Introduction: Using SIMULATED PATIENTs (SPs) in clinical skills education is a common method of training students to improve their skills for future client encounters. This systematic review aims to provide an overview of the SP strategy in Physical Therapy (PT) education. Materials and Methods: PubMed, Scopus, and Web of Science databases were searched from January 1980 up to November 2019. Different keywords related to the topic were selected using MeSH. Any types of quantitative study design which had used simulation-based learning in physical therapy were eligible for inclusion. Two reviewers read studies and appraised them critically. Results: A total of 1049 abstracts were retrieved and after reviewing the full-text paper, 11 fulltext articles met the inclusion criteria. These studies had used SIMULATED PATIENTs for various objectives, including replicate different aspects of knowledge, self-perceived skills, real clinical practice, attitudes, and feasibility. Based on the result of studies, SP as an educational technique can improve student’ s clinical reasoning skills, communication, and motivation in a safe environment. Conclusion: SP is a useful learning strategy to deliver learning activities in medical education and physical therapy curricula, facilitating feedback on students’ performance with opportunities to interact with real PATIENTs and environments.

Background & Objective: Communication skills assessment requires the use of valid instruments. The present study has done to investigate concurrent validity of the SIMULATED PATIENT meaning relationship between test results by the SIMULATED or real PATIENT and possibility to generalize the results by SIMULATED PATIENT and in SIMULATED environment for real PATIENT and in bedside.Methods: In this correlation study, 32 medical externships were enrolled by purposive sampling method. The students were divided randomly into two equal and homogeneous groups. Using crossover design, first group were assessed by real PATIENT initially and then, SIMULATED PATIENT and second group, were measured conversely. Communication skills assessment was done using a checklist retrieved from Calgary-Cambridge interview skills checklist. The data were analyzed using descriptive and analytical statistics.Results: In first assessment, comparing scores by SIMULATED and real PATIENT in first group, second group and total students showed significant differences. In second assessment between two groups, the statistics results was not significant with very minor differences (P=0.064). There were positive correlation between scores of total students by SIMULATED and real PATIENT (r=0.63).Conclusion: According to the results, communication skills of each student in SIMULATED position cannot be generalized to real situation and cannot be claimed that SIMULATED PATIENT can be used instead of real PATIENT.

Background: Correct education of asthmatic PATIENTs by pharmacists play an important role in control of asthma disease and improvement of PATIENTs’ quality of life. This study aims to evaluate community pharmacists’ knowledge and skills by demonstrating the proper inhalation technique of asthma inhaler devices in Isfahan, Iran. Methods: One hundred community pharmacies located in the Isfahan city were approached and four asthma devices were assessed (25 each of them): Metered dose inhaler (MDI), MDI with spacer, turbuhaler and revolizer. The investigator selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of inhaler device use immediately after leaving the pharmacy. Results: In total, 100 pharmacists (including 70 males with the mean age of 42. 3± 12. 1) were approached. More than half of the pharmacists approached with MDI (with or without spacer) did not know how to use the optimal technique (i. e. all steps corrected all through). The majority of pharmacists (>90%) approached with turbuhaler did not know the proper technique. More than 70% of pharmacist had an adequate technique in handling revolizer. There was an inverse relationship between pharmacist’ s knowledge and skill and age and work experience (r=-0. 18, p: 0. 037, and r=-0. 16, p: 0. 05 respectively). Conclusion: The majority of community pharmacists lack the basic knowledge of proper use of commonly dispensed asthma inhaler devices. Considering, the positive impact of pharmacists in PATIENT care and education, specific training and continuing educational programs directed specifically on asthma management is necessary.

Background: Good communication skill is as crucial for the medical practitioner as medical knowledge for better PATIENT outcome. Incorporating SIMULATED PATIENTs for teaching communication skills and assessment can be beneficial for the learners as it gives them learning opportunities under a controlled environment. Objectives: 1. To assess the improvement in communication skills with the use of SIMULATED PATIENTs after communication skills training. 2. To obtain feedback from SIMULATED PATIENTs about PATIENT satisfaction. 3. To obtain feedback from students and faculties about communication skills training intervention and SIMULATED PATIENTs for assessment. Methods: After a thorough introduction and explanation of the study, out of total of 139 students from the fifth-semester bachelor of medicine and bachelor of surgery (MBBS), 44 students gave the willingness to participate. Students were divided into two groups of 22 students; one group acted as doctors, and the other group acted as a standardized PATIENT group. Each SIMULATED PATIENT was randomly assigned to one doctor to make a pair; thus, 22 random pairs of doctor and PATIENTs were formed. Before and after giving communication skills training, each doctor-PATIENT pair’ s consultation was analyzed for clinical communication skills using the Kalamazoo scale adapted version by trained observers. After each consultation, each PATIENT was given a PATIENT satisfaction questionnaire to fill. Results: In this study, students were improved significantly in each competency of the Kalamazoo scale after communication skills training. Before giving this training, the total mean communication skills score of students was 49. 86 (SD=10. 73), and after training, it significantly improved to 75. 45 (SD=15. 78) (P< 0. 05). Before the training, themeanPATIENT’ s satisfaction score was 48. 95 (SD=12. 18), which significantly improved after training to 60. 36 (SD=3. 99) (P < 0. 05). Students as well as observers, found the Kalamazoo scale very useful for communication skills training and assessment. In feedback, they mentioned that the SIMULATED PATIENT approach for the assessment of communication skills was useful. Conclusions: This study showed that the clinical communication skills training with a structured scale was helpful for medical students. Students were found interested in learning such new skills; thus, clinical communication skills training should be an integral part of medical education. SIMULATED PATIENTs were found useful and can be used for the assessment of other clinical skills in medical education.

