محمد رجب پور

Despite advances in medical treatments, readmission of stroke patients remains high and has been reported between 31% and 56.1% during the first year after discharge. The difference between the risk factors of readmission and the risk factors of stroke is not clear. The purpose of this study is: 1) to determine the preventable risk factors associated with stroke readmission and 2) to provide a conceptual model for preventable factors that effective in the readmission of stroke patients.

This integrated review was performed according to Whittemore and Knafl (2005) method in five stages including problem identification, literature search, data evaluation, data analysis, and presentation. In order to find relevant articles, PubMed, Web of Science, CINAHL, Scopus databases and Google Scholar search engine were searched. The search was conducted using the keywords "stroke," "readmission," "recurrence," "re-hospitalization," "review," and "systematic review," for the period between January 2023 and September 2023, following the PRISMA guidelines. In addition to providing a qualitative synthesis of readmission factors categorized into categories, a conceptual model of these factors was also presented.

Out of a total of 3785 article titles, 38 articles were included in the study for the final analysis after screening and removing duplicates. The most important risk factors for readmission in four categories: (1) knowledge deficit about the comorbidities (such as hypertension, atrial fibrillation, diabetes), (2) unhealthy diet and medicine, (3) high-risk behaviors (smoking, alcohol consumption, and tobacco use disorder), and (4) psychological distress (depression and worry about the future). In addition, the conceptual model showed that the most important preventable factor in readmission of stroke patients is of knowledge deficit about comorbidities (especially hypertension). 

The most important preventable risk factors that are effective in the readmission of stroke patients are knowledge deficit regarding clinical risk factors, especially high blood pressure, high-risk behaviors and unhealthy diet and medicine. Therefore, more detailed care and follow-up programs should be designed for stroke patients after discharge.

Measurement of caring behavior can not only be useful for the measurement of the caring behavior of students and employees of the healthcare system but can also be used to identify and provide timely information about the status of these behaviors in students and employees to carry out interventions and modify policies. The present study aimed to translate and determine the psychometric properties of the Persian version of the caring behavior scale on healthcare students and providers.

This methodological study was carried out in 2023 with the participation of 330 students and employees of Mashhad University of Medical Sciences, Mashhad, Iran who were selected using the convenience sampling method. The instrument was translated using the forward-backward method. The final version of the scale was checked in terms of validity (content, face, and construct validity [using confirmatory factor analysis]) and reliability (Cronbach's alpha, test-retest, and intraclass correlation) in SPSS software (version 25) and AMOS software (version 24).

In reviewing the face validity,  scores of all items were higher than 1.5. content validity of all items was accepted, and the factor loading of all the items was higher than 0.4; therefore, all the items were retained. The goodness of fit indices of the model indicated the approval of the model and its good fit (GFI: 0.884, NFI: 0.911, CFI: 0.921, and RMSEA: 0.07). Reliability of the scale was confirmed by Cronbach's alpha coefficient, test-retest, and intra-cluster correlation of 0.84, 0.86, and 0.83, respectively.

Psychometric features of the Persian version of the CBS-HSP scale were favorable. Therefore, it can be used in future studies to measure the care behaviors of the Persian population and also evaluate effective interventions on this outcome.

With advancements in treatment and an increase in the prevalence of diseases, the number of patients requiring mechanical ventilation in intensive care units (ICUs) continues to rise each year. The ABCDE bundle is a multi-component, evidence-based approach designed to improve patient outcomes in the ICU. This study aimed to determine the effect of the ABCDE bundle on the risk of pressure ulcers, deep vein thrombosis and delirium in patients undergoing mechanical ventilation.

Methods & Materials: 

This randomized, single-blind clinical trial was conducted between September 2021 and January 2022. The sample included 100 patients undergoing mechanical ventilation in the ICU department of Imam Reza Hospital in Mashhad, who were randomly assigned to either the intervention or control group using block randomization. The intervention group received the ABCDE bundle over a period of 7 days. The control group received routine care. The criteria for assessing complications included the risk of pressure ulcers and deep vein thrombosis (DVT), evaluated at the end of the intervention and on days 0, 1, 3, 5, and 7. The study utilized several assessment tools: the COMHON Index for pressure ulcers, the Wells Deep Vein Thrombosis Scale, and the Delirium Evaluation Tool in the Intensive Care Unit (CAM-ICU). Data analysis was performed using SPSS software version 20, employing chi-square, Mann-Whitney, and independent t-tests.

