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BACKGROUND: While bedside assistants play a critical role in many robotic operations, substantial heterogeneity remains in bedside assistant training pathways. As such, this study aimed to develop consensus guidelines for bedside assistant skills required for team members in robotic operations. METHODS: We designed a study using the Delphi process to develop consensus guidelines around bedside assistant skills. We generated an initial list of bedside assistant skills from the literature, training materials, and expert input. We selected experts for the Delphi process based on prior scholarship in the area of robotic bedside assistant education and experience facilitating robotic bedside assistant training. For each item, respondents specified which robotic team members should have the skill from a list of basic bedside assistants, advanced bedside assistants, surgeons, surgical technologists, and circulating nurses. We conducted two rounds of the Delphi process and defined 80% agreement as sufficient for consensus. RESULTS: Fourteen experts participated in two rounds of the Delphi process. By the end of the second round, the group had reached consensus on 253 of 305 items (83%). The group determined that basic bedside assistants should have 52 skills and that advanced bedside assistants should have 60 skills. The group also determined that surgeons should have 54 skills, surgical technologists should have 25 skills, and circulating nurses should have 17 skills. Experts agreed that all participants should have certain communication skills and basic knowledge of aspects of the robotic system. CONCLUSIONS: We developed consensus guidelines on the skills required during robotic surgery by bedside assistants and other team members using the Delphi process. These findings can be used to design training around bedside assistant skills and assess team members to ensure that each team member has the appropriate skills. Hospitals can also use these guidelines to standardize expectations for robotic team members.

BACKGROUND AND OBJECTIVES: Musculoskeletal (MSK) complaints comprise more than 20% of all visits to health care providers each year. Despite required experiences in MSK care, family physicians report low confidence in diagnosing and treating MSK conditions. The purpose of this study was to analyze the effects of early and longitudinal exposure to MSK education on residents confidence in and likelihood of performing MSK physical exams and injections in future practice. METHODS: From 2017 to 2019, residents completed an annual survey assessing confidence in, frequency of, and future intentions to perform exams and injections for MSK conditions. We compared responses between family medicine residents who completed a 176-hour longitudinal sports medicine (LSM) curriculum distributed over all 3 years of residency and a comparable cohort of family medicine residents who completed a 188-hour concentrated MSK curriculum primarily in the final year of residency. We made comparisons using the Fisher exact test for categorical variables and an independent samples t test for numeric variables. RESULTS: We analyzed the 98 total responses from 50 residents. The proportion of residents reporting high ratings of their residency MSK education (26% to 60%), performing >5 injections (38% to 73%), reporting confidence in performing injections (12% to 40%), and indicating likelihood to perform MSK injections in the future (52% to 65%) were all greater in the LSM versus concentrated MSK curriculum cohorts (P

BackgroundIndividuals with intellectual disabilities experience barriers to quality healthcare. To reduce this disparity, equipping medical trainees with the knowledge and skills required for treating this patient population is critical. Our aim is to describe the breadth of instructional interventions and identify gaps in intellectual disability medical education curricula.MethodUsing scoping review methods, the intellectual disability programmes described in 27 articles were evaluated and their coverage of the six core competencies on disability for health care education was examined.ResultsThe most frequently represented core competencies were disability conceptual frameworks, professionalism and communication, and clinical assessment, which were, in most programmes, fulfilled by activities involving individuals with intellectual disabilities. Uneven competency coverage warrants consideration.ConclusionsConsiderable variabilities exist in medical school curricula on intellectual disabilities. Using core competencies on disability for health care education for curricular design and evaluation would provide a coherent training experience in this important area.

