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Background: A few studies have been done regarding the validity and reliability of the Mini-Peer Assessment Tool across various specialties. This study was conducted to determine the reliability, content and construct validity of Mini-Peer Assessment Tool to assess the competency of emergency medicine residents. Methods: This study was carried out to investigate the psychometric properties of the mini-PAT tool to evaluate the professional competencies of emergency medicine residents in educational hospitals affiliated to Tehran University of Medical Sciences. The initial Mini-Peer Assessment Tool was translated into Persian. After that, the content validity index and content validity ratio determined by consulting 12 professors of emergency medicine. The construct validity was determined with exploratory factor analysis and investigation of the correlation coefficient on 31 self and 248 peer assessment cases. The reliability of the mini peer assessment tool was determined by internal consistency and item deletion by using Cronbach's alpha coefficient. Reliability was also assessed by determining the agreement between the two tools of self-assessment and peer assessment by using the diagram Bland and Altman. Results: The results showed content validity ratio (CVR) of the items ranged from 0.56 to 0.83, and the content validity index (CVI) of the items ranged from 0.72 to 0.90. The reliability of the self-assessment and peer-assessment tools were 0.83 and 0.95 respectively and there was a relative agreement between the self-assessment method and the peer assessment method. Finally, the tool underwent exploratory factor analysis resulting extraction into two factors namely 'clinical competencies' and 'human interactions' in the peer assessment tool. In the self-assessment tool, the factors of 'good practice' and 'technical competence' were extracted. Conclusion: The results of the present study provided evidence of the adequacy of content validity, reliability of the contextually customized mini-peer assessment tool in assessing the competencies of emergency medicine residents., Competing Interests: Conflicts of Interest: None declared, (© 2020 Iran University of Medical Sciences.)

Background: To evaluate the outcome of retrograde endopyelotomy as a minimally invasive option for management of failed open pyeloplasty in children and assess how the duration of post-procedural stenting may affect the endopyelotomy outcome. Methods: A total of 15 patients with secondary UPJO (Ureteropelvic junction obstruction) underwent retrograde endopyelotomy. The procedure was done using low-energy monopolar electrocautery hook under direct vision of pediatric ureteroscope and control of fluoroscopy. Double J stent was placed after the operation in all cases. Stent was removed in another session, 8 weeks (Group A, n=7) vs. 12 weeks (Group B, n=8) after endopyelotomy. Patients in both Groups were followed one, six and twelve months after the stent removal, and the anteroposterior renal pelvis diameter (APD), renal cortical thickness (CT) and degree of hydronephrosis (HDN) were recorded using the repeated measure test. P-value less than 0.05 were significant. We analyzed the data using SPSS software, version 20. Results: The median interquartile range (IQR) age at time of surgery for group A and B were 24 (62) months and 12 (50) months respectively. Median (IQR) times between previous pyeloplasty and endopyelotomy were 6 (6) months and 12 (8.5) months in groups A and B, respectively. The success rate of endopyelotomy after 12 months was 57.1% in group A and 87.5% in group B. The resolution of HDN was more prominent in the 12 week stenting group compared to the 8 week group during the 12 months follow-up period (p=0.030). The APD and CT in group B compared to group A was improved during follow-up period. Conclusion: A higher one-year success rate of retrograde endopyelotomy in terms of improvements in the degree of HDN, APD and CT was observed when the double j stent was remained for 12-weeks rather than 8-weeks. This observation need to be validated in a large cohort study with a long term post procedural follow up., Competing Interests: Conflicts of Interest: None declared, (© 2020 Iran University of Medical Sciences.)

Background: Traditional approaches in Continuing Medical Education (CME) appear to be ineffective in any improvement of the patients' care, reducing the medical errors, and/or altering physicians' behaviors. However, they are still executed by the CME providers, and are popular among the majority of the physicians. In this study, we aimed to explore the parameters involved in the degree of effectiveness of CME program in Iran. Methods: In this study, 31 participants, consisting of general practitioners, CME experts and providers were recruited to participate in in-depth interviews and field observations concerning experiences with CME. Application was made of the qualitative paradigm along with the qualitative content analysis, using grounded theory data analysis methodology (constant comparative analysis). Results: Based on the participants' experiences, the insufficient consistency between the training program contents and the demands of GPs, in addition to the non-beneficiary programs for the physicians and the non-comprehensive educational designs, created a negative attitude to the continuing education among physicians. This could be defined by an unrealistic continuing education program, which is the main theme here. Conclusion: Impracticable continuing education has created a negative attitude toward the CME programs among physicians so much that they consider these programs less important, resulting in attending the said programs without any specific aim: they dodge absenteeism just to get the credit points. Evidently, promoting CME programs to improve the performance of the physicians requires factual needs assessment over and above adaptation of the contents to the physicians' performance.

