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Article: Development and psychometric properties of teamwork scale in resuscitation: A sequential exploratory mixed-method study.

Hosseini, Mohammad / Heydari, Abbas / Reihani, Hamidreza / Kareshki, Hossein

Journal of education and health promotion

2023 Volume 12, Page(s) 10

Abstract: Background: Non-technical skills as a complement to technical skills have become increasingly important in cardio-pulmonary resuscitation, and teamwork is one of the most prominent of these skills. Because of the limited number of tools introduced and ... ...

Abstract	Background: Non-technical skills as a complement to technical skills have become increasingly important in cardio-pulmonary resuscitation, and teamwork is one of the most prominent of these skills. Because of the limited number of tools introduced and validated for measuring teamwork in resuscitation, this study was conducted to develop and evaluate the psychometric properties of the Teamwork Scale in Resuscitation (TSR). Materials and methods: This study was a sequential exploratory mixed-method study and was conducted between March 2020 and April 2021 and in two phases. In the first phase (qualitative), semi-structured interviews were performed with resuscitation team members who were selected using a purposeful sampling method with maximum variation in terms of experience, level of education, age, and gender. Using directed qualitative content analysis, the data were analyzed and the primary item pool was developed. In the second phase (quantitative), assessing face, content, and construct validity as well as reliability via the internal consistency and stability, the psychometric properties of the instrument are evaluated. Results: The initial tool consisted of 54 items; after assessing the face validity, ten items were removed during content validity, and the final tool consisted of 44 items and three main categories including the essential prerequisites for resuscitation, leadership, and teamwork, which was scored based on a 5-point Likert scale from strongly disagree to strongly agree. The convergent validity and concurrent validity of the tool were confirmed. The reliability of the instrument was also confirmed using Cronbach's alpha test and re-test and the intra-class correlation coefficient (ICC) between raters. Conclusion: The validity and reliability of TSR for measuring teamwork in resuscitation in a simulated environment are approved. Further studies are suggested for different contexts of resuscitation and with trained raters to evaluate its use in real resuscitation situations.
Language	English
Publishing date	2023-01-31
Publishing country	India
Document type	Journal Article
ZDB-ID	2715449-X
ISSN	2319-6440 ; 2277-9531
ISSN (online)	2319-6440
ISSN	2277-9531
DOI	10.4103/jehp.jehp_139_22
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Author Response.

Rahmatinejad, Zahra / Hoseini, Benyamin / Pourmand, Ali / Reihani, Hamidreza / Rahmatinejad, Fatemeh / Eslami, Saeid / Hanna, Ameen Abu

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

2024 Volume 28, Issue 2, Page(s) 183–184

Abstract: How to cite this article: ...

Abstract	How to cite this article:
Language	English
Publishing date	2024-02-05
Publishing country	India
Document type	Journal Article
ZDB-ID	2121263-6
ISSN	1998-359X ; 0972-5229
ISSN (online)	1998-359X
ISSN	0972-5229
DOI	10.5005/jp-journals-10071-24609
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Article ; Online: Development and psychometric properties of teamwork scale in resuscitation

Mohammad Hosseini / Abbas Heydari / Hamidreza Reihani / Hossein Kareshki

Journal of Education and Health Promotion, Vol 12, Iss 1, Pp 10-

A sequential exploratory mixed-method study

2023 Volume 10

Abstract: BACKGROUND: Non-technical skills as a complement to technical skills have become increasingly important in cardio-pulmonary resuscitation, and teamwork is one of the most prominent of these skills. Because of the limited number of tools introduced and ... ...

Abstract	BACKGROUND: Non-technical skills as a complement to technical skills have become increasingly important in cardio-pulmonary resuscitation, and teamwork is one of the most prominent of these skills. Because of the limited number of tools introduced and validated for measuring teamwork in resuscitation, this study was conducted to develop and evaluate the psychometric properties of the Teamwork Scale in Resuscitation (TSR). MATERIALS AND METHODS: This study was a sequential exploratory mixed-method study and was conducted between March 2020 and April 2021 and in two phases. In the first phase (qualitative), semi-structured interviews were performed with resuscitation team members who were selected using a purposeful sampling method with maximum variation in terms of experience, level of education, age, and gender. Using directed qualitative content analysis, the data were analyzed and the primary item pool was developed. In the second phase (quantitative), assessing face, content, and construct validity as well as reliability via the internal consistency and stability, the psychometric properties of the instrument are evaluated. RESULTS: The initial tool consisted of 54 items; after assessing the face validity, ten items were removed during content validity, and the final tool consisted of 44 items and three main categories including the essential prerequisites for resuscitation, leadership, and teamwork, which was scored based on a 5-point Likert scale from strongly disagree to strongly agree. The convergent validity and concurrent validity of the tool were confirmed. The reliability of the instrument was also confirmed using Cronbach's alpha test and re-test and the intra-class correlation coefficient (ICC) between raters. CONCLUSION: The validity and reliability of TSR for measuring teamwork in resuscitation in a simulated environment are approved. Further studies are suggested for different contexts of resuscitation and with trained raters to evaluate its use in real resuscitation situations.
Keywords	mixed-method study ; psychometric properties ; resuscitation ; scale ; teamwork ; Special aspects of education ; LC8-6691 ; Public aspects of medicine ; RA1-1270
Subject code	370
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A comparative study of explainable ensemble learning and logistic regression for predicting in-hospital mortality in the emergency department.