As medical schools move to integrate the Core Entrustable Professional Activities for Entering Residency (EPAs) into curricula and address the transition from student to resident, residency preparatory courses have become more prevalent. The authors developed an experiential learning EPA-based capstone course for assessment to determine impact on learner self-assessed ratings of readiness for residency and acquisition of medical knowledge. All fourth-year students from the classes of 2018-2020 completed a required course in the spring for assessment of multiple EPAs, including managing core complaints, performing basic procedures, obtaining informed consent, and providing patient handoffs. Learners selected between three specialty-based parallel tracks - adult medicine, surgery, or pediatrics. Students completed a retrospective pre-post questionnaire to provide self-assessed ratings of residency preparedness and comfort in performing EPAs. Finally, the authors studied the impact of the course on knowledge acquisition by comparing student performance in the adult medicine track on multiple choice pre- and post-tests. Four hundred and eighty-one students were eligible for the study and 452 (94%) completed the questionnaire. For all three tracks, there was a statistically significant change in learner self-assessed ratings of preparedness for residency from pre- to post-course (moderately or very prepared: adult medicine 61.4% to 88.6% [p-value < 0.001]; surgery 56.8% to 81.1% [p-value < 0.001]; pediatrics 32.6% to 83.7% [p-value 0.02]). A similar change was noted in all tracks in learner self-assessed ratings of comfort from pre- to post-course for all studied EPAs. Of the 203 students who participated in the adult medicine track from 2019-2020, 200 (99%) completed both the pre- and post-test knowledge assessments. The mean performance improved from 65.0% to 77.5% (p-value < 0.001). An experiential capstone course for the assessment of EPAs can be effective to improve learner self-assessed ratings of readiness for residency training and acquisition of medical knowledge.

INTRODUCTION: Student-run free clinics (SRFCs) offer medical students a unique opportunity to develop their clinical, diagnostic, and social skills while providing care to medically underserved communities. This study aims to evaluate the value of SRFC involvement on students self-reported confidence in various clinical domains and satisfaction with their medical education. METHODS: We conducted a single-center retrospective pre-post assessment at an urban academic institution among second- to fourth-year medical students. We administered a 25-item questionnaire capturing the scope of clinic involvement and assessing self-reported confidence in multiple clinical domains following a one-year-long participation in student-run free clinics. RESULTS: Fifty-six students completed the survey. Participation in SRFCs significantly increased self-reported confidence in patient history-taking (p

ObjectiveTo investigate the impact of surgery resident training on surgery duration in tibial plateau leveling osteotomy (TPLO) and evaluate whether surgery duration differs with each year of residency training.Study designRetrospective medical record review.AnimalsA total of 256 client-owned dogs underwent TPLO.MethodsRecords of dogs that underwent TPLO between August 2019 and August 2022 were reviewed. The effects of the surgeon (faculty/resident) and the procedure (arthrotomy/arthroscopy) on TPLO surgery duration were examined with an analysis of variance, and geometric least squares means (GLSM) were compared. A linear mixed effects model (LMM) was fitted to quantify fixed and random effects.ResultsFour faculty surgeons performed 74 (29%) TPLOs, while 10 residents performed 182 (71%) TPLOs under the direct supervision of a faculty surgeon. All TPLOs were conducted with arthrotomy (109; 43%) or arthroscopy (147; 57%). Overall, residents (GLSM, 153 min) required 54% more surgery duration than faculty surgeons (GLSM, 99 min). Surgery duration among first-year residents (GLSM, 170 min) was 15% longer than second- (GLSM, 148 min) and third-year (GLSM, 147 min) residents, whereas the duration did not differ statistically between second- and third-year residents. Arthroscopy, meniscal tear treatment, surgery on the right stifle, and increasing patient weight were also associated with longer surgery duration.ConclusionThe duration of TPLO surgery significantly decreased after the first year of residency, but did not decrease afterward.Clinical significanceThe results will aid with resource allocation, curricula planning, and cost management associated with resident training.

PURPOSE: Defining prostate cancer contours is a complex task, undermining the efficacy of interventions such as focal therapy. A multireader multicase study compared physicians' performance using artificial intelligence (AI) vs standard-of-care methods for tumor delineation. MATERIALS AND METHODS: Cases were interpreted by 7 urologists and 3 radiologists from 5 institutions with 2 to 23 years of experience. Each reader evaluated 50 prostatectomy cases retrospectively eligible for focal therapy. Each case included a T2-weighted MRI, contours of the prostate and region(s) of interest suspicious for cancer, and a biopsy report. First, readers defined cancer contours cognitively, manually delineating tumor boundaries to encapsulate all clinically significant disease. Then, after ≥ 4 weeks, readers contoured the same cases using AI software. Using tumor boundaries on whole-mount histopathology slides as ground truth, AI-assisted, cognitively-defined, and hemigland cancer contours were evaluated. Primary outcome measures were the accuracy and negative margin rate of cancer contours. All statistical analyses were performed using generalized estimating equations. RESULTS: The balanced accuracy (mean of voxel-wise sensitivity and specificity) of AI-assisted cancer contours (84.7%) was superior to cognitively-defined (67.2%) and hemigland contours (75.9%; P < .0001). Cognitively-defined cancer contours systematically underestimated cancer extent, with a negative margin rate of 1.6% compared to 72.8% for AI-assisted cancer contours (P < .0001). CONCLUSIONS: AI-assisted cancer contours reduce underestimation of prostate cancer extent, significantly improving contouring accuracy and negative margin rate achieved by physicians. This technology can potentially improve outcomes, as accurate contouring informs patient management strategy and underpins the oncologic efficacy of treatment.

