Evidence Based Health Policy, Management and Economics

The Role of Dentists in Rapid Response Teams for Disasters

Ameneh Marzban — 2025-11-21

The Article Abstract is not available.

Relationship between Learning Styles and Academic Engagement in Medical Students: A Cross-Sectional Study

Amir Hossein Pourmirza — 2025-11-21

Background: Learning styles, as a personal and distinct approach that each person employs to understand and process information, play a significant role in academic success. On the other hand, academic engagement, which refers to the active participation of students in the educational processes, is considered one of the key indicators of academic progress. Therefore, the present study was conducted with the aim of examining the relationship between learning styles and academic engagement among medical students at Ilam University of Medical Sciences.

Methods: This descriptive-analytical and cross-sectional study was conducted in 2023 among medical students in the basic sciences and pathophysiology phases at Ilam University of Medical Sciences. All students were invited to participate in the study by census (N = 178). Ultimately, 153 students entered the study by completing the questionnaire. To collect data, the VARK learning styles questionnaire and the Holgado academic engagement questionnaire including three dimensions: Vigor, Dedication, and absorption were used. Data analysis was conducted using mean and standard deviation, chi-square, independent t-test, and Mann-Whitney test with SPSS₂₄.

Results: The results indicated that the average score of academic engagement and its dimensions among medical students at Ilam University of Medical Sciences is at a moderate level, with the best situation related to the dimension of Dedication (13.9 ± 4.34) and the weakest situation related to the dimension of absorption (10.27 ± 3.97). Most students (30.1%) prefer the VARK learning style (quad modal), and among various single learning styles, the auditory learning style has the highest prevalence (17.6%). A significant positive correlation was observed between the scores of the dimensions of academic engagement for male and female students. The average score of the dimension of absorption among pathophysiology students was significantly higher than that of the basic sciences. (P-values ≤ 0.001). Finally, no significant difference was found between the dimensions of academic engagement and the single-style and multi-style learning preferences.

Conclusion: The results of the study indicate that academic engagement among medical students is not at a desirable level, and learning styles do not have a statistically significant relationship with the level of academic engagement. Examining the variables that influence academic engagement and striving to strengthen this key variable can have a significant impact on learning outcomes Therefore, it is recommended to pay greater attention to improving the educational environment, enhancing students` motivation, and diversifying teaching methods. Additionally, examining structural factors such as academic workload and psychological support can help strengthen academic engagement.

The Effect of Mobile-Based Learning on Cognitive Load and Learning in Environmental Health Education

Kamaleddin Khorrami — 2025-11-21

Background: The growth of educational technologies has led to the development of mobile-based education. The purpose of this investigation was to examine the influence of mobile-based learning (M-learning) on the cognitive load, learning, and satisfaction of students in environmental health Engineering (EHE).

Methods:

The quasi-experimental study was carried out in X University of Medical Sciences. Students of EHE (n=30) participated in the intervention and control groups. In the intervention group, students were trained to use the mobile-based learning method(M-learning). Students in the control group participated in the traditional training. The students’ satisfaction and cognitive load were assessed using questionnaires. Students’ learning was assessed by multiple-choice questions with multiple answers. The data were analyzed using SPSS24 software.

Results: The results showed that students in the intervention group demonstrated 8.53±1.06 as learning scores, significantly higher than those of the control group (4.18±1.57). The intrinsic and extraneous cognitive load of the intervention group was significantly lower (P-values<0.001). The germane cognitive load was significantly higher in intervention students (P-values<0.001). Also, the results of the students’ satisfaction questionnaire showed that the participants were highly satisfied with the educational content, efficiency, and ease of use of the application (8.03±0.27), which was reported at a good level (level 6-8 out of 9).

Conclusion: The M-learning method is recommended as an effective tool for teaching the conventional activated sludge process to undergraduate environmental health engineering students. This method effectively creates a germane cognitive load by using game elements and facilitated learning at any time and any place.

Identification of Effective Factors Influencing Professional Ethics among Staff Experts in the Medical Vice-Chancellor’s Office of Iran University of Medical Services

Fatemeh Najafi Pour Moghadam — 2025-11-21

Background: Ethics is defined as a set of principles used to guide and direct. Professional ethics has an important impact on the activities and outcomes of an organization. Professional ethics promote efficiency, improve communication, and reduce threats.

