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Background and Aims: Today's working conditions in medical sciences, including dentistry, are changing rapidly. The explosion of scientific information on the one hand and the increase in consumer awareness on the other hand, along with the ever-increasing advances in artificial intelligence and access to the internet and the wide information network, has made health service providers face complex and different conditions. One of the ways to properly respond to the treatment needs of patients is to benefit from the best available evidence and clinical experience and to pay attention to the values and preferences of patients, which is manifested in the form of evidence-based practice. Dentists as members of the group of health service providers, must be familiar with evidence-based dental concepts and procedures and use them in their professional performance. This article discusses the steps of evidence-based dentistry to help empower dentists in the field of clinical decision-making based on the latest research benefiting from the best evidence and improving their clinical practice. Materials and Methods: To find relevant articles in the field of evidence-based dentistry, PubMed scientific database and Google Scholar search engine were searched from 2000 to 2023 with keywords of Evidence-based dentistry, clinical practice, and decision making. Among the articles searched based on the inclusion and exclusion criteria, 15 articles in English whose main topic was evidence-based dentistry with an educational approach were selected and used to describe evidencebased dentistry and its components. Conclusion: Due to the complexity of patients' issues and their increasing awareness, it is essential for dentists to possess specialized skills to meet patients' needs in accordance with their expectations and values, while also utilizing research findings. [ABSTRACT FROM AUTHOR]

Background and Objectives The covid-19 epidemic leads to more mortality while creating health-treatment problems. Exact identification of the patients, evaluation of immunologic and hematologic parameters and their relationship is important in determining the treatment process. Therefore, this study was conducted with the aim of investigating the relationship between red blood cell indices and CRP and IL-6 in patients with covid-19. Materials and Methods In this descriptive-analytical cross-sectional study, the data of 280 hospitalized patients with covid-19 in 3 Hamedan hospitals during 2020 and 2021 were entered in SPSS version 27 software. Data were analyzed using Chi square test, Spearman correlation coefficient, with the significance level (p< 0.05). Results By evaluation of the data of covid-19 patients, it was found that Hb, Hct, MCHC, RDW, and MCV indices with correlation coefficient of 0.16, 0.19, 0.16, 0.21, and 0.23 are related to IL-6 level significantly (p : 0.007, 0.002, 0.009, < 0.001, and < 0.001, respectively). Meanwhile, none of these indices have a significant relationship with the CRP level. Conclusions Accurate assessment of red blood cell indices and their relationship with immunological parameters could be helpful in term of choosing proper treatment method, predicting disease severity and clinical manifestations, determining required service level, and providing intensive care for patients. [ABSTRACT FROM AUTHOR]

Introduction: Dark personality traits include a range of socially aversive personality traits that are associated with risky behaviors and other mental health risk factors. However, it is not clear which specific risky behaviors are associated with each Personality trait (Machiavellianism, Narcissism, Psychopathy and Sadism) outlined in this conceptual framework. Aim: Examining the Relationship Between Dark Tetrad of Personality and Domain-Specific Risktaking Behavior Among Iranian Young People was the aim of this study. Method: The Research Design for this study is based on Descriptive Correlational Research method, A sample of 848 Young people was selected with the convenience sampling method from the Tehran using an online research platform. Domain-Specific Risk-Taking (DOSPERT) Scale and the Short Dark Tetrad (SD4) were used for data collection. The data were Analyzed by the Pearson correlation coefficient (PCC) and Stepwise regression using SPSS version 26. Results: The correlation matrix of the research variables demonstrated that all components of the Dark Tetrad of Personality (Machiavellianism, Narcissism, Psychopathy, and Sadism) are positively correlated with various domains of risk-taking (Social, Recreational, Gambling, Health/Safety, and Ethical). Among the four personality traits, Psychopathy and Sadism show the highest correlation, while Narcissism and Machiavellianism demonstrate a weaker correlation with risk-taking behaviors. Additionally, only Machiavellianism and Narcissism were linked to risky investments. Conclusion: In conclusion, for more accurate clinical decision-making concerning the relationship between Dark Personality traits and risky behaviors, it is essential to consider the specific and unique relationship between the traits and domains. [ABSTRACT FROM AUTHOR]