Rahmatinejad, Zahra / Dehghani, Toktam / Hoseini, Benyamin / Rahmatinejad, Fatemeh / Lotfata, Aynaz / Reihani, Hamidreza / Eslami, Saeid

Scientific reports

2024 Volume 14, Issue 1, Page(s) 3406

Abstract: This study addresses the challenges associated with emergency department (ED) overcrowding and emphasizes the need for efficient risk stratification tools to identify high-risk patients for early intervention. While several scoring systems, often based ... ...

Abstract	This study addresses the challenges associated with emergency department (ED) overcrowding and emphasizes the need for efficient risk stratification tools to identify high-risk patients for early intervention. While several scoring systems, often based on logistic regression (LR) models, have been proposed to indicate patient illness severity, this study aims to compare the predictive performance of ensemble learning (EL) models with LR for in-hospital mortality in the ED. A cross-sectional single-center study was conducted at the ED of Imam Reza Hospital in northeast Iran from March 2016 to March 2017. The study included adult patients with one to three levels of emergency severity index. EL models using Bagging, AdaBoost, random forests (RF), Stacking and extreme gradient boosting (XGB) algorithms, along with an LR model, were constructed. The training and validation visits from the ED were randomly divided into 80% and 20%, respectively. After training the proposed models using tenfold cross-validation, their predictive performance was evaluated. Model performance was compared using the Brier score (BS), The area under the receiver operating characteristics curve (AUROC), The area and precision-recall curve (AUCPR), Hosmer-Lemeshow (H-L) goodness-of-fit test, precision, sensitivity, accuracy, F1-score, and Matthews correlation coefficient (MCC). The study included 2025 unique patients admitted to the hospital's ED, with a total percentage of hospital deaths at approximately 19%. In the training group and the validation group, 274 of 1476 (18.6%) and 152 of 728 (20.8%) patients died during hospitalization, respectively. According to the evaluation of the presented framework, EL models, particularly Bagging, predicted in-hospital mortality with the highest AUROC (0.839, CI (0.802-0.875)) and AUCPR = 0.64 comparable in terms of discrimination power with LR (AUROC (0.826, CI (0.787-0.864)) and AUCPR = 0.61). XGB achieved the highest precision (0.83), sensitivity (0.831), accuracy (0.842), F1-score (0.833), and the highest MCC (0.48). Additionally, the most accurate models in the unbalanced dataset belonged to RF with the lowest BS (0.128). Although all studied models overestimate mortality risk and have insufficient calibration (P > 0.05), stacking demonstrated relatively good agreement between predicted and actual mortality. EL models are not superior to LR in predicting in-hospital mortality in the ED. Both EL and LR models can be considered as screening tools to identify patients at risk of mortality.
MeSH term(s)	Adult ; Humans ; Logistic Models ; Hospital Mortality ; Cross-Sectional Studies ; Emergency Service, Hospital ; Machine Learning ; Retrospective Studies
Language	English
Publishing date	2024-02-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-54038-4
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Resuscitation Team Members 'Experiences of Teamwork: A Qualitative Study.

Hosseini, Mohammad / Heydari, Abbas / Reihani, Hamidreza / Kareshki, Hossein

Iranian journal of nursing and midwifery research

2022 Volume 27, Issue 5, Page(s) 439–445

Abstract: Background: Despite the obvious importance of teamwork in emergency care, the dimensions of teamwork in resuscitation remain a subject of debate among specialists and researchers. The aim of this study was to identify the dimensions of teamwork based on ...

