Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0. 7 and 0. 8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0. 89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56. 3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P = 0. 02) and work experience (P = 0. 03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.

emergency medical services (EMS) staff can play an important role in reducing emergency department (ED) overcrowding by decreasing unnecessary transfers. The present study was designed to evaluate the role of continuous education of EMS staff in decreasing the unnecessary transfers to ED. In this before-after study, analysis of 1500 EMS calls according to transferred and not transferred patients to ED was done and an educational package consisting of indications for transferring patients to ED based on existing references was prepared. EMS staff underwent an educational course by mentioned package and data of patients’ transportation after training was gathered and compared to the period before training. 3000 calls to pre-hospital emergency service were evaluated (1500 cases before and 1500 cases after training). The number of cases not transferred by EMS increased from 243 (16. 2%) cases before training to 461 (30. 7%) after that and the decreasing number of transfers to ED after training was significant (p<0. 001). The highest percentage of decrease in transfer to ED belonged to complaints of lower back pain with 45%, mental problems with 27. 7%, and direct extremity trauma with 23. 4%, respectively. Patients not transferred to ED on the first call to EMS and coming with daily to ED during one week from the first call with the same complaint decreased from 13. 6% (33 cases) to 8% (40 cases) after training. The highest percentage of the delayed coming patient to ED during 1 week after the first call to EMS belonged to cardiac complaints with 4. 6% and mental complaints with 2. 4%. Based on the findings of the present study, empowering pre-hospital emergency staff by continuous education leads to a 14. 5% decrease in unnecessary referral cases and a 5. 6% drop in unnecessary visits in ED.

Background: Occupational burnout, as a reaction to persistent work pressures, reduces efficiency, wastes manpower, and causes physical and psychological complications. The aim of this study was to determine the frequency and intensity of occupational burnout among pre-hospital emergency staff in Iran. Materials and Methods: This study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data resources included Scientific Information Database (SID), Magiran, Islamic World Science Citation Center (ISC), Irandoc, PubMed, Scopus, Web of Science, and Google Scholar. Results: Initially, 178 articles were extracted, and then 13 articles were finally analyzed. Overall, 2034 pre-hospital emergency personnel were examined. Mean of occupational burnout in term of frequency, respectively for emotional exhaustion (16. 78, 95% CI = 8. 89-24. 67, I2 = 62. 30%, p = 0. 004), depersonalization (11. 57, 95% CI = 6. 97-16. 18, I2 = 68. 50%, p = 0. 001) and the lack of personal accomplishment (16. 11, 95% CI = 8. 60-23. 62, I2 = 74. 70%, p = 0 <001) were determined. Also, in term of intensity, respectively for emotional exhaustion (17. 90, 95% CI = 8. 24-27. 57, I2 = 64. 80, p = 0. 004), depersonalization (11. 20, 95% CI = 6. 80-16. 22, I2 = 49. 60%, p = 0. 044) and the lack of personal accomplishment (23. 45, 95% CI = 13. 41-33. 49, I2 = 84. 80%, p = 0 <001) were determined. Conclusions: According to findings, depersonalization and lack of personal accomplishment had moderate and high-level, respectively. Therefore, it is necessary health policymakers pay special attention to identifying and resolving the causes of occupational burnout in this population.

Background: The challenges of health systems emphasize the need for more motivated employees to perform better and more effectively. Therefore, pervasive attention to job satisfaction of these employees is a matter of course. Objectives: The present study aimed at investigating factors affecting job satisfaction in emergency medical services (EMS) staff of Zanjan Province, Iran, in 2019. Methods: The present descriptive-correlational study was performed on 170 EMS personnel working in the Disaster and emergency medical Management Center (DEMMC) of Zanjan Province. The stratified random sampling method was utilized to select the subjects. Job description index and GHQ-12 were administered as data collection instruments. Data were analyzed by SPSS version 16 using descriptive statistics, ANOVA, and Pearson correlation coefficient. Results: In the present study, the work experience of 46. 5% and 26% of the subjects was less than five and more than 10 years, respectively. The highest and lowest scores of job satisfaction belonged to coworkers and pay subscales, respectively (24. 4± 17 vs. 11. 5± 18. 4). The overall job satisfaction score of the subjects was 19. 7± 18. 2 out of 100. Also, a significant relationship was found between the level of education and overall satisfaction. Conclusion: Considering the low level of job satisfaction in EMS staff, it seems that modifying the reward mechanisms in the prehospital emergency department and using performance improvement levers can enhance the motivation and improve the performance of staff. Besides, strive to promote social relations among coworkers as an effective element may help to enhance job satisfaction and the overall satisfaction of personnel.