Introduction: Clinical decision-making is done based on data collection, interpretation and evaluation to choose an evidence-based treatment plan from among different ways; Since the clinical environment has dynamic, variable, uncertain and unstable conditions, the clinical decision-making of assistants has different dimensions and is influenced by several factors; As a result, it is not possible to get a deep understanding of it with quantitative and cross-sectional studies; Therefore, the present study was carried out with the aim of explaining the experiences of internal department assistants on the factors and obstacles affecting clinical decision-making in hospitals affiliated to Jahrom University of Medical Sciences. Materials and Methods: This article is a contract content analysis study in which 8 assistants of the internal medicine department from hospitals affiliated to Jahrom University of Medical Sciences were selected and participated in the study by purposeful sampling. Semi-structured in-depth personal interview method was used to collect data. All interviews were recorded and then transcribed and analyzed using Granheim and Lundman's method. Result: Data analysis revealed 4 main themes and 14 sub-categories, which main themes are: "criteria for clinical decision-making", "obstacles to clinical decision-making", "facilitators for clinical decisionmaking" and "the need for development" Training of assistants". Conclusion: Considering that clinical decision-making is based on the comprehensive benefit of the patient, ethical principles and evidence, and the lack of theoretical knowledge, little experience and insufficient skills, lack of specialists, facilities and equipment along with the lack of amenities and work pressure can prevent correct decision-making, it is better to emphasize more on these matters in educational planning. [ABSTRACT FROM AUTHOR]

Background. The available evidence has made the long-term accompaniment of COVID- 19 and its other variants with human life predictable. Different studies have proposed different and, in some cases, contradictory findings as factors determining the duration of hospitalization of patients with COVID-19. The present study aimed to identify the factors related to the duration ofICU length in patients with COVID-19. Methods. The present study retrospectively analyzed the data related to patients aged 1 to 97 years with COVID-19 registered in Isfahan's COVID-19 registration system. The data of those patients with COVID-19 who were alive at the time of discharge (n=453) were analyzed in the present study. Information related to laboratory findings, clinical data, and co-morbidities were collected. T-test, correlation, and analysis of variance tests were used in crude analysis. The linear regression model was used to determine the factors related to the ICU length and their importance. Results. The mean (SD) of intensive care unit days was 0.64 (2.39). Higher than normal values of INR, hemoglobin, and creatinine increased the average length of stay in ICU by 2.45 (p=0.001), 3.82 (p <0.001), and 0.72 (p <0.001) days, respectively. Among underlying co-morbidities, the presence of other respiratory diseases significantly increased the average length of stay in the ICU by 1.5 days (p=0.024). Standardized regression coefficients also showed that higher-than-normal hemoglobin and increased WBC values were the most important variables predicting ICU hospitalization length. Conclusion. The higher-than-normal values of hemoglobin and increased WBC values are the most important predictors of the length of hospitalization in the ICU. The findings of the present study can be helpful in the decision-making of specialists to reduce the duration of hospitalization in the ICU and to help diagnose more critical cases. [ABSTRACT FROM AUTHOR]

