Development and psychometric evaluation of a 360-degree evaluation instrument to assess medical students' performance in clinical settings at the emergency medicine department in Iran: a methodological study

BACKGROUND: In the Iranian context, no 360-degree evaluation tool has been developed to assess the performance of prehospital medical emergency students in clinical settings. This article describes the development of a 360-degree evaluation tool and presents its first psychometric evaluation. METHODS: There were 2 steps in this study: step 1 involved developing the instrument (i.e., generating the items) and step 2 constituted the psychometric evaluation of the instrument. We performed exploratory and confirmatory factor analyses and also evaluated the instrument's face, content, and convergent validity and reliability. RESULTS: The instrument contains 55 items across 6 domains, including leadership, management, and teamwork (19 items), consciousness and responsiveness (14 items), clinical and interpersonal communication skills (8 items), integrity (7 items), knowledge and accountability (4 items), and loyalty and transparency (3 items). The instrument was confirmed to be a valid measure, as the 6 domains had eigenvalues over Kaiser's criterion of 1 and in combination explained 60.1% of the variance (Bartlett's test of sphericity [1,485]=19,867.99, P<0.01). Furthermore, this study provided evidence for the instrument's convergent validity and internal consistency (α=0.98), suggesting its suitability for assessing student performance. CONCLUSION: We found good evidence for the validity and reliability of the instrument. Our instrument can be used to make future evaluations of student performance in the clinical setting more structured, transparent, informative, and comparable.

Evaluating the frequency of neurological symptoms in COVID-19 patients: A cross-sectional study.

Background and Aims: Due to the recent emergence of COVID-19, the exact pathology of this disease has not been determined. Therefore, this study evaluated the frequency of neurological symptoms in patients with COVID-19. Methods: This cross-sectional study was conducted on 2200 in patients with COVID-19 who were selected from an educational hospital in Sanandaj, Iran, from April 2020 to March 2021. The research samples were selected by census, all patients with COVID-19 were admitted to the hospital. The data collection tool was a checklist of the studied variables (dizziness, headache, and impaired consciousness) prepared by the researchers based on the specialists' opinions. The researcher completed these checklists based on the patients' hospitalization records. The data were analyzed by descriptive and analytical statistical tests using SPSS Software Version 20. The quantitative variables were compared using the independent t-test. The χ 2 test was also used to compare qualitative variables. A p Value of less than 0.05 was considered statistically significant. Results: The mean age of the patients was 57.41 years old, of whom 53.1% were male. The average blood oxygen level of the patients was 88.10%, and most disease symptoms were related to shortness of breath and cough, with a frequency of 24.3%. In addition, 20.8% of patients needed hospitalization in intensive care unit. The highest frequency of central and peripheral nervous system manifestations was related to headache, ageusia (loss of sense of taste), hyposmia (A decreased sense of smell and anosmia (The complete loss of smell). Finally, 15.3% of patients died, and 84.7% recovered. The analytical findings showed a significant relationship between the disease outcome and patients' dizziness, consciousness disorder, seizure and ageusia. There was a significant relationship between gender and headache in patients. There was a significant difference between the mean age and oxygen level with central and peripheral nervous system manifestations (dizziness, headache, impaired consciousness, smell disorder) and the disease outcome in patients. Conclusion: The pathophysiology of COVID-19 virus infection involving the central nervous system is not fully understood. Neurological symptoms of this virus include delirium, headache, decreased level of consciousness, and seizures. Identifying the symptoms and mechanisms of neurological complications of COVID-19 is necessary for proper screening and complete treatment because a patient infected by COVID-19 may not show respiratory failure signs but may be a carrier. A complete and accurate knowledge of the symptoms and complications of this infection for proper screening of patients to prevent transmission and spread of this disease is critically needed.

Overview of Stem Cell Therapy in Intervertebral Disc Disease: Clinical Perspective.

