leila sadati

Operating room personnel are exposed to all kinds of mental and physical pressures due to the stressful conditions of the work environment, their job duties, and responsibilities. Since the health and mental and physical health of people working in the operating room plays a significant role in the correct performance of duties and effective and safe care of patients; The present study was conducted to determine the level of anxiety, sleep quality, and the relationship between them in operating room and anesthesia nurses.

This descriptive-cross-sectional study was performed on 254 operating room and anesthesia nurses working in educational and non-educational hospitals. The data was collected using the demographic information questionnaire, the BAI - Beck Anxiety Inventory (BAI) questionnaire, and the Pittsburgh Sleep Quality Index. The data were then analyzed using descriptive and inferential statistics using SPSS software version 22.

The findings showed that 40.6% of anesthesia and operating room nurses did not have anxiety, while 32.7% of people had mild anxiety, 21.3% had moderate anxiety, and 5.5% had severe anxiety. 42.1 % of people reported good sleep quality and 57.9 % reported poor sleep quality. Spearman's correlation coefficient showed that there was a significant positive relationship between anxiety and sleep quality (r = 0.37).

Due to the correlation between anxiety and sleep quality, it is recommended to regularly monitor the anxiety and sleep quality of the operating room and anesthesia nurses, and if necessary, by determining the cause-and-effect relationship, appropriate intervention measures should be designed to improve the health of operating room and anesthesia nurses.

Electronic portfolios provide opportunities for students to reflect on their performance and develop their competencies.

The present study was done to improve surgical technologist students' learning through the development of a customized e-portfolio.

This interventional study was conducted using a sequential mixed method in two phases. In the "qualitative" phase, the framework of the e-portfolio was first developed via literature review. Then, it was customized and completed through a qualitative approach of guided content analysis based on Elo & Kyngas ' method. In the "quantitative" phase, by using quasi-experimental designs, the effectiveness of the e-portfolio was evaluated by measuring students' satisfaction, knowledge, and clinical skills as educational outcomes. A satisfaction questionnaire, multiple choices questionnaire (MCQ), and research-made checklist were used. Comparison of groups and data analysis was done using Fisher's exact and paired t-test. Data analysis was done using SPSS version 22 software. The maximum alpha level was considered to be 0.05 in order to confirm the difference between the groups (p<0.05).

In the first phase, an e-portfolio framework was developed, including discipline regulations, study resources, daily activities, educational objectives, assessment tools, feedback, and reflection reports. The paired t-test results show that students' knowledge (p-value=0.011) and clinical skills significantly improved (p-value=0.023). More than two-thirds of the students (71.42%) and tutors (85.72%) were thoroughly satisfied with the e-portfolio assessment.

Based on the main results, the use of applicable and standard E-portfolios is recommended as a comprehensive and cost-effective assessment method in clinical education.

</strong> The purpose of the medical curriculum is to train up-to-date physician who can safely and effectively diagnose diseases and increase the health of society.

</strong> We designed a visual system anatomy educational course to investigate the effect of the “extending the teaching of the basic science throughout the curriculum” strategy, on the level of satisfaction and learning of medical student’s anatomy knowledge.

</strong> This study was an interventional, in descriptive type, done in visual system anatomy educational course and designed in four training sessions consisted of: 1. A 15 multiple choice questions pre-course online test, distributing lesson plans and related educational videos, 2 and 3.training sessions in which education content by using cadaver and other teaching aids such as moulage and slides were presented; 4.Discussion, post-test holding and distribution of satisfaction questionnaire. The overall pre-intervention and post-intervention data were analyzed using Kolmogorov–Smirnov test and paired t-test in Statistical Package for the Social Sciences (SPSS) software. P-value less than 0.05 was considered as statistical significance.

</strong> Based on the results of the final exam, correct answer percentage to each question </strong>(CAP) of post-intervention were higher than the CAP of the pre-intervention. The statistical analysis also indicated that there was significant difference in the mean of CAPs between the two tests (p></strong>0.01).

</strong> It seems that proposing a new curriculum and including basic anatomy sessions in clinical training courses can help students to review basic science concepts and apply them in developing clinical skills and ultimately safe patient care.

With the onset of the COVID-19 pandemic and the impossibility of
face-to-face learning, universities sought alternative methods to continue education and adapt to the upcoming conditions. Although technology development and virtual education methods created many opportunities in dental education, these modern solutions were not free of problems.