Introduction: Patient participation in treatment decisions has been associated with improved treatment results. By checking the level of knowledge of patients and informing patients about the risks and benefits of treatment methods, the level of participation of patients in treatment can be checked. This study was conducted with the aim of determining the participation rate in the treatment of breast cancer patients. Materials and Methods: The current cross-sectional study was conducted in descriptive and analytical form in 2019. The statistical population includes 15 doctors who worked in the field of breast diseases and 300 patients with breast cancer who visited clinics and doctor's offices in the cities of Shiraz, Kerman, Rasht and Tabriz, who were selected by cluster random sampling. In order to measure the level of participation, a researcher-made questionnaire was used after validity and reliability. The data were analyzed using SPSS 20 software with the help of descriptive statistics and chi-square inferential tests. Results: The findings of the research showed that patients' participation in treatment has a significant and direct relationship with age, education, duration of illness and income of patients (P value < 0.05). Based on the findings of this study, patient participation was reported in three areas (decision-making process (53%), doctor's practical behavior (67.6) and patient preferences (66.2)) and in general, the level of participation in the treatment of patients with Breast cancer was estimated at 52%. Conclusion: Empowering patients by increasing awareness about diagnosis and treatment, as well as covering breast cancer as a special disease and receiving treatment allowances, can help increase patient participation. [ABSTRACT FROM AUTHOR]

Background and Objectives Severe hemorrhage is the leading cause of death in comilitary and civilian trauma. Approximately half of road crash fatalities occur due to severe hemorrhage before hospital arrival. In severe cases of bleeding, the use of agents that accelerate blood coagulation (hemostatic agents) is required. The aim of this study was to review on the hemostatic agents and products, from research to commercial stages, and categorizing them based on the physiology of hemostasis. Moreover, the applications and adverse effects of each category have been reviewed and compared; it can be an important step towards optimal clinical application of products and novel original reasearch design continuing the previous studies. Materials and Methods Literature search was conducted in scientific databases of PubMed, Scopus, Science Direct, SID, Magiran and IranMedex without filtering release date, by combining related keywords including hemostatic agents, bleeding, dressings and trauma. The abstracts were screened by two reaserchers independently to select the appropriate studies. Results In this study, according to the basics of blood coagulation, the hemostatic agents and products were classified into five groups based on the mechanism of action including: (1) coagulants and procoagulants, (2) the concentrators of coagvlant factors, (3) mechanical cougulaton substrates, (4) physiologic coagulants and (5) chemical coagulants. The mechanism of action, applications, and side effects have been compared in each category. Conclusions Each hemostatic product can be more effective in special situations, in military and civilian trauma, due to their potency and mechanisms of action. [ABSTRACT FROM AUTHOR]

Introduction: The knowledge and attitude of dentists toward the use of denture adhesives vary worldwide, and may be affected by different factors. Therefore, the current study aimed to assess the knowledge and attitude of the general dentists toward the use of denture adhesives. Materials & Methods: In the current cross-sectional study that was done in 2019 in the city of Isfahan, the knowledge and attitude of 151 general dentists toward denture adhesive in the Isfahan city were assessed using a 16-item questionnaire. Besides, the participants' age and gender were recorded as well. Statistical analyses were done by One-way ANOVA and T-test with the 0.05 level of significance. Results: The liquid and powder (57.2%) forms of denture adhesives were the most prevalent favored types of adhesives. The incidence of adverse effects following the adhesives administration (55%) was the most common underlying etiology for the reluctance to use them. The mean of knowledge and attitude scores were (54.22 ± 14.37) and (43.32 ± 14.41), respectively, that both were at an intermediate level. Neither knowledge score (p value = 0.91) nor attitude score (p value = 0.06) was affected by gender. Similar insignificant associations were found for age (p value = 0.31 for knowledge and 0.37 for age) as well. A significant direct association was found between knowledge and attitude (p value = 0.02, r = 0.196). Conclusion: Both of the knowledge and attitude of the studied population were in the intermediate range. Besides, neither their knowledge nor their attitude was affected by age and gender. We observed that the attitude was directly associated with the dentists' knowledge. [ABSTRACT FROM AUTHOR]