Abstract	Background: Despite the obvious importance of teamwork in emergency care, the dimensions of teamwork in resuscitation remain a subject of debate among specialists and researchers. The aim of this study was to identify the dimensions of teamwork based on the experiences of members of the resuscitation team. Materials and methods: This study was conducted between March 2020 and April 2021. By purposive sampling, participants were selected. Sixteen semi-structured interviews were conducted with experienced emergency nurses and emergency medicine residents individually and analysed through deductive content analysis by using the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) model. Interviews were encoded for analysis using MAXQDA software (version 2020). Results: Three main categories were identified around teamwork in resuscitation. These categories were as follows (1) leadership, (2) teamwork, and (3) essential prerequisites for resuscitation. The main leadership category consisted of three sub-categories of time management, resource allocation, and task management. From sub-categories, situation monitoring, communication, and mutual support, the main category of teamwork emerged. Also, the emerging category of essential prerequisites for regeneration included two generic categories: professional requirements and workplace requirements and the teamwork category included situation monitoring, communication, and mutual support. Conclusions: Based on the experiences of the resuscitation team members, leadership, teamwork, and essential prerequisites for resuscitation are the most important dimensions of teamwork in resuscitation. Recognizing the dimensions of teamwork in resuscitation is an initial step and then should be reflected in educational programs and future guidelines.
Language	English
Publishing date	2022-09-14
Publishing country	India
Document type	Journal Article
ZDB-ID	2609892-1
ISSN	2228-5504 ; 1735-9066
ISSN (online)	2228-5504
ISSN	1735-9066
DOI	10.4103/ijnmr.ijnmr_294_21
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Article: Elements of Teamwork in Resuscitation: An Integrative Review.

Hosseini, Mohammad / Heydari, Abbas / Reihani, Hamidreza / Kareshki, Hossein

Bulletin of emergency and trauma

2022 Volume 10, Issue 3, Page(s) 95–102

Abstract: Objective: To identify the elements of teamwork in resuscitation, an integrative review and synthesize current primary studies conducted.: Methods: PubMed, Scopus, Web of Science, and Embase, as well as Google Scholar search engine were searched from ...

Abstract	Objective: To identify the elements of teamwork in resuscitation, an integrative review and synthesize current primary studies conducted. Methods: PubMed, Scopus, Web of Science, and Embase, as well as Google Scholar search engine were searched from November 2015 to March 2020 to review previously published peer-reviewed studies. Out of the 5495 articles, 16 were finally included in the study. Search strategy implemented with these keywords (in the title/abstract) were (team* AND CPR) or (team* AND resuscitation). Six descriptive criteria was performed by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to analyze the articles and a modified version of Cooper's five-stage method. Results: Sixteen studies were included in this research. Twenty elements related to teamwork in resuscitation were identified by using data synthesis, then classified into four categories includes team interaction elements, leadership skills, individual elements and environmental elements. Communication, leadership, situation awareness and scene organization had the highest frequency of reviewed articles 10, 5, 4, 4, respectively. Conclusion: The interactions between resuscitation team members and the skills of the leader and team members along with environmental elements had attracted the most attention of researchers by focusing on teamwork in resuscitation. Due to the limited number of articles related to this subject, more research is needed to reveal all the key elements of teamwork in resuscitation.
Language	English
Publishing date	2022-08-14
Publishing country	Iran
Document type	Journal Article ; Review
ZDB-ID	2722734-0
ISSN	2322-3960 ; 2322-2522
ISSN (online)	2322-3960
ISSN	2322-2522
DOI	10.30476/BEAT.2021.91963.1291
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Article: Comparison of Six Scoring Systems for Predicting In-hospital Mortality among Patients with SARS-COV2 Presenting to the Emergency Department.

Rahmatinejad, Zahra / Hoseini, Benyamin / Reihani, Hamidreza / Hanna, Ameen Abu / Pourmand, Ali / Tabatabaei, Seyyed Mohammad / Rahmatinejad, Fatemeh / Eslami, Saeid

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

2023 Volume 27, Issue 6, Page(s) 416–425

Abstract: ... Hoseini B, Reihani H, Hanna AA, Pourmand A, Tabatabaei SM, ...