A decrease in the average pressure ulcer risk score was observed in the intervention group on day seven (P<0.05). In this group, the incidence of delirium fell decreased from 64.4% to 13.3% (P<0.05), indicating a statistically significant reduction. Additionally, the risk score for deep vein thrombosis in the control group significantly increased on day seven compared to the intervention group (P<0.05).

The use of the ABCDE bundle significantly reduces the risk of pressure ulcers, deep vein thrombosis, and delirium in patients undergoing mechanical ventilation and represents an effective strategy that can be implemented by nurses and other trained healthcare professionals.

Despite the importance of clinical evaluation in performance-oriented fields of medical sciences, this field is still facing a challenge, one of the most important obstacles of which is the lack of familiarity with the evaluation goals of tools or methods and criticism of these tools and methods. The present study was conducted with the aim of introducing the tools and procedures for evaluating the clinical performance of medical students and the advantages and limitations of each of these tools and methods.

This systematic review is based on PRISMA 2020 guidelines and by searching for evidence in external and internal databases PubMed, Web of Science, CINAHL, Irandoc, Magiran and SID and Google scholar search engine using the keywords Clinical performance, Clinical evaluation, Clinical appraisal, Clinical examination, OSCE, Assessment tool, assessment standards, clinical assessment practices, medical sciences students and their Persian equivalents were carried out until 2023. The inclusion criteria included: high-quality articles (based on the risk of bias tools, ROB 2 and STORBE), English or Persian language, descriptive, quasi-experimental and interventional studies, qualitative or letter to the editor, studies focused on clinical evaluation methods or tools, and full-text studies. Finally, the clinical performance evaluation tools and methods extracted from the evidence were summarized and categorized.

A total of 2031 article titles were determined, after screening and removing duplicates, 22 articles were included in the study for final analysis. The most common tools of evaluating students' clinical performance included: 1- structured observation and assessment of clinical performance (SOAP) (n=126), 2- Competency Inventory of Nursing Students (CINS) (n=4) and 3- Clinical Nursing Competence Questionnaire (CNCQ) (n=3). Also, the most common methods of evaluating students' performance and clinical skills included: 1- Objective structured clinical examination (OSCE) (n=2166), 2- Logbook (n=722) and 3- Direct observation of procedural skills (DOPS) and Mini Clinical Evaluation Exercise (Mini-CEX) (n = 53) that each of these tools and methods has unique objectives, advantages and limitations.

Considering the purpose of evaluation, psychometric characteristics, and the advantages and limitations of each method or tool, each or a combination of them can be used to evaluate students. Of course, it is suggested to modify these methods and tools by conducting studies in a way that is more practical for the clinical evaluation of students and facilitates its use.

Self-monitoring is a complex and subjective concept, and various definitions of it have been presented. Lack of proper understanding and application by the treatment staff leads to an increase in the burden of referrals, imposing costs and reducing the quality of people's lives. This concept has been used many times by researchers, but its dimensions have not been fully identified. This study was done with the aim of clarifying the concept of self-monitoring.

Analysis of the concept of self-monitoring, based on the model of Walker and Avant (2005) was done in eight steps by searching PubMed, Web of Science, Scopus, CINAHL, Irandoc, Magiran and SID databases and using the keywords monitoring, self-monitoring, self-control and self-regulation, and also their English equivalent without time limit until 1402 (2023).

Self-monitoring is a multidimensional concept. Health literacy, motivation and purposefulness are its most important components. This type of care can occur at different individual, interpersonal, family and community levels.

The present study identified different dimensions of the concept of self-monitoring. Future studies can use the results of this study to create tools and design effective and multidimensional interventions so that its effects can be seen on a wide scale.

Nursing is basically described as a practical discipline or pragmatism and there are many similarities  between it and the pragmatism. This study was designed aimed to determin the degree of adherence of nursing Ph.D. curriculum, especially in Iran, to pragmatism as a philosophical foundation.

This study is a narrative review. Using the keywords of curriculum/educational program, doctorate in nursing/ nursing Ph.D., pragmatism, and also the English equivalent of these keywords in foreign databases such as PubMed, Web of Science, Scopus, CINAHL and persian databases including Irandoc, Magiran and SID as well as The Google Scholar search engine was searched for studies up to the year 1402 (2023) without time limit and individually and combined.

The results showed that little attention has been paid to pragmatism as the philosophical basis of nursing Ph.D. curriculum in different countries, especially in Iran, and this problem is caused by challenges such as: the course is not responsive to the needs of society, the health system and the nursing profession, as well as neglect from the main nature of nursing field (clinical care), and excessive attention to less necessary issues.