Background and Objectives Lack of knowledge in health care providers may lead to an increased risk and associated complications of blood transfusion. In pediatric nursing care, clinical conditions requiring transfusion are highly urgent. Therefore, assessment of knowledge and clinical decisionmaking was performed to ensure clinical competency of nursing students. Materials and Methods This cross-sectional study was performed on 110 nursing students in 2020 by convenience sampling. Data collection was done through a researcher-made questionnaire that was made valid and reliable. The questionnaire included questions about personal characteristics, and those addressing knowledge level and clinical decision-making competence of students. The data was analyzed by SPSS 16 software (p<0.05). Results The majority of students (97.3%) were under 25 years old, and 55.5% were women. The mean percentage of students' total scores in knowledge areas regarding the use of blood transfusion in pediatric nursing was 50.57 ± 23.06. Moreover, the mean score of clinical decision making competence was 31.33 ± 20.18. There was a significant direct relationship between students' knowledge scores and clinical decision-making scores (r = 0.49, p < 0.001). There was a significant relationship between students’ knowledge and clinical decision-making and some factors including student's occupation, history of transfusion on a family member, and experience of caring for a blood recipient during the apprenticeship periods. Conclusions As nursing students lack a sufficient level of knowledge and ability of clinical decision making, further training courses emphasizing clinical-competency-based educational practices in the field of blood transfusion medicine to improve the patient health are required. [ABSTRACT FROM AUTHOR]

Introduction: Patients with diabetic foot ulcers are at the risk of limb amputation. One of the most common treatments to prevent limb amputation is the use of dressings or other appropriate treatments. This study was conducted to compare the effect of two methods of vacuum-assisted closure therapy and modern dressing on wound healing in patients with diabetic foot ulcers. Materials and Methods: This descriptive cross-sectional study (n=140) was performed on patients with grade 2 and 3 diabetic foot ulcers referring to selected hospitals affiliated with the Isfahan University of Medical Sciences, Isfahan, Iran, in 2019. The necessary data were collected using a two-part questionnaire of demographic characteristics and wound condition checklist distributed at the baseline and once a week up to 4 weeks. The Wagner ulcer classification system was used to measure the degree of the wound. Different types of new dressings, including foam, hydrocolloid, hydrogel, alginate, and hydrofilm, were used in the present study depending on the patient's needs and wound conditions. In this study, vacuum therapy is performed by a vacuum device made in Iran. Finally, the changes in depth, discharge, shape, size, and degree of the wound were compared in the two groups. The collected data were analyzed in SPSS software (version 22) using descriptive and inferential statistics. Results: The results showed that the mean scores of changes in the area, discharge, depth, and degree of the wound were significant in the two groups after the intervention (P-value 0.05). It was also found that it was found that the vacuum-assisted closure therapy method was more effective in wound healing than the new dressing method. Conclusion: The results indicated that both vacuum-assisted closure therapy and modern dressing methods were effective in healing diabetic foot ulcers. However, vacuum therapy-assisted closure therapy could accelerate and improve the healing process of diabetic foot ulcers, compared to the modern dressing method. Patients with diabetes, as a vulnerable group, need educational planning and counseling services regarding treatment and recovery. Since nurses are the main individuals who can provide the required services in the field of planning and caring for a patient with diabetes, they can play a key role in guiding the patient to choose the appropriate treatment for the type of wound at the onset of the treatment process. [ABSTRACT FROM AUTHOR]