Abstract	Background: The study aimed to compare the prognostic accuracy of six different severity-of-illness scoring systems for predicting in-hospital mortality among patients with confirmed SARS-COV2 who presented to the emergency department (ED). The scoring systems assessed were worthing physiological score (WPS), early warning score (EWS), rapid acute physiology score (RAPS), rapid emergency medicine score (REMS), national early warning score (NEWS), and quick sequential organ failure assessment (qSOFA). Materials and methods: A cohort study was conducted using data obtained from electronic medical records of 6,429 confirmed SARS-COV2 patients presenting to the ED. Logistic regression models were fitted on the original severity-of-illness scores to assess the models' performance using the Area Under the Curve for ROC (AUC-ROC) and Precision-Recall curves (AUC-PR), Brier Score (BS), and calibration plots were used to assess the models' performance. Bootstrap samples with multiple imputations were used for internal validation. Results: The mean age of the patients was 64 years (IQR:50-76) and 57.5% were male. The WPS, REMS, and NEWS models had AUROC of 0.714, 0.705, and 0.701, respectively. The poorest performance was observed in the RAPS model, with an AUROC of 0.601. The BS for the NEWS, qSOFA, EWS, WPS, RAPS, and REMS was 0.18, 0.09, 0.03, 0.14, 0.15, and 0.11 respectively. Excellent calibration was obtained for the NEWS, while the other models had proper calibration. Conclusion: The WPS, REMS, and NEWS have a fair discriminatory performance and may assist in risk stratification for SARS-COV2 patients presenting to the ED. Generally, underlying diseases and most vital signs are positively associated with mortality and were different between the survivors and non-survivors. How to cite this article: Rahmatinejad Z, Hoseini B, Reihani H, Hanna AA, Pourmand A, Tabatabaei SM,
Language	English
Publishing date	2023-05-22
Publishing country	India
Document type	Journal Article
ZDB-ID	2121263-6
ISSN	1998-359X ; 0972-5229
ISSN (online)	1998-359X
ISSN	0972-5229
DOI	10.5005/jp-journals-10071-24463
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Comparing In-Hospital Mortality Prediction by Senior Emergency Resident's Judgment and Prognostic Models in the Emergency Department.

Rahmatinejad, Zahra / Peiravi, Samira / Hoseini, Benyamin / Rahmatinejad, Fatemeh / Eslami, Saeid / Abu-Hanna, Ameen / Reihani, Hamidreza

BioMed research international

2023 Volume 2023, Page(s) 6042762

Abstract: Background: A comparison of emergency residents' judgments and two derivatives of the Sequential Organ Failure Assessment (SOFA), namely, the mSOFA and the qSOFA, was conducted to determine the accuracy of predicting in-hospital mortality among ... ...

Abstract	Background: A comparison of emergency residents' judgments and two derivatives of the Sequential Organ Failure Assessment (SOFA), namely, the mSOFA and the qSOFA, was conducted to determine the accuracy of predicting in-hospital mortality among critically ill patients in the emergency department (ED). Methods: A prospective cohort research was performed on patients over 18 years of age presented to the ED. We used logistic regression to develop a model for predicting in-hospital mortality by using qSOFA, mSOFA, and residents' judgment scores. We compared the accuracy of prognostic models and residents' judgment in terms of the overall accuracy of the predicted probabilities (Brier score), discrimination (area under the ROC curve), and calibration (calibration graph). Analyses were carried out using R software version R-4.2.0. Results: In the study, 2,205 patients with median age of 64 (IQR: 50-77) years were included. There were no significant differences between the qSOFA (AUC 0.70; 95% CI: 0.67-0.73) and physician's judgment (AUC 0.68; 0.65-0.71). Despite this, the discrimination of mSOFA (AUC 0.74; 0.71-0.77) was significantly higher than that of the qSOFA and residents' judgments. Additionally, the AUC-PR of mSOFA, qSOFA, and emergency resident's judgments was 0.45 (0.43-0.47), 0.38 (0.36-0.40), and 0.35 (0.33-0.37), respectively. The mSOFA appears stronger in terms of overall performance: 0.13 vs. 0.14 and 0.15. All three models showed good calibration. Conclusion: The performance of emergency residents' judgment and the qSOFA was the same in predicting in-hospital mortality. However, the mSOFA predicted better-calibrated mortality risk. Large-scale studies should be conducted to determine the utility of these models.
MeSH term(s)	Humans ; Adolescent ; Adult ; Middle Aged ; Aged ; Hospital Mortality ; Judgment ; Prognosis ; Prospective Studies ; Emergency Service, Hospital
Language	English
Publishing date	2023-05-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2698540-8
ISSN	2314-6141 ; 2314-6133
ISSN (online)	2314-6141
ISSN	2314-6133
DOI	10.1155/2023/6042762
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The Effects of Using Checklists on Electrocardiogram Interpretation: A Cross- Sectional Study on Medical Interns.