The current study explored the challenges, opportunities, and future directions of dental education from the experience of dental students, faculty members, and the dean of Alborz Dental School during the COVID-19 pandemic.

The current qualitative study was conducted in 2021 using the content analysis method and in-depth semi-structured interviews with faculty members and students of Alborz Dental School. Purposive sampling was implemented to collect data with maximum variability in the faculty and student groups. In addition, 19 semi-structured interviews were transcribed verbatim immediately after each interview. The results were analyzed using MAXQDA version 10 software through the content analysis method.

The results of data analysis in the evaluation of challenges and opportunities of dental education from the experience of dental students, faculty members, and the dean of Alborz Dental School during the COVID-19 pandemic detected three emerging categories: opportunities, challenges, and future direction with subcategories of
e-learning, clinical training, infrastructures, and personal life.

Despite creating new learning opportunities during the COVID-19 pandemic, faculty members and dental students faced many challenges. Therefore, identifying these challenges, taking advantage of opportunities, and using faculty members' and students' experiences and suggestions can improve the learning experience and quality of education during the post-pandemic era.

Due to the work in emergency situations, having high work technique and large volume of work, the operating room is known as a stressful part. Which can cause problems for the personnel working in it. The aim of this study was to investigate the effect of deep breathing on anxiety, fatigue and sleep quality of operating room personnel.

This clinical trial was performed by pre-test-post-test method in 2020 on operating room technologists and anesthesia technicians. Thirty-five people who met the inclusion criteria were randomly selected and performed deep breathing exercises for four weeks. Multidimensional fatigue intensity, Pittsburgh Sleep Quality and Beck Anxiety Questionnaires were completed and compared before, two weeks and four weeks after the intervention.

The mean anxiety score changed from 19.65 ± 9.57 to 14.2 ± 6.34 after two weeks and 10.68 ± 5.67 after four weeks. The mean fatigue scores changed from 64.37 ± 10.07 to 56.79 ± 8.72 and then 52.75 ± 8.76 Which is quite significant in both time effects (P <0.001). The average sleep quality score changed from 9.89 ± 3.41 to 8.92 ± 2.7 and then 7.71 ± 2.7. There was no significant difference in the previous time - 2 weeks later (P = 0.57). However, at 2-4 weeks later, There was significant difference (P = 0.04).

Due to the positive effects of deep breathing on operating room personnel, the use of this non-pharmacological and uncomplicated method is recommended to maintain the mental and physical health of personnel and increase safety and quality of work.

The use of task-based learning method in operating room technology students can be very important. Due to existing limitations such as the lack of hospital operating rooms, these students do not have the possibility to pass theoretical and clinical units at the same time. This possibility can be providing with the help of the task-based learning method. Therefore, the present study was conducted with the aim of investigating the effect of the task-based educational method on the operating room technologist students’ speed of operation.

Methods and Materials: 

The current research was a semi-experimental type in which 57 4th and 6th semesters operating room students were selected by head count method and they were divided into two intervention and control groups. Then, they were trained with two learning methods based on task and routine method. The speed of the students’ action was also evaluated by determining the maximum total time of 3 minutes to complete the observation checklist. Data were analyzed using Spss statistical software version 22.

The results of the present study in the implementation of training with the task-based learning method showed that the speed of the students’ performance based on the observation checklist in the case group is significantly higher than the control group. This issue is very valuable and applicable in the field of surgery. (P<0.001)

Based on the results of this study, task-based learning (TBL) is an efficient method in the clinical training of operating room technologist students. Moreover, it improves clinical performance and it increases the speed of students’ work. Therefore, the use of this training method is recommended to those who are responsible for the training of operating room technologists.

 In modern medical education, the emphasis on student-centered learning and task-based learning has made the role of a learning environment more highlighted. In curriculum development, aligning educational objectives, teaching methods, and assessment methods with the educational environment is emphasized. In the process of evaluating curriculum components, along with the assessment of the other parts, assessing the educational environment through a valid and reliable tool is essential.

 The purpose of this study was to develop a psychometric and localized version of the Surgical Theatre Educational Environment Measure (STEEM) tool for surgical technologists in Iran.

 The present study was a descriptive and analytical study that was conducted cross-sectionally in 2021. After obtaining permission from the developer of the standard questionnaire, following the principles of localization, the stages of translation and
re-translation of the STEEM tool were done. The validity of its face and content was then assessed. In order to determine construct validity, the questionnaire was distributed among 201 surgical technology students. The construct validity of the instrument and its reliability was investigated using exploratory factor analysis, and Cronbach's alpha and intra-cluster correlation coefficient, respectively. Data were analyzed using SPSS 19.