Introduction: Different studies have investigated the effects of various factors on self-efficacy and clinical decisionmaking among nurses and other professionals in the fields of health and treatment. There is, however, little research investigating self-efficacy, clinical decision-making, and the level of relationship between them with regard to the environment and culture of organizations. Objective: This study was conducted with the aim of investigating self-efficacy and clinical decision-making among nurses in terms of individual and social variables and discovering the level of relationship between self-efficacy and ‘clinical decision-making among nurses in Guilan Province in 2017-2018. Materials and Methods: This is a descriptive cross-sectional study and 222 nurses working at different units of teaching and treatment centers in the city of Rasht were recruited after obtaining formal written consent from them. The data collection instruments were a demographic questionnaire, a self-efficacy questionnaire and a decision-making questionnaire. To analyze the data, SPSS/ 21 was used. Results: The results showed no significant difference between nurses’ clinical decision-making scores and the demographic variables of age (p=0.4), education level (p=0.27), Bachelor's degree in nursing (p=0.198), work experience (p=0.39) and work shift (p=0.9). There was, however, a significant correlation between self-efficacy score and the age (p=0.001) and work experience at the hospital (p=0.002). The logistic regression analysis indicated that self-efficacy has a significant effect on decision making after controlling for the predictor effects in such a way that by adding one point to the self-efficacy score the score of clinical decision making increased by 0.39 points. Conclusions: Understanding the relationship between self-efficacy and clinical decision-making of nurses can be indicative of the need for various training courses to improve the self-efficacy level of nurses so that this working class can create better clinical decisions. [ABSTRACT FROM AUTHOR]

Background and AIM: Oral Submucous Fibrosis (OSF) is an oral premalignant condition with highest premalignant potential among oral precancerous lesions which characterized with inflammation and progressive fibrosis of submucosal oral tissues (cause to significant irreversible rigidity and trismus). During the years, many classification systems have been proposed in medicine literatures on basis clinical, functional and histopathological aspects.This review study was done with aim of assessment and presentation of proper classification systems to the physicians use in therapeutic centers for early diagnosis, disease progression and proper treatment plan for OSF patients. Material & methods: Research was done in pubmed, Google scholar, science direct, web of sciences and Scopus databases and totally ,30 articles were selected. Results: The study resulted in a new and appropriate classification system covering all aspects of the disease including clinical, functional, histological, treatment and prognosis. Also pathogenesis and new management of OSF have been discussed. Conclusion: Attempts to provide and update the knowledge of Submucous fibrosis classification system to assist clinicians, can be useful in researches and classifying this potentially malignant disease and help greatly in the early diagnosis, proper management and reduction of morbidity and mortality of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Contemporary advances in technology and sciences parallel to changeable patients' status make it essential to nurses to combine their skills and knowledge with evidences in order to identify patients' problems, care planning, implementation and evaluation through interaction with other health team members. Nurses must be able to make clinical decisions independently which is possible just by using research evidences in clinical practice. The purpose of this article is concept of evidence based nursing and teaching barriers and facilitators in nursing. Methods: This article is an integrative review. Different data bases such as ProQuest, Ovid, PubMed, Science Direct, Google Scholare magiran, sid were applied for collecting articles by using evidence based teaching, evidence based nursing and education as key words. At all 24 articles have been included in this review. Results: Studies show many barriers in implementation of EBN and teaching it to students. For example professors do not have enough time to teach EBN or do not know how to teach it. Furthermore nurses have information and time shortages and workload that make it hard to work based on evidences. Conclusion: It seems that by making national policies and making EBN compulsory, universities and professors will teach EBN to nursing students. [ABSTRACT FROM AUTHOR]

Introduction: The ability of critical thinking and clinical decision making is a professional necessity in nursing. Concept map is one of the novel and constructive methods of educational technology in nursing that can lead to meaningful deep learning. This study was conducted to determine the effect of teaching concept map on critical thinking and clinical decision making of nurses. Methods: This quasi-experimental study of pre-test and post-test method was performed on nurses of Vliasr Hospital working in neonatal intensive cares units (n=30) selected through census. Five specialized scenarios of neonatal ward were taught to nurses through concept map for 5 consecutive weeks. Data was gathered before and after intervention using a questionnaire consisting three parts of demographic characteristics, B California Critical Thinking Test Questions, and clinical decision making cards by Q-Sort. Data was analyzed using paired and independent t-test at a significance level of (P<0.05). Results: Both mean scores of critical thinking and clinical decision making showed a significant improvement from 12.6±3.3 and 84.3±4.9 respectively before the intervention to 26±5.1 and 98.2±1/9 after the intervention out of a total of 64 (P<0.001). Moreover, the increase in clinical decision making score was significantly higher among impermanently employed nurses compared to officially employed ones (P=0.004, 16.5±5 versus 11.4±3.9). Furthermore, this score was higher among those with working background of less than 10 years compared to those having longer working backgrounds (P=0.002, 16.7±4.9 versus 11.2±3.8). Conclusion: Concept map in nursing education could result in development of critical thinking skills and clinical decision making. So it is recommended to employ this method in clinical nursing education. [ABSTRACT FROM AUTHOR]

