physicians’ knowledge of CRC and their age (r = -0.342, P < 0.001), years since graduation (r = -0.228, P = 0.005), and work experience (r = -0.247, P = 0.002). However, after multiple regression analysis, only higher age significantly predicted lower total knowledge scores (P = 0.002). No significant relationship was found between participants' knowledge scores and their gender (P = 0.929) or place of employment (P = 0.399).

Family doctors had insufficient knowledge regarding CRC screening programs. To address this issue, health education programs should be designed to enhance their knowledge of CRC screening guidelines.

To evaluate the decision-making proficiency among medical residents at Tehran University of Medical Sciences in the year 2022-2023.

A structured online web-survey via national approved services Author’s designed questionnaire was used to collect the relative data based on variables of the study and was developed by the authors of the study by reviewing the previously conducted studies. The forms were sent to the medical residents at Tehran University of Medical Sciences as a link via electronic mail and social media; assistance was offered via direct or indirect contact upon request.

In this study, 88 medical residents of Tehran University of Medical Sciences were evaluated. Out of 88 participants, the frequency of females was 52(59.09%) and frequency of males was found out to be 36(40.91%). The frequency of the first- year residents was 28(37.50), second year residents was 33(21.59), third year residents was 19(9.09) and the fourth- year residents was found out to be 8(31.82). The frequency of different specialties were: Pathology 1(1.14%), Infectious diseases 1(1.14%), Cardio vascular diseases 1(1.14%), Emergency medicine 1(1.14%), Orthopedics2(2.27%), Psychiatry 3(3.41%), ENT 12(13.64%), Internal Medicine 13(14.77%), Pediatrics13(14.77%), OB&GYN 19(21.59%), Anesthesiology19(21.59%), Dermatology 2(2.27%), General Surgery 1(1.14%).

There is a significant relationship based on linear regression between not having self - reported availability bias and surgical residency specialties. The surgical specialty is less prone to the availability bias. A difference of communication exists between the surgical and nonsurgical speciality and the nonsurgical specialties need to confirm their decision using other methods to prevent the patient harm.

The development of societies relies on the type and manner of activities performed at universities. Professors play a pivotal role in the development of universities and societies. Assessment of professors’ motivation and behavior and factors affecting them can improve the educational system and increase its performance. This study aimed to assess the validity and reliability of the Physician Teaching Motivation Questionnaire (PTMQ) from the viewpoint of clinical professors at Iran University of Medical Sciences (IUMS).

This is an instrument psychometric study in which the questionnaire’s validity was determined through the face and content validity and its construct validity through exploratory and confirmatory factor analysis. Reliability was determined through the calculation of Cronbach’s alpha and intraclass correlation coefficient and consistency between agreers. The data were analyzed in SPSS 23 and LISREL 8.8.

The results showed that all 18 items had acceptable content validity (0.68-0.97). The Cronbach’s alpha and intraclass correlation coefficients were 0.81 and 0.86, respectively. The number of items remained unchanged at 18 according to exploratory factor analysis which classified them into six categories (intrinsic motivation, identified motivation, introjected motivation, career motivation, external motivation, and teaching assistant motivation) and explained 54% of the total variance of the mentioned variables. Also, the value of CFI was equal to 0.93 and the value of Cohen’s kappa was between 0.77 and 0.84.

The Persian version of PTMQ is a valid and reliable instrument that can be used for research, educational, and practical purposes to evaluate the teaching motivation of clinical professors in other groups.

It is well known that disclosure of Medical Errors (MEs) is the duty of physicians and it is the right of patients to be aware of any error occurring in their medical care process. This study was planned to asses to what extent the patients expect to be informed of the occurrence of MEs, they prefer who reports the medical error to them, and what are the influential factors in taking legal action against physicians in disclosed MEs from their point of view.

In this cross-sectional study, eligible patients admitted to academic hospitals of Guilan (Poorsina; Razi; Alzahra; Amir Al-Momenin; Dr. Heshmat), were interviewed directly and a questionnaire which was divided into four sections was filled out. The first part was about socio-demographic data of the responders and the next three sections included their preferences towards the type of MEs to be disclosed, who is responsible for this task, and in which conditions they sue against the medical team.

