A systematic review of faculty development programs based on the Harden teacher's role framework model.

BACKGROUND: Despite the changing roles of faculty in the health professions over the past two decades, none of the reviews has been paid enough attention to the impact of the faculty development programs on these roles. The objective of this review is to synthesize the existing evidence that addresses the questions: "What are the types and outcomes of faculty development programs based on the Harden teachers' role framework and which of the areas described by Harden and Crosby are the authors referring to?" METHODS: This review was conducted according to the guidance for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. In 2020, a literature search was conducted in MEDLINE/PubMed, Scopus, ERIC, ScienceDirect, Google Scholar, Magiran and SID databases. The review included 119 studies (between 1990 and 2020) that met the review criteria. Data were extracted using a modified coding sheet. We used the modified Kirkpatrick model to assess the educational outcomes of faculty development programs. RESULTS: The majority of faculty development programs were workshops (33.61%) with various durations. Most programs focused on the domain of information provider and coach (76.47%), followed by the facilitator of learning and mentor (53.78%) and assessor and diagnostician (37.81%). Only five faculty development programs focused on the domain of role model. The majority (83.19%) of outcomes reported were at level 2B, level 1 (73.95%) and level 2A (71.42%). Gains in knowledge and skills related to teaching methods and student assessment were frequently noted. Behavior changes included enhanced teaching performance, development of new educational curricula and programs, improved feedback and evaluation processes, new leadership positions, increased academic output and career development. The impact on the organizational practice continued to be underexplored. CONCLUSION: Based on the review findings, broadening the scope of faculty development programs beyond the traditional roles of the faculty members by utilizing a competency-based framework for developing a comprehensive faculty development program is recommended. Attention to individualized form of faculty development programs and incorporating more informal approaches into the design and delivery of faculty development programs is also needed.

Rationales of restricted visiting hour in Iranian intensive care units: a qualitative study.

BACKGROUND: Today, critical care visitation is considered an important aspect of patient-centred care and its positive effects on patients and their relatives have been demonstrated. However, restricted visiting hours in the intensive care units (ICUs) is often an adopted norm. The reasons for such restricted policies in Iran still remain unknown. OBJECTIVES: The purpose of this study was to identify the rationales for restricted visiting hours in adult ICUs in Iran. METHODS: A qualitative design using a thematic analysis approach was used for data gathering and analysis. Participants in this study were six nurses, three head nurses, two patients and four visitors. They were chosen through purposive sampling method. Data were gathered through semi-structured individual interviews. FINDINGS: The data analysis resulted in three themes: 'health protection', 'safety promotion' and 'privacy preservation'. CONCLUSION: The result showed that through restricted visiting hours, nurses try to protect vulnerable ICU patients from physical, psychological and legal risk. Although the ICU nurses' concerns seem reasonable in some cases, a review of visiting policies in order to meet the needs of patients and their families is essential. RELEVANCE TO CLINICAL PRACTICE: Effective supervision by charge nurses and regulation of environmental activities with visiting hours can resolve many concerns. Health care professionals, especially nurses, are required to create the conditions in which patients' family members are informed about the patients' health status and patients can be visited in suitable ward conditions.

Effects of expiratory ribcage compression before endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation.

AIM AND OBJECTIVES: To investigate the effects of expiratory ribcage compression (ERCC) before endotracheal suctioning on the arterial blood gases (ABG) in patients receiving mechanical ventilation. BACKGROUND: Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients receiving mechanical ventilation. Chest physiotherapy techniques such as ERCC before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretions and improving alveolar ventilation. DESIGN: A prospective, randomized, controlled cross-over design. METHODS: A randomized controlled cross-over trial with a convenience sample of 70 mechanically ventilated patients was conducted from 2006 to 2007. The patients received endotracheal suctioning with (experiment-period) or without (control-period) an antecedent 5-min expiratory ribcage. All the patients experienced both periods with at least a 3-h washed-out interval between the two periods. ABG were measured 5 min before and 25 min after endotracheal suctioning. RESULTS: The statistical tests showed that the levels of partial pressure of oxygen (PaO2 )/fraction of inspired oxygen (FiO2 ), partial pressure of carbon dioxide (PaCO2 ) and arterial oxygen saturation (SaO2 ) in the experimental period at 25 min after the intervention were significantly different from the control period. The tests also revealed that the levels of these variables at 25 min after suctioning were also significantly different from baseline values. However, these differences were clinically significant only for PaO2 /FiO2 . CONCLUSION: By improving the levels of PaO2 /FiO2 , ERCC can reduce the patients' need for oxygen and hence it can at least reduce the side effects of oxygen therapy. RELEVANCE TO CLINICAL PRACTICE: Improving PaO2 /FiO2 levels means less need for oxygen therapy. Hence, by applying ERCC we can at least minimize the side effects of oxygen therapy.

Occult hepatitis B demonstrated by anti-HBc and HBV DNA in HIV-positive patients.

BACKGROUND: In patients who are hepatitis B virus (HBV) DNA-positive, but HBV surface antigen (HBsAg) -negative, the infection is referred to as occult hepatitis B infection (OBI). Occult HBV infection is harmful when other liver diseases are present, and can aggravate liver damage in in patients with chronic liver diseases. In human immunodeficiency virus (HIV) infection the suppression of viral replication by the immune system might be inactivated, and classical HBV infection in OBI patients may occur. Health care professionals should be aware of OBI in HIV patients. The routine test for HBV infection in Iran is the enzyme-linked immunosorbent assay for the HBV surface antigen (ELISA HBsAg); therefore, the aim of this study was to evaluate the prevalence of OBI in Iranian HIV patients. METHODS: This cross-sectional study was conducted in 2012 on sera from all the known and accessible HIV patients in Jahrom and Fassa, two cities in southern Iran. All samples were tested for the HBsAg, HBV core antibody (HBcAb). All the results were analyzed using SPSS. RESULTS: Of the 91 patients, seven (7.7%) were HBsAg-positive and forty-five (49.5%) were HBcAb-positive. In patients with negative HBsAg (84 patients), 39 (46.4%) were HBcAb positive and 53 (63%) were positive for HBV DNA. CONCLUSION: The prevalence of HBV infection is relatively high in HIV patients, and more accurate tests than those presently in use should be used for diagnosis.