Introduction: Since critical thinking disposition is an essential component for clinical decision-making and professional qualifications in medical sciences education. Also, learning styles are one of the effective factors in tendency to critical thinking hence, it may be expected to be effective in the manner of clinical care by health professionals. This study aimed to find learning style priorities and its role in critical thinking disposition, among students of nursing and midwifery school in Mashhad University of Medical Sciences Methods: In this descriptive and cross-sectional study, the population consisted of all undergraduate students (N=550) of nursing and midwifery school in Medical Sciences University of Mashhad (MUMS) in 2011-2012 academic year. A proportional stratified sample of 214 students was selected. The data gathering instruments included Ricketts' tool for Critical Thinking Disposition (CTD), and Kolb's Learning Styles Inventory. Data was analyzed using descriptive and inferential statistics. Results: The frequency of preferred styles of students were: Divergent 32% (n=62), Assimilation 47.17% (n=92), Convergent 11.7% (n=23) and Accommodation 9.13% (n=18). The total mean score of Critical Thinking Disposition was 119.16±14.31. The mean scores of CTD were not significantly different among different learning styles (p=.21). However, the CTD mean scores was highest in students with convergent style (124.68±34.13) and lowest among students with assimilation style (117.77±14.04). The mean score of CTD among female students (119.0±14.76) was not significantly different (p=0.92) from male students (119.26±12.97). Conclusion: According to the unsatisfactory levels of CTD scores, and it's highest values among students with Convergent learning style, it may be recommended to pay more attention to critical thinking and to provide conditions for adjustments in learning styles, so that students could cope with the nature of their and attain the optimal level CTD. These changes may be provided by revisions in the curriculum and education system. [ABSTRACT FROM AUTHOR]

Introduction: Critical Thinking (CT) is an essential component of clinical decision-making and professional competence. Personal characteristics of the students are one of the factors influencing their critical thinking development. The aim of this study was to determine the correlation between Critical Thinking Disposition (CTD) and self-esteem among pre-clinical and clinical medical students in Kermanshah University of Medical Sciences. Methods: In this descriptive-analytic study, 225 pre-clinical and clinical medical students were randomly selected through stratified sampling method in Kermanshah University of Medical Sciences in 2011. The data gathering tool included California Critical Thinking Disposition Inventory (CCTDI), and Cooper-Smith self-esteem inventory. The results were analyzed using descriptive statistics, Spearman correlation coefficient, Chi-Square, and independent sample t-test. Results: Results showed the students' mean scores in critical thinking disposition was 212.99±28.87(out of 420). Among all, CTD scores of 120 students (53.3%) were in ambivalence range, 102 (45.3%) were strong opposition, and 3(1.4%) positive inclination. There was a significantly positive correlation between CTD and self-esteem scores (r= 0.429, P=0.001). Also, there was a significant correlation between being in high or low self-esteem groups and CTD scores (P=0.0001, χ2=25.9). Conclusion: Students with higher self-esteem had a better CTD scores compared with those who had lower self-esteem and there was a direct and positive correlation between these two variables. Thus, faculty members should impart adequate self-esteem to their students for proper clinical judgment and decision making in different clinical circumstances. [ABSTRACT FROM AUTHOR]