BACKGROUND: Although polyp size dictates surveillance intervals, endoscopists often estimate polyp size inaccurately. We hypothesized that an intervention providing didactic instruction and real-time feedback could significantly improve polyp size classification. METHODS: We conducted a multicenter randomized controlled trial to evaluate the impact of different components of an online educational module on polyp sizing. Participants were randomized to control (no video, no feedback), video only, feedback only, or video + feedback. The primary outcome was accuracy of polyp size classification into clinically relevant categories (diminutive [1-5mm], small [6-9mm], large [≥10mm]). Secondary outcomes included accuracy of exact polyp size (inmm), learning curves, and directionality of inaccuracy (over- vs. underestimation). RESULTS: 36 trainees from five training programs provided 1360 polyp size assessments. The feedback only (80.1%, P=0.01) and video + feedback (78.9%, P=0.02) groups had higher accuracy of polyp size classification compared with controls (71.6%). There was no significant difference in accuracy between the video only group (74.4%) and controls (P=0.42). Groups receiving feedback had higher accuracy of exact polyp size (inmm) and higher peak learning curves. Polyps were more likely to be overestimated than underestimated, and 29.3% of size inaccuracies impacted recommended surveillance intervals. CONCLUSIONS: Our online educational module significantly improved polyp size classification. Real-time feedback appeared to be a critical component in improving accuracy. This scalable and no-cost educational module could significantly decrease under- and overutilization of colonoscopy, improving patient outcomes while increasing colonoscopy access.

BACKGROUND: Incorporation of the rapid advances in ophthalmologic surgical and diagnostic techniques inherent in the field poses a challenge to residency training programs. This study investigates exposure to new technologies during residency and perception of its impact on practice patterns. METHODS: Ophthalmology residents at various training levels and practicing ophthalmologists who had completed their training were invited to participate in a survey study assessing exposure to various technologies in residency and in practice. Data collection occurred from December 2022 to June 2023. Descriptive statistics were performed. RESULTS: The study received 132 unique responses, including 63 ophthalmology residents and 69 practicing ophthalmologists. 65.2% (n = 45) of practicing ophthalmologists and 47.6% (n = 30) of current residents reported discussion/training on newly developed products on the market (e.g. premium IOLS, MIGS), was minimally discussed but not emphasized or not discussed at all in residency. 55.1% (n = 38) of practicing ophthalmologists reported that exposure to new technologies during residency did influence types of technologies employed during practice. The majority resident physicians reported enjoying being trained on newer technology and feeling more prepared for future changes in the field (95.2%, n = 60) and felt that having industry partnerships in residency enhances education and training (90.5%, n = 57). CONCLUSIONS: Considering how to maximize exposure to newer technologies/devices during residency training is important, and may contribute to training more confident, adaptable surgeons, who are more likely to critically consider new technologies and adopt promising ones into their future clinical practice.

BACKGROUND: Despite the central importance of physical examination (PE) skills to patient evaluation, early trainees struggle with its correct application and interpretation. This struggle may reflect the instructional strategies of PE courses which have largely ignored the clinical reasoning necessary to accurately apply these skills. The core + cluster (C + C) is a recent approach to teaching PE to clerkship-level medical students that combines a basic core exam with cluster based on the students hypothesis about their patients clinical presentation. Our institution developed a novel C + C curriculum to teach PE to preclinical students. We aimed to assess the impact of this new curriculum on students clinical skills and course evaluations in comparison to the traditional head-to-toe approach wed used previously. METHODS: This was a retrospective study comparing two consecutive medical school cohorts exposed to the new (C + C) and prior (HTT) curricula respectively. We studied two complete cohorts of first-year medical students at our institution who matriculated in 2014 and 2015. The 2014 cohort received PE training via an HTT approach. The 2015 cohort received PE training via a C + C approach. Outcomes included performance scores on a statewide clinical performance exam (CPX) and student course evaluations. RESULTS: We found no statistically significant difference in mean CPX scores between the two cohorts. However, student course ratings were significantly higher in the C + C cohort and students rated the C + C format as highly useful in clinical encounters. CONCLUSIONS: The C + C curriculum appears to be as effective a method of teaching PE to preclinical students as the HTT approach and is better received by students. We believe that this approach more appropriately reflects the way PE is used in clinical encounters and may help students with diagnostic hypothesis generation.

