فصلنامه طب و تزکیه
سال سی و یکم شماره 2 (پیاپی 122، تابستان 1401)

Since professional development is one of the goals of any medical school, an essential element in this regard will be the evaluation of professional behavior which is important as one of the most important competencies in the medical profession. Therefore, the present study was conducted with the aim of determining the level of observance of behavior and professional commitment of specialized physicians from the perspective of patients in 2020.

This descriptive study was performed on 150 patients admitted to Imam Khomeini Hospital in Tehran who were selected by simple random sampling. Data collection tools included two sections: demographic variables and 18-item 5-point Likert scale professional behavior and commitment. Data were analyzed using descriptive statistics, Pearson and Spearman correlation tests and multiple linear regression.

The mean and standard deviation of the score of the instrument for observing the behavior and professional commitment of specialized physicians from the patients' point of view was 70.55 ± 9.68 with the lowest score of 49 and the highest score of 90. More than half of the patients 67.3% (101 people) determined the level of professional behavior and commitment at a good level and 32.7% (49 people) at a moderate level.

  Based on the results of this study, professional commitment and behavior are at a good level. The lowest level of compliance was related to not accepting responsibility for diagnostic and treatment errors. Therefore, the relevant authorities should pay attention to identifying the causes of these shortcomings and taking measures to gain experience from the errors.

The emergence of technological innovations and digital medicine is making fundamental changes in the healthcare sector towards personalized medicine. Therefore, in the near future, we will have to pass from population-based medicine to personalized medicine. The purpose of this study is to identify the appropriate framework for the transition to personalized medicine.

The study method was a systematic literature review with a content meta-analysis approach. The statistical population of the research was personalized medicine articles that have been conducted during the last 12 years (2010-2022). After several screening stages of the papers, finally 7 articles have entered the meta-analysis process as samples (articles related to policy making or transition to PM).

Findings show the most of the studies in the field of PM were specialized and clinical, and only a few studies have briefly addressed the management and policy issues of PM, and the transition and transition pathways regarding PM have not been studied much.

Adapting from the proposed PM model and technological transition pathways, the framework for the transition to personalized medicine includes the transformation pathway from conventional medicine to stratified medicine and then technological substitution pathway from stratified medicine to personalized medicine. In order to appropriate policy making in this framework, we need appropriate policy tools of science, technology and innovation.

The development of interdisciplines in higher education at the world level is a solution to accurately understand the changes and to learn how to face the challenges of the expanding world. It is because of these changes that health in the world have become complex and it is not possible to understand this field only by relying on medical sciences. Based on this, the main goal of this article is that the appropriate development model for the expansion of interdisciplines in Iran's medical sciences. In this model, we will focus on the uncertainties, describe the leading scenarios for the future development of interdisciplinary fields in Iran's medical sciences.

Methods and Materials:

 In this article, the expert panel method has been used to gather, prioritize and validate the factors influencing the future development of interdisciplinary studies in medical sciences universities, relying on expert meetings with the elected representatives of ten medical sciences macro-zone of the country. Also, we have used the structural-interpretive analysis method to calculate the most important factors shaping the future of interdisciplinary studies, and the modeling method has been used to formulate the development model of interdisciplinary studies in universities of medical sciences, and the uncertainty analysis method to determine the most important shaping factors in the future of interdisciplinary studies. The scenario method has been used to visualize alternative futures for the advancement of interdisciplinary development in medical sciences.

In this article, the factors influencing the development of interdisciplinary knowledge, uncertainties and four scenarios for advancing interdisciplinary development in the country's medical sciences, statistics and a proposed model for the advancement and expansion of interdisciplinary knowledge in the country's medical sciences at the educational and research levels are presented.

The proposed model of interdisciplinary development in medical sciences based on the interaction of the two main driving forces, namely "creating dialogue and participation at the national level" and "focusing and strengthening cooperation" in other layers of the higher education system of health and health, emphasizing the role of a network of actors and key stakeholders directly and Indirect in the definition, application and development of interdisciplinary knowledge is the result of this research.

Today, due to the numerous issues that exist in the health sector, the government alone is not able to improve the conditions and it is necessary to use the capacity of the private sector and civil society to improve the health sector. Therefore, the aim of this research is to identify and prioritize good governance affairs in health system. 