Intervertebral Disc Degeneration (IDD) is recognized as an aging process, an important and most common pathological condition caused by an imbalance of anabolic and catabolic metabolisms in the Intervertebral Disc (IVD), and leads to changes in the Extracellular Matrix (ECM), impaired metabolic regulation of Nucleus Pulposus (NP), and increased oxidative stress. IDD is mostly associated with pain in the back and neck, which is referred to as a type of disability. Pharmacological and surgical interventions are currently used to treat IDD, but evidence has shown that these interventions do not have the ability to inhibit the progression of IDD and restore IVD function because IVD lacks the intrinsic capacity for regeneration. Thus, therapies that rely on a degenerative cell repair mechanism may be a viable alternative strategy. Biological interventions have been assessed by attempting to regenerate IVD by restoring ECM and cellular function. Over the past decade, stem cell-based therapies have been considered, and promising results have been obtained in various studies. Given this, we reviewed clinical trials and preliminary studies of biological disc repair with a focus on stem cell therapy-based therapies.

Nursing students' experience of incivility behaviours and its correlation with their nursing professional values: A cross-sectional descriptive study.

AIMS: The purpose of this study was to determine the relationship between experienced incivility behaviours and professional values in the clinical setting and also the factors influencing incivility and professional values. DESIGN: Cross-sectional descriptive study. METHODS: Data gathering tools used in the study includes demographic characteristics, incivility behaviour and nursing professional values. Data were analysed using IBM SPSS version 21. RESULTS: The findings showed that incivility behaviours had a statistically significant negative correlation with professional values (r = -.150, p = .003), so that the level of incivility behaviours experienced by students was low (1.76 out of 5). This was while the level of professional values was moderate to high among students (3.72 out of 5). Due to the negative and statistically significant correlation between incivility behaviours experienced by students and nursing professional values, it is necessary that the officials of teaching hospitals inform nurses about incivility behaviours. Considering the negative and statistically significant correlation, it can be concluded that the reduction in nurses' incivility behaviours as patterns of the nursing profession causes nursing students to better acquire and internalize nursing professional values in the clinical setting. Nurse educators should also try to communicate with nursing administrators to exchange information about nurses' civil and incivility behaviours perceived by students.

Investigating the relationship between workplace stressors and caring behaviours of nursing staff in inpatient wards: A cross-sectional study.

AIM: The present study aimed to investigate the effects of various job stressors on caring behaviours of nursing staff. DESIGN: A cross-sectional nationwide study. METHODS: This cross-sectional, descriptive-correlational study was conducted on 260 nurses employed in the inpatient wards of seven teaching hospitals in Tehran, Iran during December 2019-February 2020. The participants were selected via convenience sampling. Data were collected using a demographic questionnaire, the nursing stress scale and the caring behaviours inventory. Data analysis was performed in SPSS version 20 using descriptive statistics and linear regression analysis. RESULTS: The results of regression analysis indicated that job stress is correlated with nurses' caring behaviours (ß = -.36; p = .001). Factors such as workload (ß = -.27; p = .001), uncertainty about patient treatment (ß = -.26; p = .017) and lack of emotional preparation (ß = -.20; p = .017) were the important stressors associated with nurses' caring behaviours. CONCLUSIONS: According to the results, high levels of perceived job stress due to workload, uncertainty about patient treatment and lack of emotional preparation are associated with lower levels of nurses' caring behaviours. IMPACTS: The findings of this study showed that to provide patients with optimal caring behaviours, hospital and nursing managers should design interventions to reduce nurses' job stressors, especially in terms of their interactions with their colleagues and physicians.

Stem cell therapy as a recent advanced approach in male infertility.

Infertility is one of the most common problems in the world that has negative effects on society and infertile people. Among the various causes of infertility, male infertility accounts for almost half of all infertility cases. Despite advances in medicine, current male infertility treatments such as assisted reproductive technology (ART) have not been successful in treating all types of male infertility. Recently, stem cells have been considered as therapeutic targets for many diseases, including infertility, due to their self-renewing and high differentiation. The purpose of this review is to discuss different types of male infertility and the effect of various stem cells against the treatment of male infertility.