It seems that the spirit of pragmatism is not included in the nursing curriculum (especially in Iran), while this foundation can act as a bridge between education, practice and research. Therefore, it is recommended to make changes in this educational program and move the curriculum more towards pragmatism.

Clinical education is the basis of nursing education. In addition to the educational environment, a supportive environment may also help achieve the goals of internships and student's satisfaction with the acquisition of clinical skills. The present study was designed to determine the impact of a supportive clinical environment on nursing students' satisfaction.

This quasi-experimental study with post-test and control group was performed in Mashhad teaching hospitals in the academic year 2018-2019 with the participation of 60 nursing students who were randomly assigned to two equal intervention and control groups. For the students of the intervention group, the supportive clinical environment program, which included three components of knowledge, skills and learning context, was held for two weeks (50 hours). After the intervention, their satisfaction was measured with a clinical education satisfaction questionnaire. Data were analyzed using SPSS 16 software and independent t-test and chi-square. The significance level was considered 0.05 in all tests.

The mean and standard deviation of the students age was in the intervention group (20.9 ± 0.8 years) and control (20.3 ± 1.1 years) (p=0.232). The result of independent t-test showed that after the intervention, the mean of the total satisfaction score of the students in the intervention group [85.4 ± 11.4] was 26.9% higher than the control group (67.3 ± 15.8) (p < 0.001). Also, the highest satisfaction score was related to the performance of the instructor in the intervention group and the lowest satisfaction score was related to the scope of dealing with the student in the control group (P <0.05).

Creating a supportive clinical environment enhances students' satisfaction, especially in the area of ​​instructor performance and dealing with students, and it is recommended to pay more attention to it in planning nursing clinical education.

The pragmatism in various studies is considered as the philosophy of science and a philosophical movement. The present study was conducted with the aim of answering the question whether the introduction of pragmatism as a philosophy of science is correct or has problems.

In this letter to the editor, first, the studies published in the reliable databases PubMed, Web of Science, Scopus, CINAHL and Google scholar search engine using the keywords Pragmatism, Doctrine/Philosophical Movement, Philosophy, perspective, Worldview until 2023 and also the English equivalents of these keywords in internal databases including Irandoc, Magiran and SID were examined until 1402 without time limit. Finally, the studies were descriptively combined with each other.

According to the definition of philosophy based on the systematic study of general and fundamental questions, such as issues related to existence, reason, knowledge, values, mind and language. Conclusions from the studies and claims of pragmatists show that the answers to these questions are probably not compatible with the spirit of pragmatism.

Due to the fact that pragmatism has not given a clear and definite answer to the basic philosophical questions. On the other hand, the words used have little compatibility with the reality of pragmatism, so there is a need for more studies to answer this question.

Considering the need for emergency medical technicians and triage nurses to familiarize themselves with stroke triage tools for faster diagnosis and referral of patients, the present study was conducted with the aim of comparing the psychometric characteristics of stroke triage scales for patients with neurosensory complaints.

In this review, the concept of electronic search based on PRISMA guidelines in reliable databases PubMed, Scopus, and Google Scholar search engines using the main keywords include triage, stroke, hospital, prehospital, emergency, tool, and scale in combination and individually were done from 1990 to 2022. Then, the data extraction included the name of the first author, the year of publication, the target population, the country, the name of the scale, the type of scale, and the components of the scale based on the checklist prepared by the researchers.

In general, the Twenty-five triage scales of this group of patients can be divided into two categories: pre-hospital stroke scales (including 18 scales) and hospital (including 7 scales), each of which has different psychometric characteristics. Scales, such as LAPSS, MAS, OPSS, and IPSS, which have covered stroke mimics, have high specificity. Scales, such as IPSS, which in addition to mimics examine vision status seem more comprehensive.

Less comprehensive scales have high sensitivity and low specificity, and scales that cover stroke mimics have high specificity. The high incidence of strokes caused by the middle-occluded artery reduced the differences between the scales.

Considering the importance of effective communication skills to support patients and their families, and on the other hand, the negative impact of nurses' unfavorable self-concept on patient care, it is necessary to identify factors affecting professional self-concept. The purpose of this study was to determine the relationship between the quality of patient interaction and the professional self-concept of nurses and nursing students of Birjand University of Medical Sciences.

