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Background: Workplace violence (WPV) presents challenges in intensive care units (ICUs) calling for reliable prediction of violence. This narrative review aimed to identify and evaluate risk assessment tools from acute care settings which are or might be used to predict violent behavior in adult ICU patients focusing on their performance and clinical utility., Methods: A screening of PubMed, Scopus and Google Scholar was conducted to identify risk scores used in the acute care setting such as emergency departments, hospitals and ICUs. Risk factors, predictive validity of scores and their relevance to the ICU setting were evaluated., Results: 24 studies were included. Two studies reported the use in general ICU populations, while eight studies were conducted in psychiatric ICUs and 14 studies implemented the use of risk tools in emergency departments or general wards. Ten risk scores were identified using 30 different variables. Those could be categorized into patient demographics, behavior, history of violence, mental status and other items such as sleep disturbances. The Broset Violence Checklist (BVC) was the most commonly used risk score. It showed moderate predictive accuracy in psychiatric settings including psychiatric ICUs, but limited validation for general ICUs. The overall evidence level was low with serious risk of bias. Other tools demonstrated varying sensitivity and specificity but lacked validation in ICUs., Implications for Clinical Practice: ICU nurses and physicians are often subjected to violence. There is little evidence on scores to predict patients' behavior. Most assessments come from outside the ICU, but may be promising in critical care., Conclusion: This review underscores the need for the development of violence risk assessment tools tailored to the ICU, as the challenges with violent ICU patients differ from other populations. New predictive models must be developed including factors associated with patients' violent behavior in ICUs as compiled in this review., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background and Purpose: Pharmacists are frequently faced with evocative patient care conversations surrounding medication taking behaviors and overall health and wellness. Teaching communication is a core focus within pharmacy education; however, there is often less emphasis placed on learning motivational interviewing (MI). We will share challenges and successes associated with the creation and dissemination of a MI-based communications course with pharmacy student learners., Educational Activity and Setting: A fast-paced, five-week, active learning course was created for first-year pharmacy students. Learning activities focused on exploration of ambivalence in clinical practice, roadblocks to active listening, resisting the righting reflex, the spirit of MI, and the core skills of MI. The Motivational Interviewing Competency Assessment was utilized to assess student MI competency at the completion of the course., Findings: This MI-based course has been well-received by pharmacy student learners. It serves as a foundation for communication skills development, as students continue the practice and grow these skills throughout the curriculum. Communication skills assessment and feedback are an integral aspect of MI learning; however, this process does increase the workload of course instructors. A limitation to the global creation of a MI-based course is the reduced number of pharmacy educators who are proficient in training MI., Summary: As the practice of pharmacy and patient care continues to evolve, effective communication skills that include MI, are essential to the provision of person-centered, empathic patient care., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: This study identified advanced pharmacy practice experience (APPE) activities students wish to pursue via a qualitative analysis of goal setting. It also aimed to understand student goal setting alignment with core Entrustable Professional Activities (EPAs)., Methods: SMART (specific, measurable, achievable, realistic/relevant, time-bound) goal data were reviewed, analyzed, and coded to develop an inductive thematic analysis. Overall frequency of SMART goal coding themes was analyzed using descriptive statistics, along with frequency of themes based on rotation type. Relative percentages of each rotation type were compared. A crosswalk between themes and EPA was created post-coding., Results: Several themes among student SMART APPE goals from one complete academic year were identified (n = 79). A total of 1690 SMART goals were categorized into 22 themes. The top five most frequently utilized themes represent 60.6% of all goals, and included "Assess, Select, Recommend Therapy" (19%); "Patient Communication" (15.4%); "Foundational Knowledge" (12.4%); "Interprofessional Collaboration" (7.9%); and "Workflow, Roles and Responsibilities" (6%). The core EPA Patient Care Provider Domain was most common and accounted for 46.4% of SMART goals. The remainder included Information Master (18.8%); Practice Manager (16.1%); Interprofessional Education Team Member (7.9%); Population Health Promoter (6.6%); and Self-Developer (3.6%)., Conclusions: Our analysis revealed that students set goals in alignment with the profession's primary focus of providing direct patient care however some EPAs were infrequently citied by students in their goal setting process which may mean there is less focus on these important skills., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: Breaking bad news (BBN) is challenging for physicians and patients and specific communication strategies aim to improve