The set covering problem (SCP) is one of the location -allocation models. It s objective is to minimize the cost of facilities location-allocation in an optimal structure in such a way that each customer or zone has been covered by at least one facility. The above problem is a class of NP-Hard problems that cannot be solved by exact algorithms in a reasonable amount of computational time. Thus in this paper, a SIMULATED annealing (SA) algorithm is proposed to solve the SCP. This algorithm is one of the efficient metaheuristics based on a neighbourhood search within solution space, acceptance of probability, and inferior solutions to scape from trap (i.e., local optimal solution). Ten test problems are solved in which associated results show the efficiency and validity: of the SA algorithm for solving the SCP. The validity comparisions of the results obtained the proposed algorithm are compared with the results reported by three methods named as Lingo 8 Software, Heragu's heuristic, and Genetic Algorithms (GAs).

Background and Objectives: SIMULATED PATIENT applications are integral to healthcare training, providing realistic scenarios for skill enhancement. This study evaluated the impact of SIMULATED PATIENT application on anxiety levels and occupational health perceptions in paramedic training. Methods: This quasi-experimental study was conducted at a public university between June and December 2023, with 69 second-year paramedic students who had completed relevant courses. Data were collected at three points: before the training, immediately after, and six months later, using sociodemographic forms, the Generalized Anxiety Disorder Scale (GAD-7), and the Perceived Occupational Health and Safety Competence Scale (POHSCS). Paired t-tests and Pearson correlation analyses were used for statistical analysis, with significance set at p<0. 05. Results: The mean pre-test GAD-7 score was 8. 69 ± 4. 88, increasing to 9. 05 ± 5. 09 post-test, and decreasing to 8. 34 ± 5. 23 at follow-up. The mean OHSCPS score was 94. 50 ± 26. 94 pre-test, 96. 39 ± 25. 25 post-test, and 99. 28 ± 28. 11 at follow-up. Strong correlations were found in OHSCPS pre-test to post-test (r=0. 624, p<0. 001), pre-test to follow-up (r=0. 544, p<0. 01), and post-test to follow-up (r=0. 712, p<0. 001). For GAD-7, correlations included pre-test to post-test (r=0. 776, p<0. 001), pre-test to follow-up (r=0. 606, p<0. 01), and post-test to follow-up (r=0. 527, p<0. 05). Conclusion: This study indicates the potential of simulation-based training to reduce anxiety and enhance occupational health perceptions among paramedic students. Future research with larger sample sizes is needed to provide stronger evidence.

Objective: Sleep is critical for good health and quality of life, but many people struggle with sleep disorders. Pharmacists are on the front lines, helping PATIENTs manage these problems. However, there is growing concern that some pharmacists are dispensing benzodiazepines over-the-counter and failing to provide proper counseling. This study examined how pharmacists in Iran performed in these areas. Methods: Between January and April 2022, we conducted a cross-sectional study in three major Iranian cities, using a “SIMULATED PATIENT” to observe how pharmacists interacted with them. In total, 431 pharmacies participated, and we used detailed forms to record the pharmacists’ behavior. We then analyzed the data using descriptive statistics and the Chi-square tests. Findings: Of 549 visits, 78. 5% were managed by pharmacists, whereas the remainder were managed by other pharmacy staff. 79. 7% of pharmacists evaluated the PATIENT before deciding whether or not to prescribe the medication and 58. 9% provided a kind of counseling for their offered medication, but just 10. 6% of pharmacies had a private counseling area. Despite regulations that require a valid prescription for benzodiazepines, 9. 2% of pharmacies dispensed diazepam, and 13. 2% dispensed alprazolam without requesting one, and when counseling was offered, it often lacked critical details. Conclusion: These findings raise serious concerns. There are deficiencies in how pharmacists and PATIENTs interact, with many pharmacists spending minimal time assessing PATIENT needs. The high rates of benzodiazepine dispensing without valid prescriptions and inadequate counseling point to a need for stricter protocols and more training. To address these issues, health-care professionals and policymakers must collaborate to improve the quality and safety of sleep disorder treatment in community pharmacies.