Methods: The present study is qualitative and has an applied purpose. Based on the opinions of experts, the researcher pursued the identification of the components of professional ethics among the experts of the Vice President of Treatment of Iran University of Medical Sciences and Health Services. Information was obtained through interviews with experts. Given the complexity and multidimensionality of the issue, the concepts were examined from the experts' perspective to discover the hidden dimensions of this issue. Purposive sampling was carried out until data saturation and interviews were conducted with 40 experts. The information was collected and, after confirming the face and content validity by the experts, open, axial and selective coding was carried out and the result was determined.

Results: Information includes 8 topics, including responsibility, honesty and integrity, justice and fairness, loyalty, respect for others, sympathy for others, compliance with laws and guidelines and competition were detected.

Conclusion: In order to improve professional ethics among experts, it is necessary for the authorities to pay attention to the categories of responsibility, honesty and integrity, justice and fairness, loyalty, respect, sympathy for others, compliance with laws and guidelines, and competition. Given its importance in organizational culture, appropriate incentive and punishment mechanisms should be used to improve the current situation.

Designing a Model of Brand Authenticity Drivers in Healthcare with a Focus on Patient Trust

Parisa Imani — 2025-11-21

Background: The purpose of this study is to design and present a model of the effective factors influencing brand authenticity in the healthcare sector, with a specific emphasis on its role in building trust among patients.

Methods: This research is applied in terms of its purpose and utilizes a mixed-methods (qualitative-quantitative) approach. Based on an interpretive paradigm and an inductive approach, it is exploratory-analytical in nature. The statistical population consisted of industry and academic experts, selected via purposive sampling. The research was conducted in three main stages: 1) Identifying brand authenticity factors through a systematic review of national and international literature and qualitative content analysis using NVivo software; 2) Localizing these factors for the healthcare context via the Delphi method; and 3) Structuring the final model by determining the relationships and hierarchy among the factors using the Interpretive Structural Modeling (ISM) technique.

Results: The initial literature review identified 15 potential factors of brand authenticity. Through the Delphi process with experts, 3 factors were eliminated due to low consensus (average score < 3), resulting in 12 validated key factors specific to the healthcare sector. The ISM analysis then structured these factors into a four-level hierarchical model. The results pinpointed uniqueness, commitment to customers, brand distinctiveness, and customer engagement as the most influential (Level 1) drivers. Conversely, Brand’s strong legacy was identified as the most dependent (Level 4) and foundational factor, indicating that it is significantly influenced by other factors but is crucial for achieving overall brand authenticity.

Conclusion: This study provides a novel, validated hierarchical model that delineates the interrelationships between the key factors of brand authenticity in the healthcare sector. It offers valuable strategic insights for managers by highlighting which factors to prioritize, from building a strong brand legacy, ensuring authenticity, and leveraging a rich historyto most effectively build patient trust. The findings empower healthcare sector managers in Iran and similar contexts to develop targeted strategies for enhancing brand perception and fostering long-term patient relationships.

The Relationship between Demographic Variables and Psychological Capital in Pregnant Women

Zahra Zamanian — 2025-11-21

Background: Pregnancy is one of the most sensitive and challenging periods in women’s lives, accompanied by significant physical, psychological, and social changes that may affect mental health. Psychological capital, as a valuable internal resource, plays a critical role in empowering women to cope with the pressures of pregnancy. This study aimed to examine the relationship between components of psychological capital (self-efficacy, hope, resilience, and optimism) and demographic variables during pregnancy.

Methods: This cross-sectional study was conducted on 70 pregnant women attending health centers affiliated with Qom University of Medical Sciences. Data were collected using the McGee Psychological Capital Questionnaire, along with demographic information such as age, employment status, husband’s occupation, and education. Data were analyzed using Pearson correlation, independent t-test, one-way ANOVA, and linear regression. A significance level of P<0.05 was also considered.