This correlational study was conducted in 2019. Nurses were selected by stratification and nursing students of Birjand University of Medical Sciences by convenience method. In order to collect data, the communication skills with patients and the nursing professional self-concept questionnaire were used. Data were analyzed using SPSS v.16 software and descriptive statistics and t-tests, Pearson's correlation coefficient and linear regression.

The mean age of students was 21.4±1.6 years and nurses were 28.0±4.5 years. The results of linear regression showed professional self-concept, directly and significantly predicts the quality of interaction with the patient (p<0.001, β=0.351). The result of the Pearson correlation coefficient showed that there is a direct and significant relationship between professional self-concept and the quality of interaction with the patient (p <0.001, r=0.351).

According to the results of the study, communication skills and professional self-concept of nursing students and nurses are moderate and need to be improved. On the other hand, due to the direct connection between these two concepts, it is felt necessary to train and prepare nurses and nursing students with the help of workshops and revisions of nursing educational curriculum, in order to have a higher professional self-concept and increase patient interaction skills.

Quality of care in the health system is one of the most important issues and one of the most important indicators in organizational accreditation. Use of managerial principles, such as the division of labor among nurses, can affect the quality of care.

This was a randomized double-blind clinical trial which included 44 nurses and 59 patients in 4 CCU wards. The intervention included 3 sessions of 2-hour workshops and then implementing the two above-mentioned care methods for the patients. After the intervention and at the time of discharge, the quality of care provided was assessed from the patients' point of view by means of quality care patient scale. Data were analyzed by Mann-Whitney test.

The results showed after the intervention, the mean values for general quality of patient care in the primary group and case method group were (14.2 ± 1.9) and (11.2 ± 2.8) respectively. Also the quality of professional care in the primary group and case method group were (18.2 ± 2.2) and (3.5 ± 14.2) respectively. Mann-Whitney test in both aspects showed that the quality of general and professional care was significantly higher in the primary group than in the case-method group (p <0.05).

The results of this study indicated that the primary method can be used in some wards, and was more effective than the case-method. Therefore, paying more attention to nursing care management planning is recommended.

clinical education is the most fundamental part of nursing training, so appropriate evaluation methods should be used. Although various evaluation methods such as case based discussion and logbooks, each one has its own advantages and limitations, this study had designed aimed to comparison of the effect of clinical evaluation method with case based discussion and logbooks On satisfaction of nursing students.

This experimental study with two groups after the intervention was conducted in 2017. Participants were 58 nursing students of Mashhad nursing and midwifery school that draw on both the patient discussion and log books by random assignment. Students' satisfaction was measured by researcher- made questionnaire that its´ reliability and content validity was confirmed by Cronbach's alpha and using expert opinion, respectively. Data were analyzed using independent and paired T-tests and Mann-Whitney through SPSS.

The results showed that the mean and standard deviation of students' satisfaction of case based discussion group was 69/06 ± 22/7 (of 100) and logbook 67/8 ± 21/8 (of 100). Results of Independent T test showed no significant differences between the two groups in satisfaction score (p=0/757). Although students' satisfaction of case based discussion group in suitability field was statistical significant higher than the other group (p= 0/018).

Considering the students´ higher satisfaction of case based discussion method, it seems this method has somehow achieved the expectations of students compared to the logbook method. However, due to insignificant results, studies with a larger sample size and devoting more time to implement this method is necessary.

Colonoscopy is a valuable diagnostic method that patients are not willing to undergo because of the fear of its complications. The purpose of this study was to determine the effect of intravenous fluid therapy prior to colonoscopy on blood circulation parameters and pain in patients and duration of Colonoscopy. This randomized clinical trial was conducted on 60 patients referred to the Endoscopic Department of Ghaem Hospital in Mashhad in 2016. Elderly people were randomly assigned to two groups of 30 as control and intervention groups. Patients in the intervention group received one liter of solution 1/3 normal saline, 2/3 D5W, one hour before colonoscopy. Before and 1, 3, 5, 9, and 10 minutes after colonoscopy, arterial blood oxygen saturation, heart rate, and blood pressure in both groups were measured and recorded in the checklist. 2 hours later, the patients’ pain levels were measured by Circulation Parameters checklist. The numerical value of pain was measured, and the durations of colonoscopy in both groups were also measured and recorded by a timer. The mean age of the patients in the intervention group was 38.4 ± 13.6 years and in the control group was 44.2 ± 14.4 years. The results of post start colonoscopy stage showed that there was a significant difference between the two groups in the mean arterial oxygen saturation after 5 and 9 minutes of fluid therapy (p < 0.001), systolic blood pressure 1 and 10 minutes after fluid therapy (p = 0.047), and diastolic blood pressure 5 minutes after the fluid therapy (p = 0.049). The mean duration of colonoscopy in the intervention group (18.15 ± 4.21 min) was significantly lower than the control group (22.13 ± 5.29 min, p = 0.002). Also, the mean pain score 2 hours after colonoscopy was significantly lower in the intervention group (1.53 ± 1.65) compared with the control group (3.26 ± 3.24, p = 0.010). The results of this study indicate the positive effect of fluid therapy prior to the onset of colonoscopy on the patients’ circulatory parameters, the duration of colonoscopy, and the patients’ pain. Therefore, with this effective, cost-effective, and safe intervention, patients can have a better experience in performing this diagnostic test.

