Zohreh Ghazivakili’s research while affiliated with Alborz University of Medical Sciences and other places

Background Medical education is viewed as a challenging phenomenon, which can cause stress in learners and affect the learning quality. Considering the importance of basic sciences education, development of new pedagogical approaches is necessary to improve medical education. Role-play is an efficient simulation-based approach, which can improve the students’ perception and imagination. In basic sciences, immunology is of high relevance in clinical situations, as immunological disorders are becoming increasingly prevalent. Objectives Given the importance of deep learning in immunology, we integrated role-play in teaching immunology to medical students in order to promote deep and durable learning. Methods In this study, two independent classes of medical students were evaluated in two consecutive academic semesters in 2014 - 2015. In one class, only lectures were conducted, while in the other class, lectures, along with role-play, were integrated. Pretest and posttest scores were determined at the beginning and end of the semesters in both classes, and the scores were compared. Also, the students’ point of view was studied using a questionnaire. Results The pretest score, which indicated the students’ general knowledge of immunology, was not significantly different between the two classes. However, there was an increase in the score of students participating in the class, which integrated lecture and role-play. In addition, the score obtained by female students, who participated in the class with lecture and role-play, was significantly higher than that of female students in the lecture-based class. The results of the questionnaire revealed that the students were satisfied with the integrated teaching method and believed that their knowledge had improved. Conclusions Based on the findings, dramatization can make learning an exciting process and improve the students’ understanding of immunology concepts.

Objective: the maternal near miss approach has been developed by World Health Organization for assessing and improving the quality of care. This study aimed to examine the incidence, characteristics, and features of the care provided for maternal near-miss cases in public and private hospitals in Alborz province, Iran. Methods: a cross sectional, facility-based study was conducted in all 13 public and private hospitals of Alborz province between April 2012 and December 2012. The World Health Organization near miss criteria were applied to gather and analyse the data, and indicators related to maternal near miss, access to and quality of maternal care. Findings: 38,715 deliveries were assessed. There were 38,663 live births, 419 (1.08%) had potentially life-threatening conditions and 199 had severe maternal outcomes (SMO) (192 near miss cases and 7 maternal deaths). The maternal near-miss ratio was 4.97 cases per 1000 live births. The incidence of severe maternal outcome was 5.15 cases per 1000 live births. Severe mortality outcomes index within 12 hours of hospital stay from admission (SMO12) was 3.52%. The proportion of SMO12 cases from the total SMO cases was 99.5%. The Intensive Care Unit (ICU) admission rate among women with SMO was 72.7%, while the overall admission rate was 0.7%. Overall, hypertensive disorder was the most frequent condition among women with potentially life-threatening conditions and maternal near-miss cases. Cardiovascular dysfunction and respiratory dysfunction were the most prevalent dysfunctions among maternal near miss (MNM) cases and maternal death cases respectively. Key conclusions and implications for practice: the WHO maternal near miss criteria help to identify issues that may lead to life threatening conditions and can be used to monitor and improve the quality of care in maternity settings. Hypertensive disorders related to near miss conditions need more attention to prevent maternal severe outcomes in Alborz province. Most of the process indicators were not satisfactory. The WHO tool enables health managers to improve maternal health care.