Background One of the important indices for the efficacy of pre-hospital emergency services is telephone triage. The dispatching team members are faced with many challenges in telephone triage which can adversely affect their performance. This study was conducted in the south of Iran to determine the challenges to telephone triage in pre-hospital emergency services. Method The present study is qualitative-descriptive where the sample was selected purposefully. Data were collected through 18 semi-structured, in-depth interviews with 18 dispatching team members in pre-hospital emergency care. The collected qualitative data were analyzed using the content analysis approach recommended by Graneheim and Lundman. Results Analysis of the data resulted in the emergence of three themes and ten sub-themes. The three main themes extracted from the data included inefficient interaction, insufficient and unreal information, and professional challenges. Conclusion The dispatching unit personnel in pre-hospital emergency care are confronted with various interactional, organizational, and professional issues. Accordingly, the senior managers in emergency departments should take effective measures to remove the existing barriers toward improving the efficacy of telephone triage and, by extension, the quality of pre-hospital emergency care services.

BACKGROUND Communication skills are one of the main capabilities expected from nursing students and the core of nursing care. This study was conducted with the aimed of the effect of group reflection on the development of communication skills. Methods The study was a two-group quasi-experimental pre-test-post-test that was conducted at Fasa University of Medical Sciences in the south-west of Iran. The study population consisted of 48 second-semester nursing students enrolled in clinical fundamental of nursing course in February 2018. Group reflection based on Borton's Development Framework was used in learning communication skills to the test groups for 6 sessions. Conventional method was used for control groups. Results The mean score of communication skills among students in both control and test groups, before and after the group reflection sessions, indicated a significant difference (P < .0.001). CONCLUSION This study suggests that employing a reflection group can be a basis for developing students' communication skills in clinical education.