IntroductionUrology residency prepares trainees for independent practice. The optimal operative chief resident year experience to prepare for practice is undefined. We analyzed the temporal arc of cases residents complete during their residency compared to their chief year in a multi-institutional cohort.MethodsAccreditation Council for Graduate Medical Education case logs of graduating residents from 2010 to 2022 from participating urology residency programs were aggregated. Resident data for 5 categorized index procedures were recorded: (1) general urology, (2) endourology, (3) reconstructive urology, (4) urologic oncology, and (5) pediatric urology. Interactions were tested between the trends for total case exposure in residency training relative to the chief resident year.ResultsFrom a sample of 479 resident graduates, a total of 1,287,433 total cases were logged, including 375,703 during the chief year (29%). Urologic oncology cases had the highest median percentage completed during chief year (56%) followed by reconstructive urology (27%), general urology (24%), endourology (17%), and pediatric urology (2%). Across the study period, all categories of cases had a downward trend in median percentage completed during chief year except for urologic oncology. However, only trends in general urology (slope of -0.68, P = .013) and endourology (slope of -1.71, P ≤ .001) were significant.ConclusionsOver 50% of cases completed by chief residents are urologic oncology procedures. Current declining trends indicate that residents are being exposed to proportionally fewer general urology and endourology cases during their chief year prior to entering independent practice.

Background Medical trainees must learn how to provide effective feedback as an essential communication skill, yet few models exist for training and assessing these skills. Objective To develop an observed structured feedback examination (OSFE) to provide feedback training to pediatric fellows and assess changes in skills and self-reported confidence. Methods This educational study was conducted from 2019 to 2020 at an academic childrens hospital. Our team developed the OSFE and trained standardized feedback recipients and faculty. Fellows completed baseline self-assessments (31 items) on prior exposure to feedback training, application of skills, and confidence. They then participated in the OSFE, giving feedback to a standardized recipient using a standardized scenario, and were scored by faculty and recipients using a 15-item checklist for performance. Next, fellows participated in feedback training and received individualized feedback, after which they repeated the OSFE and confidence self-assessment. Three months later, fellows completed self-assessments on confidence and application of skills and another OSFE to assess retention. Descriptive statistics and signed rank sum test were used for analysis. Results Of 60 eligible fellows, 19 participated (32%), with 100% follow-up. After training and individualized feedback, all fellows improved feedback skills as measured by OSFE performance (mean change +0.89). All items, measured on a 5-point Likert scale, were sustained 3 months later (mean change +0.92). All fellows reported improved confidence in feedback knowledge (mean change +2.07 post, +1.67 3 months post). Conclusions Feedback training using simulation and individualized feedback moderately improved fellows performance, confidence, and 3-month retention of feedback skills.

BACKGROUND: Equitable assessment is critical in competency-based medical education. This study explores differences in key characteristics of qualitative assessments (i.e., narrative comments or assessment feedback) of internal medicine postgraduate resident performance associated with gender and race and ethnicity. METHODS: Analysis of narrative comments included in faculty assessments of resident performance from six internal medicine residency programs was conducted. Content analysis was used to assess two key characteristics of comments- valence (overall positive or negative orientation) and specificity (detailed nature and actionability of comment) - via a blinded, multi-analyst approach. Differences in comment valence and specificity with gender and race and ethnicity were assessed using multilevel regression, controlling for multiple covariates including quantitative competency ratings. RESULTS: Data included 3,383 evaluations with narrative comments by 597 faculty of 698 residents, including 45% of comments about women residents and 13.2% about residents who identified with race and ethnicities underrepresented in medicine. Most comments were moderately specific and positive. Comments about women residents were more positive (estimate 0.06, p 0.045) but less specific (estimate - 0.07, p 0.002) compared to men. Women residents were more likely to receive non-specific, weakly specific or no comments (adjusted OR 1.29, p 0.012) and less likely to receive highly specific comments (adjusted OR 0.71, p 0.003) or comments with specific examples of things done well or areas for growth (adjusted OR 0.74, p 0.003) than men. Gendered differences in comment specificity and valence were most notable early in training. Comment specificity and valence did not differ with resident race and ethnicity (specificity: estimate 0.03, p 0.32; valence: estimate - 0.05, p 0.26) or faculty gender (specificity: estimate 0.06, p 0.15; valence: estimate 0.02 p 0.54). CONCLUSION: There were significant differences in the specificity and valence of qualitative assessments associated with resident gender with women receiving more praising but less specific and actionable comments. This suggests a lost opportunity for well-rounded assessment feedback to the disadvantage of women.

Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best practices for implementation, and criteria for successful curriculum integration. To address the lack of consensus surrounding integration, we reviewed the literature and herein propose a definition for curriculum integration for the medical education audience. We further believe that medical education is ready to move beyond “horizontal” (1-dimensional) and “vertical” (2-dimensional) integration and propose a model of “6 degrees of curriculum integration” to expand the 2-dimensional concept for future designs of medical education programs and best prepare learners to meet the needs of patients. These 6 degrees include: interdisciplinary, timing and sequencing, instruction and assessment, incorporation of basic and clinical sciences, knowledge and skills-based competency progression, and graduated responsibilities in patient care. We encourage medical educators to look beyond 2-dimensional integration to this holistic and interconnected representation of curriculum integration.

INTRODUCTION: Laparoscopic surgery requires significant training, and prior studies have shown that surgical residents lack key laparoscopic skills. Many educators have implemented simulation curricula to improve laparoscopic training. Given limited time for dedicated, in-person simulation center practice, at-home training has emerged as a possible mechanism by which to expand training and promote practice. There remains a gap in published at-home laparoscopic curricula employing embedded feedback mechanisms. METHODS: We developed a nine-task at-home laparoscopic curriculum and an end-of-curriculum assessment following Kerns six-step approach. We implemented the curriculum over 4 months with first- to third-year residents. RESULTS: Of 47 invited residents from general surgery, obstetrics/gynecology, and urology, 37 (79%) participated in the at-home curriculum, and 25 (53%) participated in the end-of-curriculum assessment. Residents who participated in the at-home curriculum completed a median of six of nine tasks (interquartile range: 3-8). Twenty-two residents (47%) responded to a postcurriculum survey. Of these, 19 (86%) reported that their laparoscopic skills improved through completion of the curriculum, and the same 19 (86%) felt that the curriculum should be continued for future residents. Residents who completed more at-home curriculum tasks scored higher on the end-of-curriculum assessment (p = .009 with adjusted R 2 of .28) and performed assessment tasks in less time (p = .004 with adjusted R 2 of .28). DISCUSSION: This learner-centered laparoscopic curriculum provides guiding examples, spaced practice, feedback, and graduated skill development to enable junior residents to improve their laparoscopic skills in a low-stakes, at-home environment.

INTRODUCTION: As surgical technologies grow, so too do demands on surgical trainees to master increasing numbers of skill sets. With the rise of endovascular surgery, trainees have fewer opportunities to practice open vascular techniques in the operating room. Simulation can bridge this gap. However, existing published open vascular simulation curricula are basic or based on expensive models. METHODS: We iteratively developed an open vascular skills curriculum for second-year surgery residents comprising six 2-hour sessions. We refined the curriculum based on feedback from learners and faculty. The curriculum required skilled facilitators, vascular instruments, and tissue models. We evaluated the latest iteration with a survey and by assessing participants technical skills using the Objective Structured Assessment of Technical Skills (OSATS) form. RESULTS: Over the past 10 years, 101 residents have participated in the curriculum. Nine of 13 residents who participated in the latest curricular iteration completed the survey. All respondents rated the sessions as excellent and strongly agreed that they had improved their abilities to perform anastomoses with tissue and prosthetic. Facilitators completed 18 OSATS forms for residents in the fifth and sixth sessions of the latest iteration. Residents scored well overall, with a median 26.5 (interquartile range: 24-29) out of a possible score of 35, with highest scores on knowledge of instruments. DISCUSSION: This simulation-based curriculum facilitates open vascular surgical skill acquisition among surgery residents. The curriculum allows residents to acquire critical vascular skills that are challenging to learn in an increasingly demanding operative setting.