Background: Professionalism is a core competency of physicians. This study was conducted to design a model for formative assessment of professional commitment in medical students according to stages of change theory. Methods: In this qualitative study, data were collected through literature review & focus group interviews in the Tehran University of Medical Sciences in 2013 and analyzed using content analysis approach. Results: Review of the literature and results of focus group interviews led to design a formative assessment model of professional commitment in three phases, including pre-contemplation, contemplation, and readiness for behavior change that each one has interventional and assessment components. In the second phase of the study, experts' opinion collected in two main categories: the educational environment (factors related to students, students' assessment and educational program); and administrative problems (factors related to subcultures, policymakers or managers and budget). Moreover, there was a section of recommendations for each category related to curriculum, professors, students, assessments, making culture, the staff and reinforcing administrative factors. Conclusion: This type of framework analysis made it possible to develop a conceptual model that could be effective on forming the professional commitment and behavioral change in medical students.

Background: Simulation can be used for educating, evaluating and assessing psychometric properties of an instrument. The aim of this study was to contextualize and assess the validity and reliability of the Interprofessional Collaborative Assessment tool (ICAR) in an Iranian context using simulation., Methods: In this descriptive study, contextualization of the ICAR was assessed through several steps. Firstly, validity assessment was approved through expert panels and Delphi rounds. Secondly, reliability assessment was done by arranging a simulation video and assessing reproducibility, test-retest (ICC), internal consistency (Cronbach's Alpha) and inter-rater reliability (Kappa).The participants included 26 experts, 27 students and 6 staff of the Standardized Simulation Office of Teheran University of Medical Sciences., Results: Contextualization and validity of the ICAR were approved in an Iranian context. The reliability of the tool was computed to be 0.71 according to Cronbach´s Alpha. The test-retest was calculated to be 0.76., Conclusion: The Iranian ICAR can be a useful tool for evaluating interprofessional collaborative competencies. The development of the instrument through a simulation scenario has been a positive prospect for researchers.

Background: Primary health care physicians (PHCPs) are the first in the clinic to detect and help victims of intimate partner violence (IPV). Therefore, their attitude and practice toward domestic violence (DV) are important to manage this problem. The aim of current study was to compare the behavior and attitude of PHCPs about DV versus other health risk factors in Tehran, Iran., Methods: A convenience sample of 220 PHCPs was evaluated. The study was carried out in April 2012. Two self-administered questionnaires were used to identify physicians' beliefs and behaviors on screening and intervention of DV and other health risk factors. All analyses were performed using SPSS version 18.0 (SPSS, Inc. Chicago, IL)., Results: One hundred and ninety eight questionnaires were analyzed. PHCPs' mean age was 39.06 (±7.5) years. Participants were just reported 10% screening of regular patients for DV compared with 29% to 48% for other health risk factors. Mean age of PHCPs was not associated with their approach toward the DV. Compared to male physicians, females spared more time for DV victims. Major of physicians (96%) believed that DV is not a private problem and is something that needs to be addressed cautiously., Conclusion: The results of this study indicated that DV screening occurs less than that of other health risk factors. Attitude of majority of PHCPs was positive for addressing this problem.

Background: Effective leadership is of prime importance in any organization and it goes through changes based on accepted health promotion and behavior change theory. Although there are many leadership styles, transformational leadership, which emphasizes supportive leadership behaviors, seems to be an appropriate style in many settings particularly in the health care and educational sectors which are pressured by high turnover and safety demands. Iran has been moving rapidly forward and its authorities have understood and recognized the importance of matching leadership styles with effective and competent care for success in health care organizations. This study aimed to develop the Supportive Leadership Behaviors Scale based on accepted health and educational theories and to psychometrically test it in the Iranian context., Methods: The instrument was based on items from established questionnaires. A pilot study validated the instrument which was also cross-validated via re-translation. After validation, 731 participants answered the questionnaire., Results: The instrument was finalized and resulted in a 20-item questionnaire using the exploratory factor analysis, which yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors (all above 0.6). Mapping these four measures of leadership behaviors can be beneficial to determine whether effective leadership could support innovation and improvements in medical education and health care organizations on the national level. The reliability measured as Cronbach's alpha was 0.84., Conclusion: This new instrument yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors which are applicable in health and educational settings and are helpful in improving self -efficacy among health and academic staff.