Effect of matrix metalloproteinase inhibitors on microtensile bond strength of dental composite restorations to dentin in use of an etch-and-rinse adhesive system.

AIM: This study assesses the effect of matrix metalloproteinases on microtensile bond strength (µTBS) of an etch-and-rinse adhesive system. METHODS: This in vitro study evaluated 88 extracted premolars. The teeth were sectioned to expose dentin and were then randomly divided into four groups (n = 22). In group 1 (control), dentin surface was etched, and Adper Single Bond 2 was applied. In groups 2-4, dentin surface was etched and chlorhexidine (CHX), 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC), and dimethyl sulfoxide (DMSO) were applied on the surfaces, respectively, and blotted dry. Next, Adper Single Bond 2 was applied and all teeth were built up with Z350 composite. In each group, half the samples immediately and the other half after 10,000 thermal cycles underwent µTBS test. Data were analyzed using ANOVA and Tukey's test (α = .05). RESULTS: In thermocycled samples, maximum µTBS was noted in CHX group followed by DMSO, EDC, and control group (p < .001). The thermocycled µTBS of composite to dentin was significantly higher in CHX group compared with EDC, DMSO, and control groups (p < .001) but was not significantly different in EDC and DMSO groups (p = .498). CONCLUSION: The thermocycled µTBS obtained by the application of CHX, EDC, and DMSO was significantly higher compared with the value to the control group.

The Effect of Medical Recording Training on Quantity and Quality of Recording in Gynecology Residents of Tabriz University of Medical Sciences.

Introduction: Medical records contain valuable information about a patient's medical history and treatment. Patient safety is one of the most important dimensions of health care quality assurance and performance improvement. Completing the process of documentation is necessary to continue patient care and continuous quality improvement of basic services. The aim of the present study was to evaluate the effect of medical recording education on the quantity and quality of recording in gynecology residents of Tabriz University of Medical Sciences. Methods: This study is a quasi-experimental study and was conducted at Al-Zahra Teaching Hospital, Tabriz, Iran, in 2016. Thirty-two second through fourth year gynecologic residents of Tabriz University of Medical Sciences who were willing to participate in the study were included by census sampling and participated in training workshop. Three evaluators reviewed the residents' records before and after training course by a checklist. Statistical analyses were performed using SPSS 13 software. P-values less than 0.05 were considered statistically significant. Results: The results showed that before the intervention, there were significant differences in the quantity of information status among the evaluators and no significant difference was observed in the recording of qualitative status. After the workshop, among the 3 evaluators, there were also significant differences in the quantity of data recording status; however, no significant change was observed in recording of qualitative status. Conclusion: The study findings revealed that a sectional training course of correct and standardized medical records has no effect on reforming the process of recording.

The Effect of Simulation Teaching on Baccalaureate Nursing Students' Self-confidence Related to Peripheral Venous Catheterization in Children: A Randomized Trial.

INTRODUCTION: In recent decades, nursing instructors have tended to use simulation rather than traditional methods due to benefits such as increased self-confidence. However, little academic literature is available to verify this claim. The procedure of establishing peripheral venous catheterization in pediatric patients is of great importance. Therefore, the researchers attempted to review the effect of the simulation teaching method on nursing students' self-confidence related to peripheral venous catheterization in pediatric patients. METHODS: In this trial, 45 students in the 5(th) and 6(th) semester of nursing school in the first half of school year 2012 from the Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Iran, were randomly assigned to three groups (a control group, and two intervention groups). They were trained in establishing peripheral venous catheterization in pediatric patients through simulation teaching method and practical training. The students' self-confidence was assessed by C-Scale before and after the intervention. RESULTS: The students' self-confidence score showed a significant increase in the simulation group after the intervention in comparison to other groups (p = 0.03). CONCLUSION: RESULTS revealed a significant increase in self-confidence of nursing students related to peripheral venous catheterization in pediatric patients by simulation. This substantiates the assertion that simulation can improve self-confidence. Due to the low sample size, further studies with larger population are suggested.

Does an outcome-based approach to continuing medical education improve physicians' competences in rational prescribing?