 The study of face, content, and construct validity resulted in providing a STEEM questionnaire with 5 subscales and 30 questions covering 55.6% of the total variance. The reliability of the whole questionnaire (Cronbach's alpha) was 0.845.

 Based on the findings of this study, the Iranian version of STEEM, entitled Iranian Measure of Operating Theatre Educational Climate (IMOTEC) has appropriate validity and reliability, and can effectively measure operating theatre educational climate from the perspective of undergraduate surgical technology students.

The training and education of competent and qualified surgeons have been one of the challenges of the surgical profession. The concept of surgical competence has been affected widely due to a series of developments in the new disease emergence, various surgical techniques and the introduction of advanced tools and equipment into the operating. The development of surgical competence and achieving this goal requires accurate identification and analysis of the dimensions of competence. This study was done to explain the concept of surgical competence using the 8-step Walker and Avant approach.

This study is a qualitative study that was conducted from May- October 2016 at Shahid Beheshti University of Medical Sciences. The present study is a qualitative and conceptual analysis study, which is done with Walker&Avant's eight-step approach to determine the defining characteristics of the concept of surgical competence. A systematic search was conducted between 1990 and 2020 by keywords search such as surgery, surgical, operation OR laparoscopy AND competence competency development competency proficient, proficiency, expertise, clinical, in the database like Google Scholar, PubMed, SID, Magiran, Scopus, Web of Science. Twenty articles were included in the study based on inclusion and exclusion criteria. Moreover, the defining features of the concept were extracted from it.

Based on the results of this study, the concept of surgical competence was defined and the four dimensions of elements, goals, components and the process of developing surgical competence were identified. Then, by clarifying the characteristics of surgical competence, a model of surgical competence development was drawn. Surgical competence development depends on the acquisition of specialized knowledge and numerous skills that are acquired through experience and deliberated practice under the supervision of others in the surgical community of practice and over time.

Surgical competence is a set of observable and measurable skills that allows a surgeon to manage the surgical process independently pbt while maintaining the patient's safety. It includes specialized knowledge, communication skills, cognitive and technical skills, and basic surgical skills.

 Extensive and rapid changes owing to the arrival of new needs, along with technological innovations and the development of surgical and anesthesia techniques, has exposed surgical teams to various operating room ethical issues. Undoubtedly, offering a theoretical topic for a number of hours will not be sufficiently effective. The present study was conducted with the aim of comparing the professional ethics curriculums in the Operating Room Technology undergraduate program in Iran and in the similar disciplines in the selected universities around the world in order to identify the approaches to the revision of the existing program.

 The current research is a comparative study which was conducted based on Bereday’s four-step comparative analysis method. After data collection, the data were analyzed using a researcher-made verification checklist based on Harden's integration strategy and the curriculum components. Then they were placed in a table according to the similarities and the differences. Next the key and important items were explained based on the research topic in order to identify the approaches to the revision of the curriculum of the operating room professional ethics in the country.

Ethical Considerations: 

The present research has been approved by the Ethics Committee of Alborz University of Medical Sciences.

 According to the results of the present study, in many universities, the professional ethics course is offered in the form of integration during the training course. This course is offered considering the educational goals in the theoretical and psycho-motor dimensions, in addition to the cognitive dimension, and using active teaching methods such as story writing, scenario-based, simulation, and group discussion, as well as the assessment methods such as conducting projects, recording experience writing, case study, reflection writing in the portfolio, and direct observation in addition to the written test is offered.

 In comparison to other universities in the world, the curriculum of professional ethics in the operating room in Iran has serious defects in various aspects, including educational strategy, educational goals, teaching methods and assessment methods, which require revision and basic reforms.

Blended learning (BL) is trending among medical education colleges around the world, and its many benefits, including the lack of physical presence in all sessions, have led to the popularity of this teaching method for adult learners. Therefore, the present study was conducted to explain the experiences of Part-time undergraduate operating room students from teaching by Blended learning method.Materials &

 This qualitative research was conducted by content analysis method in the first semester of 2019. Data were collected through semi-structured interviews during 15 interviews with Part-time operating room students. Then the data were analyzed by content analysis using MaxQDA2 software.