these situations. This study evaluates whether an E-learning assignment could improve medical students' accurate recognition of BBN communication techniques., Methods: This randomized controlled trial was conducted at the University of Basel. After a lecture on BBN, 4th year medical students were randomized to an intervention receiving an E-learning assignment on BBN or to a control group. Both groups then worked on an examination video and identified previously taught BBN elements shown in a physician-patient interaction. The number of correctly, misclassified and incorrectly identified BBN communication elements as well as missed opportunities were assessed in the examination video., Results: We included 160 medical students (55% female). The number of correctly identified BBN elements did not differ between control and intervention group (mean [SD] 3.51 [2.50] versus 3.72 [2.34], p = 0.58). However, the mean number of inappropriate BBN elements was significantly lower in the intervention than in the control group (2.33 [2.57] versus 3.33 [3.39], p = 0.037)., Conclusions: Use of an E-learning tool reduced inappropriate annotations regarding BBN communication techniques., Practice Implications: This E-learning might help to further advance communication skills in medical students., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: The study objective was determining the relationship of certain predictor variables with student performance on an advanced pharmacy practice experience (APPE)-readiness performance-based assessment (PBA) in the third professional year (P3)., Methods: This retrospective study aimed to identify if student predictors and/or curricular-related predictor variables correlate with student performance on a patient interview and documentation activity (PIDA), an APPE-readiness assessment. Student predictors included Pharmacy College Admission Test score, pre-pharmacy cumulative grade point average (GPA), end of first professional year (P1) GPA, end of second professional year GPA, end of fall P3 GPA, and elective Pharmacists' Patient Care Process (PPCP) score. Curricular-related predictor variables comprised specific activities with emphasis on patient care skill development in P1 through P3 years. Adjusted and unadjusted linear regression models assessed correlations between PIDA score and student predictors as well as curricular variables., Results: Students from the Classes of 2018 through 2020 at Southern Illinois University Edwardsville School of Pharmacy (N = 231) were included. Two student predictors, P3 GPA and PPCP elective score, showed statistically significant correlations with PIDA performance. One curriculum-related variable, P3 activity with an emphasis on medication reconciliation, demonstrated a statistically significant correlation with student performance on the PIDA., Conclusions: Student performance on a cumulative PBA may be predictive from prior curricular learning experiences that assess similar patient care skills. The predictive impact of the elective PPCP score on a PBA needs additional research. Recent implementation of a new curriculum may lead to identification of other predictors of student success on PBAs., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: An increasing number of consultations are delivered in group practices, where a stable 1:1 relationship between patient and physician cannot be guaranteed. Therefore, correct documentation of the content of a consultation is crucial to hand over information from one health care professional to the next., Methods: We randomly selected 20 interviews from a series of 56 videotaped consultations with patients requesting a general check-up exam in the outpatient department of Internal Medicine at the University Hospital Basel. All patients actively denied having any symptoms or specific health concerns at the time they made their appointment. Videotapes were analysed with the Roter Interaction Analysis System (RIAS). Corresponding physician notes were analysed with a category check-list that contained the information related items from RIAS., Results: Interviews contained a total of 9.002 utterances and lasted between 15 and 53min (mean duration: 37min). Patient-centred communication (Waiting, Echoing, Mirroring, Summarising) in the videos significantly correlated with the amount of information presented by patients: medical information (r=.57; p=.009), therapeutic information (r=.50; p=.03), psychosocial information (r=.41; p=.07), life style information (r=.52; p=.02), and with the sum of patient information (r=.64; p=.003). Even though there was a significant correlation between the amount of information from the video and information in physician's notes in some categories (patient gives medical information; Pearson's r=.45; p=.05, patient gives psychosocial information; Pearson's r=.49; p=.03), an inspection of the regression lines shows that a large extent of patient information is omitted from the charts. Physicians never discussed with patients whether information should be documented in the charts or omitted., Conclusions: The use of typical patient-centred techniques increases information gathered from patients. Physicians document only a small percentage of patient information in the charts, their 'condensing heuristic' is not shared with patients., Practice Implications: Patient involvement should be advocated not only to medical decision making but also to the way physicians document the content of a consultation. It is a joint responsibility of patient and health care professional to decide, which information should be kept and thus be communicated to another health care professional in future consultations.