Purpose: To explore what patients with rheumatic and musculoskeletal diseases (RMDs) need and receive of follow-up care after specialized rehabilitation, and whether received follow-up is associated with health outcomes after 1 year. Further, to compare these findings with patients' experiences to improve the understanding of how follow-up takes place. Methods: In a mixed methods study, patients received a rehabilitation programme designed to improve the continuity in rehabilitation across care levels. A total of 168 patients completed questionnaires, of which 21 were also interviewed. Results: At discharge, most patients reported needs for follow-up. These needs were largely met within 1 year, mainly resulting from patients' initiatives to re-connect with previous contacts. The degree of received follow-up was not associated with goal attainment, quality of life, or physical function. Factors related to providers (competence, communication skills), context (delays, limited access to care), and patients (motivation, life situation, preferences) seemed to be decisive for the progress of the rehabilitation process over time. Conclusions: The results provide evidence that access to follow-up care is crucial to patients with RMDs. However, it also highlights several factors that may influence its impact. These results can be used to optimise design and implementation of future follow-up interventions. IMPLICATIONS FOR REHABILITATION: Healthcare providers should take greater responsibility for creating continuity in rehabilitation across levels of care. Follow-up care should be adapted to patients' needs, goals, and preferences as regards content, timing, and mode of delivery. Follow-up should be linked to a rehabilitation plan for each patient to ensure continuity of care. More effective communication systems across service levels should be established. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Clinical skills are fundamental to medical school curriculums and typically introduced within the preclinical years. In their experiential learning, students' self‐efficacy, or the belief in their ability to succeed, is an important factor in influencing clinical skill mastery. Reflection is thought to affect self‐efficacy; however, its exact impacts remain largely unexplored within published literature. This mixed methods study investigated whether preclinical students' engagement with reflection affected self‐efficacy for clinical skills.Two hundred seventy‐three of the 289 preclinical medical students who were invited to participate responded to this 2022 study. We used validated questionnaires to measure engagement with reflection and perceived self‐efficacy for clinical skills, conducting hierarchical multiple linear regression for analysis. Thirteen students participated in semi‐structured interviews and focus groups, which were analysed via thematic analysis.While statistical analysis showed no significant effects of engaging with reflection on clinical skill self‐efficacy, thematic analysis suggested that students perceived the opposite. The themes through which reflection affected self‐efficacy were by ‘evaluation of performances’ against expected outcomes, ‘familiarisation and understanding of skills’, by ‘transforming personal mindsets’ and allowing students to ‘connect to their emotions’.This study suggests that engaging with reflection can positively or negatively affect self‐efficacy for clinical skills, depending on students' attitudes towards reflective practice. Solely engaging with reflection is insufficient to alter self‐efficacy beliefs and should be considered alongside personal factors including the individual's mindset and perceived need for reflection. The medical educator's role in facilitating reflection is important, enabling students to reap the benefits of this practice. [ABSTRACT FROM AUTHOR]

Background: Clinical education is a significant part of medical education, and paying attention to clinical evaluation is important. One of the challenges in the teaching-learning process is evaluating students' performance. Learners, as the main stakeholders of the educational system, may have different experiences of evaluation quality. Awareness of these experiences is effective in improving the quality of clinical evaluation. Therefore, this study was conducted to "explore the experiences of nursing students for evaluation of professional competence by using the objective structured clinical examination (OSCE)". Method: This study was conducted with a qualitative descriptive research approach and conventional content analysis method in 2022–2024. The participants included 12 undergraduate nursing students at Maragheh University of Medical Sciences, who were selected by purposeful sampling, and their experiences were collected using semi-structured and in-depth interviews until reaching data saturation. Results: The data analysis of the interviews led to the extraction of 268 primary codes, 7 subcategories, 2 categories, and 1 theme: "Credibility and stability". The category "Exam's accuracy in measuring competence " included 3 sub-categories: "Challenges in objective adaptation ", " Communication and organizational challenges for exam preparation " and " Inadequate simulation of stations and exam environment ", and the category " Exam power for repeatability" included 4 sub-categories: " Characteristics of the students ", " Lack of evaluators' skills and mastery ", " Inefficiency of the evaluation tool " and " Disturbance in executive affairs". Conclusions: OSCE can be used in self-evaluation, creating motivation and strengthening different dimensions of students' learning, as well as discovering weaknesses and strengths for planning by managers and faculties. According to the results of this study, many factors such as management before and during the exam, characteristics of the evaluators, prevailing educational conditions in the faculty, and the method of clinical training are effective in achieving the "reliability and sustainability" required in the OSCE. [ABSTRACT FROM AUTHOR]