 Data in three main categories of "challenges" with subcategories; Selection of appropriate curriculum content and secure social network, "Arrangements related to the implementation of the program by professors" category with sub-categories; Ability of teachers to teach and be motivated and the category of "brought" with subcategories; Multiplicative individual growth and interaction and increased self-confidence were categorized.

Based on the findings of the study, the use of this teaching method with considerations such as a suitable Internet platform, the existence of motivation and capability in professors, the selection of appropriate content can lead to satisfaction of adult students working in medical centers and individual growth and provide more versatility and interaction in the classroom.

Due to the crisis of shortage of specialized nurses and high workload in intensive care units and emergency departments of hospitals during the COVID-19 pandemic, hospital managers had to use nurses and staff in other departments as reinforcements despite their lack of necessary competency to work in those departments. Hence, this study investigated surgical technologists’ work experiences during the COVID-19 disaster.

This qualitative study was conducted using the conventional content analysis method at Alborz University of Medical Sciences. The participants were 42 surgical technologists selected using purposive sampling from 14 hospitals in 10 cities of Iran. Data were collected through semi-structured interviews and analyzed in MaxQDA2 software using the content analysis method.

The results of this study were classified into two main categories, "challenges" and "coping strategies. The first main category consists of three subcategories, "psychological-emotional stress," "managerial crises," and "physical injuries." The second main category also includes three subcategories, "emotion-based strategy," "cognition-based strategy," and "problem-based strategy."

The surgical technologists’ experience indicated that the COVID-19 crisis posed serious challenges, mostly related to the shortage of protective facilities and the lack of adequate training about self-care and patients in wards with no work experience. Therefore, managers of hospitals should offer appropriate purposive training courses to sufficiently develop their staff’s knowledge and competence to manage the crisis in pandemics or epidemics.

Numerous factors and elements are effective in the professional development of any field of study, including the educational structure, the individual characteristics of learners, and the educational atmosphere prevalent in the educational environment. Understanding each of these factors and elements and the relationships among them can guide educational system administrators in the direction of professional development. Surgical residents’ professional development is no exception to this rule. As a consequence, the present research sought to explain and suggest a model for surgical assistant professional growth in Iranian operating rooms. The present research was a grounded theory study based on a post-positivist approach, in which data analysis was performed using Clark’s situational analysis methodology by drawing three maps, situational map, social worlds/arenas map, and positional map.
In the presence of human and non-human factors, cultural, political, historical, and social components, the ordered situational map demonstrated the complexity of the operating room learning environment. The social worlds/arenas map confirmed the existence of several communities of practice wherein surgical residents were present with different power roles, and the positional map showed role of the educational level in the acquisition of thecompetence in the professional development pathway. Finally, the Triple Helix model of professional development was extracted, which has three components: psychological identity, social identity, and surgical competency. The surgical residents’ professional development in operating rooms occurs due to the acquisition of surgicalcompetency along with the growth of individuals and socialization. As a result, all factors and components impacting the residents’ competence development process in this learning environment must be identified and their linkages clarified.

Traditional teaching and learning methods are losing their effectiveness due to the advancement of communication technology and science in the new century. Therefore, educational software development can improve medical and paramedical students’ learning in modern medical education. The current study was conducted to investigate the effect of software on the principles of surgical table setting on the learning and practical skills of the students of operating room technology.

A semi-experimental study was conducted using a census method among 57 operating room students who met the inclusion criteria. The students were divided into two groups, intervention, and control. The two groups were pre-tested before the intervention to assess their knowledge and practical skills. Additionally, the control group was regularly trained, and the intervention group was provided with educational software simultaneously with routine training. A post-test was given to both groups at the end of the semester. The data were analyzed by SPSS 22 using the descriptive and inferential statistical indicators of paired t test and Mann-Whitney test.

The results of this study showed that the intervention group and the control group did not differ significantly in any of the demographic parameters (P < 0.05). Considering the normality of the data, comparing the level of knowledge and practical skills of the operating room technology students before and after the intervention in both groups using paired t-test showed that the level of knowledge and practical skills in the intervention group increased significantly (P > 0.001).

According to the results of this study, educational methods in conjunction with the appropriate software can effectively increase students’ awareness of operating room technology and help improve their practical skills. Therefore, educational aid software is a useful tool to be used during internship courses as an effective method of training operating room students.