Now, all efforts of mediapunditsin schools and clinical Environments are immobilized conditions that the students give to specialize, because the clinical training of medical students is the most important part of learning professional performances. Therefore, this study aimed to determine the viewpoints of nursing teachers with regard to the coordination of theoretical and clinical training.
Material and This study is descriptive. The research tools are Demographic questionnaire and "check compliance theory and practice" whose three parts. After confirming the validity and reliability by Cronbach's Alpha(0.08) the questionnaire was given to all of coaches Clinical Nursing and Midwifery Mashhad (29members) during the sampling period were taught in school. Data were analyzed using SPSS 16 software.
The average age of coaches 41/53±11/99, 82.8% (24 members) were married and 62.1% (n = 18) were male 89.7% (n = 26) had a master's degree and the others were PhD. The professors lessons Duration of training with the skill that most closely matches their lessons including public health (3/88± 1/47), Psychiatric Nursing (3/77 ± 1/15) and management (3/77±1/31) and lessons that are least adapted to particular sectors intensive care (2/14 ± 0/9) and emergency (2/26 ± 1/28) (P According to the results of this study, the duration of most of the workshops to become proficient enough in those lessons. Since now on nursing care and nursing education are traditional and basic needs students are not taught to them in the workplace, It seems that the modified curriculum or specialized nursing course is way to solve problems.

The nursing profession is mainly based on the quality of care. Different approaches to provide nursing care in nursing management can affect the quality of service. This study aimed to compare the effect of “Primary Nursing” and “Case Method” on patient's quality of physical care.
This study is quasi-experimental study that was performed in two Critical Care Units (CCU) of the Ghaem Hospital and two CCU of Imam Reza Hospital in Mashhad. 59 patients (33 patients in the “Primary Nursing” group and 26 patients in the “Case Method” group) were studied. Data was collected using “Quality of Patient Care” (QUALPAC). The content and face validity was confirmed by 10 members of the Faculty of Nursing and Midwifery in Mashhad University. Furthermore, the reliability was achieved by Cronbach's alpha. In this study, both “Primary Nursing” and “Case Method” approaches were implemented in CCU and their impacts on patients’ quality of care was evaluated. Data were analyzed using SPSS/16.
The mean of patient quality of physical care in “Primary Nursing” group (5.2 ± 44.4) was significantly higher than the one in the “Case Method” (6.5 ± 29.8) (P The patient quality of physical care in the division of labor "Primary Nursing" is higher than "Case Method". Therefore, the "Primary Nursing" is recommended.

Quality of patient care is enhanced by effective communication between nurses and patients. One of the most important management practices to improve the quality of nursing care is applying nursing care delivery systems by nurse managers; especially by head nurses effectively.
Aim: This study was done for comparing the effectiveness of primary nursing care and case method on quality of nursepatient interaction in CCU.
Methods and materials: This study was a quasi-experimental study that was done in four CCU in two teaching in Mashhad in 2014. Two units for case method (n=26 patients) and two units for primary nursing (n=33patients) randomly selected. In implementation, at first all of the nurses trained with two nursing care delivery systems by workshops. And then, in primary system allocated (3) patients to primary nurse who was responsible to their discharge. In other shifts sh/he supervised him/her associate nurse. Also, in case method, head nurse allocate (3) patients to nurses in the shift, only they were here. All of the policies established thatwere needed by head nurse mutually. Both of two nursing care delivery systems implemented for (2) months. Data were gathered by standardized questioner QUAL PAC) Quality of patient care) that its reliability was measured by α-Chronbach (0.89). Data were analyzed by SPSS16 and statistical tests such as Mann-Whitney, 2 and others were used. Applying descriptive statistics (mean and standard deviation) and inferential statistics (Pearson moment correlation coefficient and stepwise multiple regression analysis) data were analyzed by SPSS16.
findings showed that there is a significant difference between two group (case method and primary nursing) in quality of interaction between nurses- patients (p In order to effectiveness primary nursing care in promotion in quality of interaction between nurse- patients, it is suggests to nurse managers that they apply its model in CCU.