Results: Significant associations were found between self-efficacy and husband’s age (P=0.046), women’s employment (P<0.001), and planned pregnancy (P=0.048). Hope correlated positively with women’s age (P=0.034), husband’s age (P=0.012), employment (P<0.001), husband’s job (P=0.045), and planned pregnancy (P=0.030). Resilience was associated with women’s age (P=0.027), husband’s age (P=0.033), satisfaction with pregnancy (P=0.027), and women’s employment (P<0.001). Optimism correlated significantly with employment (P=0.004), husband’s job (P=0.028), and planned pregnancy (P=0.013). Overall psychological capital was significantly higher in employed women (P<0.001) and those with planned pregnancies (P=0.020). Linear regression showed that only maternal employment had a significant positive effect on psychological capital (β=0.38, P=0.002).

Conclusion: The findings highlight the importance of social support and psychological factors in promoting maternal mental health. Social and individual factors such as employment and planned pregnancy play a vital role in strengthening women’s psychological resources during pregnancy, potentially improving quality of life and reducing stress.

The Role of Nursing in Health Economics: A Narrative Review Study

Fatemeh Mehrabirad — 2025-11-21

Background: Health economics, as a branch of economics, examines how resources are utilized in the healthcare sector. The primary objective of efficient healthcare systems is to improve patient outcomes while reducing treatment costs. Nurses, being the largest group of healthcare providers, play a significant role in health economics. Given the crucial role of nurses in the healthcare system and the necessity of enhancing the efficiency and effectiveness of health services, conducting precise and comprehensive research in the field of nursing and health economics is of particular importance.

Methods: This narrative review was conducted by searching the databases SID, PubMed, CINAHL, and Scopus, with the aim of exploring the roles of nurses in health economics. The keywords used included: resource allocation, allocation, cost-effectiveness, health economics, nursing, healthcare policy, decision-making participation, and their equivalents, using the operators AND and OR. Articles published between 2016 and 2024 were reviewed.

Results: Out of 83 retrieved articles, 19 were selected for final analysis based on the researcher’s access to the full text and the relevance to the study topic. The collected materials were categorized thematically by the researchers into two main themes: "Nurses and Health Economics" and "Nursing and the Value of Health Services."

Conclusion: Nurses play a crucial role in enhancing the efficiency of healthcare systems and reducing costs by delivering high-quality and cost-effective care. They fulfill multiple roles in health economics through clinical interventions, resource management, policy participation, and specialized education—contributing to improved care quality and system performance. Further research is needed to better understand the long-term impact of nurses on economic decision-making and to provide effective strategies.

Key Factors Influencing Health System Governance in Iran: A Scoping Review

Elaha Salarikheh — 2025-11-21

Background: Governance is one of the important functions of health system management. Good health system governance leads to better health system performance and ultimately, better health outcomes for the people. However, the concept of governance in the health system is ambiguous and complex. Therefore, this study aims to explain the key factors affecting health system governance.

Methods: This research was conducted using a conceptual review method. For this purpose, all articles related to health system governance were searched and collected from the databases Google Scholar, Science Direct, PubMed, EMBASE, ProQuest, and Scopus. Search keywords included "health governance," "Iran health system," and "health challenges." After initial screening, 80 relevant articles were selected and meticulously analyzed using content analysis method.

Results:Analysis of the 80 selected studies showed that the key factors affecting health system governance in Iran fall into five main categories: Economic-financial factors: International sanctions (40% reduction in imports of specific drugs), high out-of-pocket payments (38-42%), and inefficient budget allocation. Structural challenges: Severe centralization (87% of decisions made in Tehran), parallel work by institutions, and policy changes with government shifts. Information technology weakness: Lack of integrated electronic health records and absence of a performance monitoring system. Socio-cultural factors: Regional inequalities and rising public expectations. International environment: Dependence on imports of medical equipment.

Conclusion: Improving health system governance in Iran requires comprehensive reform in four key areas: enhancing transparency and accountability through a Supreme Health Council, increasing financial flexibility via a sustainable health fund and value-based payments, promoting digital transformation with integrated electronic records and AI, and ensuring equity through fair resource allocation. Global evidence shows that such reforms can boost system efficiency by up to 40%, making governance improvement a crucial investment for advancing population health and achieving sustainable development in Iran.