The COVID-19 pandemic crisis has led to the shift from in-person education to e-learning in universities. In addition to its many benefits, e-learning also has its own disadvantages that can have detrimental effects on the effectiveness of education during the pandemic in addition to the problems caused by the COVID-19 crisis itself. Therefore, understanding the experiences and challenges of the students of universities can help education authorities in providing appropriate solutions to alleviate some of these problems. To this aim, this qualitative research was conducted using content analysis method. Structured interviews were conducted with 24 students in various undergraduate and graduate programs. Finally, the text of the interviews was analyzed by content analysis using MaxQDA2 software. Four main categories emeraged after data analysus: "Individual barriers to the effectiveness of e-learning" (sub-categories: personality traits, effects of family environment and facilities and resources); "Inefficient education" (sub-categories: quantity, quality, and order of content presentation and evaluation); "Negative consequences"(subcategories: lost identity, psychological stress, conflict in the use of cyberspace; and "Gains" (subcategories: available content, reduced costs, eliminaton of the problems of class attendance, family attendance and spiritual empowerment). Based on the results, students face serious challenges in the family environment and educational centers, and it is necessary to provide effective solutions to solve problems in universities, specifically and in accordance with the structure of their environment.

Failure to follow the standard principles in establishing lithotomy position will cause can lead to serious complications such as pain. This study was performed with aim to evaluate the pain experienced by patients in pressure areas in lithotomy position.

This descriptive-analytical cross-sectional study was performed in 2017 on 200 female patients who had undergone gynecological surgery using lithotomy position in the teaching hospital of Karaj. The researcher-made questionnaire was used to assess pain experienced by patients; the questionnaire includes: patients' demographic information and the checklist of recording the amount and severity of pain using a standard ten-point scale. Data were analyzed using SPSS software (version 22) and descriptive and inferential statistical tests of Chi-square, Mann-Whitney and Kendall correlation coefficient. P< 0.05 was considered statistically significant.

Based on the results of data analysis, within 24 hours after the surgery, 180 patients had complaint from low back pain, 94 from the groin region pain, 164 from the knee pain and 34 from the ankle pain in moderate to severe level. Also, a high correlation was observed between the variables of patients' body mass index and duration of surgery with the incidence of pain in some areas such as the lumbar region and the ankle region.

In this study, a significant percentage of patients following placed in the lithotomy position experienced postoperative pain in different areas.

 In a laparoscopic surgery team, a surgical technologist as a skillful assistant surgeon is responsible for camera navigation and peg transfer.

 We assessed the effect of the fundamentals of laparoscopic surgery curriculum on improving the skills of surgical technology students in camera navigation, pattern cutting, and peg transfer.

 A study was conducted on 30 surgical technology students at the Iran University of Medical Sciences based on Kern's six-step model. After assessing the needs and defining the educational goals, the course content was determined. Afterward, students were trained in a simulation-based learning environment. Then, in the evaluation stage, using the standard task completion time (TCT) tool, their competence in performing the three skills was evaluated. The results of the first comprehensive attempt to perform each skill were recorded as the pretest, and the results of the sixth and 10th repetitions were recorded as the posttest. Data were analyzed using analysis of variance with duplicate data.

 The TCT score improved in this study. The time of camera navigation decreased from 92.14 to 56.42 s, pattern cutting from 186.07 to 118.21 s, and peg transfer from 93.03 to 54.10 s.

 This study showed that the fundamentals of laparoscopic surgery curriculum improved the surgical technologists’ competence in performing triple skills essential for performing laparoscopic surgeries. Thus, this learning method could play an essential role in laparoscopic surgery.

M‑learning is “learning across multiple contexts, through social and content interactions, using simple hand‑held technologies, wireless and mobile network. This personal electronic device is a way to facilitate the transfer of learning and improve teaching. Hence, the researchers decided to design a mobile‑based learning application to teach surgical instruments comprehensively and compare students’ learning and satisfaction in both mobile‑based learning and flashcards methods.

An interventional study was conducted on surgical technologist students in Alborz University of medical science (2019). Students were divided into two groups: flashcards (n = 21) and mobile application learning group (n = 21). The difference of pre‑ and post‑test scores was considered for the evaluation of learning level in two groups. Data were entered into SPSS 20.0 software and analyzed by statistics tests.Data were analyzed by a paired t‑test, independent t‑test, and Pearson’s correlation coefficient.