The current research is applied-developmental in terms of purpose. After examining the theoretical foundations and previous researches, the governance issues of the health system were identified. Then, using the fuzzy Delphi method and asking the opinions of 13 experts who were selected purposefully, the final variables were designed. Finally, in order to validate the model, 169 health department managers in Tehran city were asked for their opinions using a questionnaire and the data were analyzed with confirmatory factor analysis and Smart PLS software. 

Based on the findings, strategic orientation strategies, balanced and integrated management, value orientation and ethical orientation, optimal management of financial resources, promotion of administrative health and development of knowledge resources were identified for governance affairs. Also, for contractual affairs, strategies including development of technical knowledge, development of executive and operational platform and management of service provision capacity, and for partnership matters, strategy of development of stakeholders' participation were identified. Also, all the identified matters were confirmed by factor analysis method and the coefficient of determination for governance, contractual and partnership affairs was calculated as 0.674,0.605 and 0.551 respectively, which are suitable values. 

Good governance in the health system is a combination of governance, contractual and partnership affairs. In order to move in the direction of improving the health system, it is necessary to pay serious attention to these affairs at the same time and to use the capacity of the private sector and civil society in addition to the government's capacity.

In reverse learning; Instructors changed the place from direct teaching in a large group learning environment. The aim of the present study was to model the reverse learning process in education of Mazandaran University of Medical Sciences.

The research design is also of exploratory mixed type. The statistical population in the qualitative section includes academic experts and members of the Education and Empowerment Committee of Medical Universities (Mazandaran, Tehran, Babol, etc.) and in the quantitative section includes Employees of the Department of Management and Resources Development, Health and Education Branch of Mazandaran University of Medical Sciences; In the qualitative section, in-depth interviews were conducted with 12 experts using the snowball sampling method, and in the quantitative section, a questionnaire was used to measure the model using the multi-stage relative stratified method among 310 samples. The face and content validity of the questionnaire and the reliability was confirmed by Cronbach's alpha method. Data were analyzed by exploratory and confirmatory factor analysis with SPSS and Smart PLS software.

The results showed that the reverse learning process has 12 dimensions in terms of learning motivation, individual factors, organizational culture factors, structural factors, the establishment of reverse learning, facilitation measures, organizational barriers and challenges, non-organizational barriers and challenges, bedding and planning, awareness, quality of education and quality of learning. The results of the quantitative section showed that all dimensions of the research paradigm model were confirmed.

It is Recommended to the officials of Mazandaran University of Medical Sciences to provide the necessary conditions for the establishment of reverse learning, make the necessary arrangements according to the results of the present study.

Most of a person's life is spent in employment. Today, we see a trend and special attention to the issue of job burnout all over the world. Burnout is a psychological symptom, an ongoing response to chronic personal and emotional stress in the workplace. Pediatric resident physicians are exposed to job burnout for various reasons, which reduces the quality of service delivery. Therefore, due to the importance of paying attention to the issue of job burnout and also the lack of a studies in this field in the community of pediatric resident physicians of Tehran University of Medical Sciences, this study was conducted with the aim of investigating the job burnout of pediatric resident physicians of Tehran University of Medical Sciences based on Maslach questionnaire in 2020-2021.

This descriptive-analytical cross-sectional study was conducted on 57 active in Pediatric resident physicians of Tehran University of Medical Sciences. To determine the level and intensity of job burnout, the Persianized Maslach questionnaire was used. To analyze the data, first descriptive statistics were used, including the mean standard deviation of burnout scores and their severity, and for comparison, a two-sample t-test or Mann-Whitney test was used. SPSS 26 software was used for data analysis.

The average intensity of job burnout in pediatric resident physicians of Tehran University of Medical Sciences is 55.45 and also the mean frequency of job burnout in pediatric resident physicians of Tehran University of Medical Sciences is 62.1.  In this study, there was no significant difference between the severity and frequency of job burnout with age, marital status, and work experience. However, a significant relationship was observed between the intensity of emotional burnout and the number of working days per week. A significant relationship was observed between the frequency of emotional burnout and living in a family. A significant relationship was observed between the severity of personality disorder and having children.

Based on the results of this study, job burnout among pediatric resident physicians of Tehran University of Medical Sciences showed the level of severe personal failure in terms of frequency and in average level, while this variable in the dimensions of emotional exhaustion has low intensity and moderate frequency, and depersonalization has low intensity and frequency.