Reihani, Hamidreza / Azarfardian, Neda / Ebrahimi, Mohsen / Foroughian, Mahdi

Advances in medical education and practice

2019 Volume 10, Page(s) 1089–1095

Abstract: Introduction: Electrocardiogram (ECG), behind medical examination, is the easiest way to check the heart diseases, especially in an emergency department. Although the acquisition of Terrace from patients in the right method does not require a high level ...

Abstract	Introduction: Electrocardiogram (ECG), behind medical examination, is the easiest way to check the heart diseases, especially in an emergency department. Although the acquisition of Terrace from patients in the right method does not require a high level of expertise, the interpretation of this Terrace needs adequate knowledge, proficiency, and experience. The purpose of this study was to examine the effect of using the checklist in the ECG interpretation by medical interns. Methods: The present cross-section descriptive study was carried out on medical interns of Mashhad University of Medical Sciences in 2015. 40 students who were attending a one-month emergency medicine course were randomly divided into two groups of 20. In one group, 9 standard tracings classified with equal difficulty level (easy, medium, and hard) with a standard checklist form and a questionnaire for each were completed and in the other group, the same tracings of the first group were first handed without checklists and then handed with checklists for the second time. Finally, the scores of completing the checklists and the correctness of tracing interpretations were recorded in both groups. Data analysis was done using descriptive and inferential statistical tests. Results: There was no statistically significant difference between the two groups in terms of baseline variables. The first group identified 41.6% of the terraces correctly using the checklist. The second group, without using the checklist, correctly identified 25.5% of the terraces; and after using the checklist, this indicator increased to 32.7% in this group. Considering at least three correct responses in the ECG interpretation as "desirable response", it was found that 50% of the subjects in the first group (using the checklist) (n=10) and only 15% (n=3) of the second group (without using the checklist) had desirable responses (p = 0.531). On the other hand, the comparison of responses before and after the use of the checklist in the second group showed a significant improvement in the number of desirable responses (15% (n=3) versus 25% (n=5), p = 0.009). Conclusion: The use of a checklist for the ECG interpretation by interns of emergency medicine did not affect improving the accuracy of the interpretation than the object-oriented system, but was effective in the diagnostic review and confirmation step.
Language	English
Publishing date	2019-12-31
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2578539-4
ISSN	1179-7258
ISSN	1179-7258
DOI	10.2147/AMEP.S218542
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Article ; Online: Comparing the Emergency Medicine Residency Programs in Iran and around the World; a Descriptive Study

Mahdi Talebi / Morteza Talebi Doluee / Mohamadali Jafari / Hamid Zamani Moghaddam / Mojtaba Moazzami / Mahdi Foroughian / Hassan Gholami / Hamidreza Reihani

Archives of Academic Emergency Medicine, Vol 11, Iss

2023 Volume 1

Abstract: Introduction: To identify the strengths and weaknesses of emergency medicine residency curriculum in Iran, and to benefit from the experiences of successful universities, comparative studies are crucial. This study compared the components of the national ...

Abstract	Introduction: To identify the strengths and weaknesses of emergency medicine residency curriculum in Iran, and to benefit from the experiences of successful universities, comparative studies are crucial. This study compared the components of the national curriculum of emergency medicine in the United States, Canada, the European Union, Australia, and Saudi Arabia with Iran. Method: Data for this research was collected by searching the websites of different universities and also contacting them for requesting curriculums. The leading countries in emergency medicine and one of the countries in the Middle East region (Saudi Arabia) along with the World Federation of Emergency Medicine were selected as the sample. The model used in this field is a range model that identifies four stages of description, interpretation, proximity, and comparison in comparative studies. Results: In the curriculum of the United States, Canada, the European Union, Australia, and Saudi Arabia, there were lots of similarities in expressing the general characteristics of the curriculum, mission elements, vision, values, and beliefs of the discipline, educational strategy, techniques, expected competencies, rotation programs, and evaluation method, which were also similar to the Iranian curriculum. However, the duration of residency for emergency medicine in Iran is three years, which is shorter than other countries. As expected, the number and duration of rotations are less than other countries. Also, the process of entering into this field is different in Iran and is based on an exam for entrance, while most other countries use self-requested residency program. Conclusion: Considering the results of comparing the Iranian curriculum with the curriculums of the United States, Canada, the European Union, Australia, and Saudi Arabia, it seems that Iran's program is comprehensive and complete; but, a reappraisal of the course duration and entering options are necessary to eliminate or improve the inadequacies.
Keywords	Comparative Study ; Curriculum ; Education ; Internship and Residency ; Emergency Medicine ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
Subject code	320
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Shahid Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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