There was no significant difference in students’ knowledge level between two groups before intervention ( P = 0.87) but there was significant difference between groups after the intervention (P = 0.003). In the evaluation of student’s satisfaction, the mobile application was preferred by 84.28% of students.

Given the effectiveness of using both methods (flashcards and mobile application), it is recommended that these methods especially mobile application be used for surgical instruments education.

Clinical education environment with different educational models is a place to develop students' clinical skills to enter their working community, i.e. the hospital. The aim of this study was to determine the level of satisfaction of operating room students with the implementation of clinical education by preceptorship method in Alborz University of Medical Sciences in 2019-2020.

In this descriptive-analytical cross-sectional study, 52 7th and 8th semester undergraduate operating room students entered the study. Data were collected through a clinical facilitation satisfaction questionnaire and entered into SPSS software and analyzed through descriptive tests (mean and standard deviation) and analytical tests (Pearson’s correlation coefficient, t-test).

The results of the present study showed that the students' satisfaction with the implementation of the preceptorship model is at a desirable level and its average is 97.51. T-test showed a significant difference between the mean satisfaction score in women and men (p = 0.007) and the satisfaction score was significantly higher in men than women.

Considering the satisfaction of final year students of the operating room with the implementation of this educational model, this method can be used along with other methods in the clinical education of students.

The commitment of faculty members to observe ethical principles and values in the role of a model leads to the strengthening of ethics in students and consequently the development of ethics in society. Therefore, universities need to promote and effectively teach ethics to their professors.

The present intervention study was designed, implemented and evaluated in the form of a scholarly activity following the Kern curriculum model. Initially, after reviewing the studies and needs assessment, the course objectives, educational content and teaching strategy were determined. Then, ten training sessions were held with a discussion-based teaching method based on real scenarios. All discussions in the classrooms were recorded and implemented. At the end of each session, participants were asked to submit scenarios based on their personal experiences. For evaluation, the number of participants and scenarios were evaluated and the discussions were analyzed and interpreted by content analysis.

Data analysis confirmed the presence of 110 faculty members and the submission of 32 scenarios. In the qualitative section, 194 initial codes were extracted in four main categories: "commitment to teaching and student learning ", "ethics as law", "ethics-oriented educational atmosphere" and "teacher role model".

 Considering the welcome of the faculty members and the extraction of key concepts, It is suggested to use this teaching method in the ability of professors to understand the principles of ethics in education, create moral sensitivity and strengthen moral decisions.

The necessity of virtual learning during the COVID-19 epidemic has caused serious challenges due to the lack of preparedness of educational centers, regarding the provision of appropriate educational infrastructure and the unfamiliarity of teachers with virtual learning methods. Over time, some educators have turned threats into innovative opportunities in learning and have improved education in some cases. Without a doubt, studying these challenges and understanding teachers’ experiences in this field can help better arrangement for the growth and excellence of virtual learning.

In this qualitative research, 11 semi-structured interviews were made with the faculty members of Alborz University of Medical Sciences in 2020. The texts of interviews were analyzed by conventional content analysis method using MaxQDA software.

In this study, two main classes of “individual barriers to virtual learning efficiency” were extracted, which encompassed the sub-classes of personality traits and family factors, and “organizational management”, comprised of the sub-classes of infrastructure provision, management and leadership, training and supervision, ethics and law and evaluation.

Given the continuity of the Corona crisis, each university must specifically evaluate teachers’ challenges and experiences in the field of virtual learning during the COVID-19 pandemic in order to find effective solutions to tackle them.

Despite the development of valuable teaching methods and assessment tools in the field of surgery education, yet unpreparedness for independence practice by surgical residents remains a problem in most of the countries.

This study aims to explain the surgical residents’ experience of the teaching and learning process in the operating rooms in Iran.

This study is a qualitative research that was done from May 2019 to June 2020 in Tehran and eight other cities in Iran. The selected methodology was constructivist grounded theory. The study setting was 11 teaching hospitals. Data were collected through 36 in‑depth interviews and 132 h of observation. Participants were selected initially by purposive sampling and then by theoretical sampling for covering gaps and completing categories.

Findings showed that the confused educational system was the main concern of the residents’ experience of the teaching and learning process in the operating room. This concern is investigated by dividing into four subcategories: Education in the shadow of treatment, inefficient education, patient safety versus trusting residents for independent practice, and unstructured assessment.

Based on residents’ experience about challenges such as inefficient education, the influence of patient safety versus trusting residents for independent practice, and unstructured assessment, the surgical residents’ education in the operating rooms needs to revise.