Background and purpose: Critical thinking has a major role in desirable professional attribute and a highly valued educational outcome. The aim of this paper was to assess the dimensions of critical thinking abilities among medical students in Mazandaran University of Medical Sciences. Materials and methods: Using multistage cluster random sampling, 120 medical students were assessed. Critical thinking skills were measured using the California critical thinking skills test (CCTST). The data was analyzed through descriptive statistics and t-test in SPSS. Results: In this study 118 students completed CCTST questionnaire. The mean of critical thinking score for medical students was 10.91±3.37. Dimensions of critical thinking were not related to gender, marital status, and academic level (P>0.05). Conclusion: This study revealed that critical thinking did not enhance among medical students while studying at university. It is widely believed that critical thinking is essential to clinical decisionmaking, so lecturers in medical universities should focus more on nurturing critical thinking in order to improve the clinical competency of medical students. [ABSTRACT FROM AUTHOR]

Background and Objective: Acinetobacter baumannii is an important human pathogen that has been a focus of attention in recent years. These bacteria are a leading cause of therapeutic resistant nosocomial infections especially in burned or hospitalized patients in intensive care Units. The aim of this study was to isolate the Acinetobacter baumannii species from the wounds of burned patients and to determine antimicrobial resistance pattern of these bacteria for selection of appropriate antibiotics. Materials and Methods: Samples were collected from patients and transferred to the laboratory under standard conditions. Bacteria were isolated and purified by conventional culture methods. Identification of bacterial species was performed by standard biochemical tests. The isolates that were identified as Acinetobacter baumannii were subsequently tested for antibiotic resistance by the disk diffusion agar method for 17 different antibiotics. The tests were carried out on Muller Hinton agar (MHA) plates and incubated at 35˚C for 18 hrs. The minimum inhibition concentrations were determined for 5 common therapeutic antibiotics. Results: Out of the 65 clinical Acinetobacter baumannii isolates collected, 61 (94%) were multi drug resistant (MDR). Ceftazidime and aztronam (98%) were the most effective antibiotics against Acinetobacter baumannii. To determine the MIC, the highest levels of antibiotic resistance were seen against ceftazidime, cefepime, and ciprofloxacin. Conclusion: Our results confirm the high prevalence of Acinetobacter baumannii resistant isolates and the ensuing therapeutic problems in Iran. Determination of the resistance patterns of these bacteria according to MIC is necessary, and it can be especially helpful in treatment of burned patients. [ABSTRACT FROM AUTHOR]

Introduction: With regards to the importance and role of critical thinking in nursing , especially in clinical setting, achieving this goal(improving critical thinking) is very important. So nursing teachers encounter with the challenge of how assisting their students for promoting the critical thinking skills especially in clinical setting. The aim of this study is investigating the ways of improving critical thinking in students and suggesting implications in this field. Methods: This study is a review article has done by searching the books, Databases such as Iranmedex- Irandoc-Magiran-SID-Ovid-PubMed,... using key words such as 'critical thinking "Students","clinical education"and "nursing". Conclusion: Nurses in goal- directed education need to critical thinking. For improving it, providing especial contexts is necessary. Achieving this goal necessitate knowledge , attitude, ability , preparedness and exercise. After the presence of this elements there is need skill to improving critical thinking. These skills include general critical thinking skills such as using scientific approach ,hypothesizing, problem solving ,decision making and especial critical thinking skills in clinical settings. Results: Improving cognitive and affective domains ,motivating, developing imbalance and situations for interactions and balance between challenge and support , writing assignments such as short summary(approaching methodology , summarizing materials, is the way for critical thinking education) writing short analytical articles, problem solving exercises, using mass media research proposals and simulation are some ways, that in different situations by modifying and changing, can use for improving the students critical thinking. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades integration of pedagogic and technologic approaches resulted in a change in main structure of universities. Appearance and utility of electronic education especially in assessment system and examinations of medical students, necessitates designing new assessment methods and tools. This study is to discuss and design EPMP software as an appropriate tool for measurement of the ability in students' clinical reasoning and problem solving. Methods: Regarding the structure of PMP examination, this software was designed in form of a three layer object generated using program C language and visual studio.Net with software base of SQL server 2000 as well as Ajax software to promote user interface (UI) to be used as an internet explorer IEO6. Results: This soft ware represents patients' problem in form of some text hints and fixed and animated pictures through simulation and then with some questions, lets the student or assistant follow up patients' management and treatment. Conclusion: Because of the consistency of the designed software with international standards, this was welcomed by faculty members and assistants in university level and board of examinations. Assistants' survey results showed their desire to hold these examinations with more frequencies within their education period and the potentiality to enable them to work with computer more skillfully. [ABSTRACT FROM AUTHOR]