About 96.6% of the patients believed that MEs had to be disclosed to the patients. Moreover, 29.3% preferred to be informed about all MEs that occurred during their medical care even if it caused no harm. 51.1% expected that physician who committed the error informs the error. On the whole age, gender, employment status, residency and education were among the influential factors of the patients’ willingness and point of view and filing a lawsuit against physicians. 

Based on the findings of this study, it is recommended that all minor and major MEs should be disclosed sympathetically by the physician who committed the error.

Premature infants often encounter different challenges due to their underdeveloped systems at birth and require specialized care to survive. Telecare usage as a follow-up tool is a proper line to increase infants’ health by reinforcing parents’ competency to care effectively during the post-discharge period. However, there is controversy about telecare for post-discharge infant care. This study aimed to investigate and compare the experiences of nurses and physicians about post-discharge telecare usage in premature infants.  This qualitative study employed conventional content analysis. Semi-structured interviews were conducted with 30 nurses and 25 physicians using purposive sampling. The participants were recruited from three neonatal intensive care units (NICU) affiliated with Isfahan University of Medical Sciences, Iran, from October 2022 to February 2023. All participants had at least two years of experience providing teleconsultation care for premature infants through a web-based national social media platform. The interviews aimed to explore participants’ experiences with teleconsultation. Data collection spanned five months, and the analysis was guided by Granheim and Lundman’s method to extract core concepts until data saturation was reached, meaning no new information emerged from further interviews. The findings demonstrated two main components, including the challenges and benefits of telecare. Both nurses and physicians generally agreed on the usefulness of telecare, but they differed in opinions regarding infant safety and trust in parents’ understanding of telecare monitoring. The study highlighted safety concerns and parental internet literacy levels related to telecare follow-up, advocating for its integration alongside traditional care. Valuable insights were provided for policy-makers in managing post-discharge care for premature infants, emphasizing the need for further exploration into long-term impacts and parental adherence to telecare protocols.

“Interprofessional Collaboration” is associated with improving the quality of care. The objective of this study was the analysis of the concept of “Interprofessional Collaboration” using a hybrid model.

A hybrid model was used in order to analyze the concept of “Interprofessional Collaboration.” The first phase was the scientific search of texts in all valid electronic databases. The second phase includes fieldwork in which medical, pharmaceutical, and nursing staff were interviewed. Data were collected, reviewed, and analyzed in the third phase.

The four main themes extracted in the theoretical phase included: “attributes of individual, team, organizational, and system.” In the fieldwork phase, three themes and seven sub‑themes were identified: “Dynamism/effectiveness of collaboration, uncertain boundaries of collaboration, advanced organizational culture.” In the final phase, with the combination of the results of two previous phases, the final definition of the concept was presented: “A process that brings together systems, organizations and individuals from various professions to achieve common interests and goals. Achieving common goals and interests is influenced by individual, team, organizational, and system attributes.”

Defining the concept of interprofessional collaboration and identifying its various aspects can be a practical guide for creating and evaluating it in educational and clinical settings.

As the vital and scarce resource of the health system, physicians are responsible for treating patients and saving lives and the equitable distribution of physicians among the whole population is a prerequisite to achieving health for all. We aimed to investigate inequality in physician distribution in the world using the Gini coefficient.

This descriptive-analytical study was conducted in 2021. The number of physicians and the population of countries were obtained from the WHO and United Nations (UN) databases. The Gini coefficient was calculated in three different modes and the distribution of physicians among countries in various Human Development Index (HDI) groups was determined using the physician ratio per 10,000 population.

There were generally more than 13 million doctors in the world. About 43% of the world's physicians were available to 20% of the world's population in very high HDI countries, and 12% of the population had access to about 1% of physicians in low HDI countries. An average of 19.5 physicians are distributed per 10,000 population worldwide. The Gini coefficient between the four groups of HDI countries was 0.55, and that of all countries in the world was 0.640.

There was a shortage and inequality in the distribution of physicians worldwide. Governments should eliminate inequality in the distribution of the medical workforce, in particular physicians, by redoubling their efforts and accurate planning.