Context: 

The operating room is a unique environment in which learning happens through interactions with others and facing complex situations. The results of studies show that non-technical skills play a key role in successful technical performance in critical situations. Therefore, the identification and assessment of them are very valuable. This review study was performed to identify and critique non-technical skill assessment tools for surgical team members.

Evidence Acquisition: 

The Carnwell and Daly critical review method was used for the study design. Articles and documents were searched in databases of PubMed, Google Scholar, Scopus, and ScienceDirect from 1999 to 2019.

 This literature review yielded 13 assessment tools of non-technical skills in the operating room, including ANTS, AS-NTS, N-ANTS, ANTS-AP for the anesthesia team, OTAS, Oxford NOTEHS, Oxford NOTECHS II, and Revised NOTECHS for the surgical team, SPINTS for scrub nurses, and OSANTS, NOTSS, SDM-RS, and SLI for surgeons.

 Since the development of the tools depends entirely on the context and task analysis of any member of the surgical team, all countries must customize the available tools and develop similar tools for other members of surgical teams.

Training in operating rooms is challenging. Specifically, surgical residents often experience a stressful environment in training arenas that, in turn, might affect their ability in the acquisition of the required qualifications. This study aims at the qualitative explanation of how the surgical residents acquire the surgical skills in operating rooms.

This qualitative study was conducted in 2019-2020 using the conventional content analysis method. Participants were selected using purposive sampling. Data were collected through 25 semi-structured in-depth interviews. Then, the interview transcriptions were analyzed in MaxQDA2 software using the content analysis method.

The data were classified into two main categories, namely challenges/obstacles and strategies for dealing with the challenges. The data in the first category were further classifiedinto four subcategories, including burnout, confusion in technique selection, unequal learning opportunities, ignorance, and responsibility misassignment. Similarly, four subcategories of establishing communication channels with chief residents and faculty members, learning by the non-surgeon pathway, covert progress in the learning path, and taking advantage of force from a position of power in the learning path were considered for the second category.

Based on the findings of the study, surgical residents face serious challenges and obstacles in their training course. To address these challenges, the curriculum of the surgical course needs to be improved with the emphasis on the balanced responsibility assignment and enhanced human communication.

Implementation of task-based learning approach is very important and effective in surgical technologists. Because of the lack of enough hospital operating rooms, they cannot be experienced at the same time as passing the surgical technology courses.

This study was a quasi-experimental study which samples were 57 surgical technology students of the 6th semester who selected based on include criteria of the study and divided into two intervention and control groups. Then they trained by two methods of teaching (routine method versus task-based learning method). Before and after training, their basic knowledge and practical skills were evaluated and compared using multi choice question and observational checklist. Data were analyzed using SPSS version 22 software. The

This study showed that after teaching by task-based learning method, there was a significant difference between the mean scores of the knowledge and the practical skills in the intervention group students in comparison to the control group. The results also indicated that the intervention group in practice test were significantly faster than that of the control group. This issue is very valuable in the field of surgery, and the consequence is notable.

Based on the results of this study, task-based learning (TBL) is an effective method for surgical technologists in the clinical education. Therefore, the use of this method is recommended for all instructional directors in surgical technology course.

Considering the importance of standards in improving the quality of health care centers and the role of sterilization units in controlling hospital infections, especially surgical site infections, a study is done with the goal of investigating compliance of structural and functional standards in sterilization units in educational hospitals in Guilan province.

This analytical cross-sectional study was carried out in the educational hospital of Guilan in 2019-2018 with a sterilization unit using a structured checklist in two dimensions of physical space and equipment. 30 personnel working in units using 360-degree and census method were selected using a functional checklist in 5 dimensions of health, cleaning, packing, cycle control, maintenance and storage. The data were analyzed after collection using SPSS software version22.

Physical dimension had 61/1% and equipment dimension had 71/92% of the standards. There was significant difference between different units in terms of structural dimensions (P<0.001). Also, the average performance of the employed personnel was 84/4%, which followed the principles of hygiene the weakest observation rate. Also, there was a significant negative correlation between age and performance and there was a significant positive correlation between performance, and their training course.

The need to review spaces and eliminate defects in control equipment to ensure the functioning of the devices, as well as the use of interested and young forces and the organization of regular training courses are recommended using a continuous monitoring system to promote the highest standards.