Peer education can be a useful approach in learning difficult and important courses such as physiology. Since students encounter new teacher roles and learning from classmates in this approach, they might go through new experiences which contribute to developing effective peer education. However, few studies have examined these experiences, especially in Iranian culture; therefore this study aimed to explain the experiences of nursing students participating in peer education programs for physiology course. This was a qualitative content analysis study. The sample included 16 second semester undergraduate nursing students studying at Mashhad School of Nursing and Midwifery in 2013 who had earlier experienced peer education in Physiology. Participants were selected through purposive sampling then interviewed. All interviews were transcribed and analyzed. Two major themes including ease of learning and educational participation were emerged from data analysis. Ease of learning consisted of four minor themes including ease of understanding, modification of methods, course norm selection, and internalization of learning. Educational participation included two minor themes namely critical consciousness and new educational horizon. The results of this study indicated that the need for greater attention by educational institutions and universities to student-centered teaching methods such as peer education since these methods could be a supplement to faculty members` teaching by providing a positive experience and continuous in-depth learning.

Electronic technology has been developed in health system like other areas. Application of electronic software for nursing process can facilitate this service. Foreign software cannot be an appropriate one for domestic use in terms of its language, clinical situations, cultural factors, and social variables. As a result, the aim of this study is to design and assess the local nursing process computerized software. This study was conducted in two phases of software design and assessment. The first phase was implemented in 4 stages of “developing the steps of nursing process in accordance software”, “algorithm design”, “test” and “final revision”. The second phase included a pilot study with participation of 20 students and nurses performed in ICU ward of Ghaem hospital in Mashhad. These individuals performed nursing process on three clients using the newly designed software. Then their opinions were taken using a validated and reliable researcher-made questionnaire for assessing the software. Data was analyzed using descriptive statistics and mann withney. First phase of the study encompassed designing the software; software menus included data base menu, patient's background information, registration of nursing process, setting, alarm, and help. In second phase, the results of pilot study showed that 81.3% of participants rated software as good or very good. The main advantages of the software, according to 90% of nurses, related to accuracy and preciseness of data compared to handwritten documents and facilitating the arrangement of client’s problems and according to 100% of the students, simplicity, sharing the labor, assessing the warning signs, and avoiding errors. The average of software evaluation scores by students was (84.3±5.83) out of 100 which is significantly higher than that of nurses (73.2±1.13, p =0.02). Development of the local nursing software in accordance with our health system was feasible and associated with satisfaction among nurses and students. Application of this software leads to increased accuracy, decreased error, and shared labor that are counted as factors promoting patient care services.

An important part of nurse’s professional behavior forms during academic education and develops throughout professional career. Therefore comparing professional behavior of freshmen and seniors at graduation with that of nurses can illustrate the formation and development of professional behavior at the time of formal and informal nursing education. This study was conducted to compare professional behavior of nursing students to that of nurses employed in Mashhad University of Medical Sciences. In this descriptive cross-sectional study of trend type، study population included all freshmen and senior nursing students of school of nursing and midwifery in Mashhad University of Medical Sciences as well as nurses employed in hospitals affiliated to this university in year 2011 (n=322). Professional behavior of these students and nurses was assessed using modified “nursing student professional behavior” questionnaire of Goze. The validity of the questionnaire was confirmed using content validity index and its reliability was confirmed using Cronbach''s alpha coefficient. Data was analyzed using descriptive statistics، Kruscall-Wallis، and Spearman correlation coefficient. 72 freshman students of clinical nursing (64%)، 40 senior nursing students (35%)، and 322 nurses formed the sample. The mean score of professional behavior of freshman students was 110/3±17. 3 out of total score of 135 and this mean score was 107±12/8 for senior nursing students and 109±12/6 for clinical nurses. The result of Kruscall-Wallis test showed no significant difference among these three groups (p=0. 2). Although basic nursing educations prior to clinical education has lead to development of a desirable level of professional behavior in junior nursing students، development of these behaviors did not have an appropriate trend among senior students and employed nurses. Further studies using other ways of assessment are needed to assess nursing students and clinical nurses'' professional behavior considering factors promoting professional behavior.