BACKGROUND: Continuing medical education (CME) is compulsory in Iran, and traditionally it is lecture-based, which is mostly not successful. Outcome-based education has been proposed for CME programs. AIM: To evaluate the effectiveness of an outcome-based educational intervention with a new approach based on outcomes and aligned teaching methods, on knowledge and skills of general physicians (GPs) working in primary care compared with a concurrent CME program in the field of "Rational prescribing". METHOD: The method used was cluster randomized controlled design. All GPs working in six cities in one province in Iran were invited to participate. The cities were matched and randomly divided into an intervention arm for education on rational prescribing with an outcome-based approach, and a control arm for a traditional program on the same topic. Knowledge and skills were assessed using a pre- and post-test, including case scenarios. RESULTS: In total, 112 GPs participated. There were significant improvements in knowledge and prescribing skills after the training in the intervention arm as well as in comparison with the changes in the control arm. The overall intervention effect was 26 percentage units. CONCLUSION: The introduction of an outcome-based approach in CME appears to be effective when creating programs to improve GPs' knowledge and skills.

Identifying outcome-based indicators and developing a curriculum for a continuing medical education programme on rational prescribing using a modified Delphi process.

BACKGROUND: Continuing medical education (CME) is compulsory for physicians in Iran. Recent studies in Iran show that modifications of CME elements are necessary to improve the effectiveness of the educational programmes. Other studies point to an inappropriate, even irrational drug prescribing. Based on a needs assessment study regarding CME for general physicians in the East Azerbaijan province in Iran, rational prescribing practice was recognized as a high priority issue. Considering different educational methods, outcome-based education has been proposed as a suitable approach for CME. The purpose of the study was to obtain experts' consensus about appropriate educational outcomes of rational prescribing for general physicians in CME and developing curricular contents for this education. METHODS: The study consisted of two phases: The first phase was conducted using a two-round Delphi consensus process to identify the outcome-based educational indicators regarding rational prescribing for general physicians in primary care (GPs). In the second phase the agreed indicators were submitted to panels of experts for assessment and determination of content for a CME program in the field. RESULTS: Twenty one learning outcomes were identified through a modified Delphi process. The indicators were used by the panels of experts and six educational topics were determined for the CME programme and the curricular content of each was defined. The topics were 1) Principles of prescription writing, 2) Adverse drug reactions, 3) Drug interactions, 4) Injections, 5) Antibiotic therapy, and 6) Anti-inflammatory agents therapy. One of the topics was not directly related to any outcome, raising a question about the need for a discussion on constructive alignment. CONCLUSIONS: Consensus on learning outcomes was achieved and an educational guideline was designed. Before suggesting widespread use in the country the educational package should be tested in the CME context.

Morning report: a survey of Iranian senior faculty attitudes.

Morning report (MR) is a universal component of internal medicine training. Despite its omnipresence, little is known about senior faculty attitudes toward MR. We aimed to survey expert attitudes towards MR. Using an 85-item self-administered questionnaire, we made a survey of medical education-trained faculty members (FMs) who participated in and presented articles at the Seventh National Iranian Congress on Medical Education, 12-15 November 2005, Tabriz, Iran, on the processes of teaching and learning during MR (n=175). Among the 111 FMs (63.4%) who completed the survey, education was the most frequently cited goal of the MR. Clinical wisdom and the ability to expand a resident's differential diagnosis skills were the attributes most often proposed as essential for the FMs. Respondents believed the FM in cooperation with the senior resident of the last duty (41%) or the senior resident of the last duty alone (40%) should select the presenting cases. The study participants stated that 41% of the MR should be spent discussing common cases, 33% in the area of expertise of the FM and 26% in discussing rare or interesting cases. A common opinion was that treatment recommendations should be based on the medical literature. In terms of the educational impact of activities during the MR, listing differential diagnoses and bedside visits to examine unique findings scored the highest. Education as the main goal of the MR can best be achieved by expanding residents' skills in differential diagnosis and in making decisions using an evidence-based, self-directed method.