Clinical reasoning is not only a critical skill in medicine, but also central to the clinical practice. Considering that there is no method of assessing clinical reasoning based on the theoretical framework of medical expertise research, we could approach assessment in an innovative way taking the model of clinical reasoning as a guide. In this model three major components of clinical reasoning (i.e. information gathering, hypothesis formation and hypothesis evaluation) have been measured, treating them collectively as a single score that reflects clinical reasoning competency. This battery permits the inclusion of different formats of clinical reasoning tests that cannot be administered simultaneously and assesses different aspects of clinical reasoning. This article explains the process of designing and implementing the battery of clinical reasoning in the first Olympiad for medical sciences students using action research method. [ABSTRACT FROM AUTHOR]

The first national medical science Olympiad suggested by Isfahan University of Medical Sciences was hold in 2009 in Isfahan. The venture had the mission to identify and flourish potentials in Iranian medical science students - the health system's capital. The ministry of health in collaboration with the affiliated universities hosted 364 medical science students. Students formed teams of three members and competed excitingly in a friendly atmosphere in solving problems which could help promote our health system or basic medical sciences. To reach better coordination, meetings with authorities of ministry of health and academic members of universities were held. 35 academic members from 13 universities formed committees to set questions/ problems to be discussed and solved. Questions were of Key features, scenario, script concordance, matching, and open ended types. Individual and group tests on three domains (clinical reasoning, basic science reasoning, and health system managerial reasoning) were held in 2 days each. To assess the quality of the tests and also the Olympiad itself, students were asked to take part in a survey. Most participants (94%) believed there was a difference between the Olympiad and the usual university exams. Also about 60% found the quality of the event satisfactory and 72% said they would encourage friends to take part in the following year's Olympiad. It appears that such events, creating an exciting and happy atmosphere, could help nurture educational creativity in students and inspire them to go beyond routine studying and thus fill certain educational gaps in health system. The Olympiad being the first medical experience of the kind, further studies and modifications will certainly be necessary to improve it further. [ABSTRACT FROM AUTHOR]

Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent pulmonary diseases. Use of an automatic system for the detection and diagnosis of the disease will be beneficial to the patients' treatment decision-making process. In this paper, we propose a new approach for the Computer Aided Diagnosis (CAD) of the disease and determination of its severity axial CT scan images. Methods: In this study, 24 lung CT scans in full inspiratory and expiratory states were performed. Variations in the normalized pattern of the lungs' external parenchyma were exploited as a feature for COPD diagnosis. Subsequently, a Bayesian classifier was used to classify variations into two normal and abnormal patterns for the discrimination of patients and healthy individuals. Finally, the accuracy of the classification was assessed statistically. Results: With the proposed method, the lungs parenchymal elasticity and air-trapping were determined quantitatively. The more this feature tended to zero, the more severe air-trapping and obstructive pulmonary disease is. By analyzing CT images in the healthy and patient groups, we calculated the hard threshold for the diagnosis of the disease. Clinical results tested by the mentioned method, suggested the effectiveness of this approach. Conclusion: In regard to the challenges of COPD diagnosis, we propose a new computer-aided design which may be helpful to physicians for a more accurate diagnosis of the disease. Moreover, this severity scoring algorithm may be useful for targeted disease management and risk-adjustment. [ABSTRACT FROM AUTHOR]