Objective: The study was to survey the current situation and explore the relationship between pain assessment ability, palliative care core competence and palliative care practice ability among oncology nurses in mainland China. Methods: A multicenter cross-sectional study design was employed. Study data were collected in 26 tertiary hospitals among 1198 registered oncology nurses in the oncology department in Hubei province, China. A web-based survey was conducted using a stratified random integral sampling method to obtain data. All variables were measured using standardized instruments. Data was analyzed using SPSS 26.0 and AMOS 26.0 statistical software. All statistical tests were two-sided, with the significance level set at P < 0.05. The structural equation model was utilized to test the mediation effect of pain assessment ability on the pathway from palliative care core competence to palliative care practice ability. Results: The mean scores for pain assessment, core competence and practice ability were 125.68 (SD = 31.16), 76.67 (SD = 19.59) and 67.17(SD = 12.57), respectively. Pearson correlation analysis revealed significant positive correlations among the PCPS, EPCS, and Self-PAC scores of the oncology nurses (P < 0.01). The association between core competence and palliative care practice ability was mediated by pain assessment ability (ES = 0.125, 95%CI: 0.090–0.168). Conclusions: To enhance the effectiveness of palliative care practice, managers need to strengthen the core competencies of palliative care nurses and their ability to assess patients' pain, as these two factors will promote the practical abilities of oncology nurses. [ABSTRACT FROM AUTHOR]

Background: The intention to more effectively mobilise and integrate the capabilities of the community pharmacy workforce within primary care is clearly stated within National Health Service (NHS) England policy. The Pharmacy Integration Fund (PhIF) was established in 2016 to support the development of clinical pharmacy practice in a range of primary care settings, including community pharmacy. Objective: This study sought to determine how PhIF funded learning pathways for post-registration pharmacists and accuracy checking pharmacy technicians enabled community pharmacy workforce transformation, in what circumstances, and why. Methods: Realist evaluation. We identified two main programme theories underpinning the PhIF programme and tested these theories against data collected through 41 semi-structured qualitative interviews with community pharmacist and pharmacy technician learners, educational supervisors, and community pharmacy employers. Results: The data supported the initial programme theories and indicated that the learning pathway for post-registration pharmacists had also provided opportunity for pharmacists to develop and consolidate their clinical skills before pursuing an independent prescribing qualification. Employer support was a key factor influencing learner participation, whilst employer engagement was mediated by perceptions of value expectancy and clarity of purpose. The study also highlights the influence of contextual factors within the community pharmacy setting on opportunities for the application of learning in practice. Conclusions: When designing and implementing workforce transformation plans and funded service opportunities that require the engagement of a diverse range of private, for-profit businesses within a mixed economy setting, policymakers should consider the contextual factors and mechanisms influencing participation of all stakeholder groups. [ABSTRACT FROM AUTHOR]

Aim: Identify the skills and knowledge future nurse and midwife leaders might require in the next 6 years. Design/methodology/approach: An online questionnaire elicited health professionals' perspectives on the future requirements for nurse and midwife leaders. Qualitative data were generated in response on health care and the likely leadership skills for the future. Data were extracted and analysed using qualitative content analysis. Findings: Four generic categories were abstracted from the core category 'Nursing and Midwifery Leadership'. These were values/traits; creating positive healthcare cultures; digital capability/competence; and systems thinking. Limitations/implications. This first stage evaluation has gained a wide variety of perspectives regarding the perceived skills and knowledge future nurse and midwife leaders might need. This is important to enable those who deliver leadership development programmes to plan appropriately, ensuring their programmes are designed and adjusted in response to the needs of a shifting health and care landscape. However, over 50% of respondents were White, so the data may not be representative of the diversity of registered nurses and midwives. The findings may not have direct relevance to the global context due to geographical limitations. [ABSTRACT FROM AUTHOR]

Recent shifts in nursing education towards generic proficiencies pose challenges to the unique demands of mental health nursing education. Student mental health nurses at the authors' higher education institution (HEI) have provided service feedback that has expressed the difficulties they have encountered. This article examines the issues faced by students, assessors and educators in interpreting and applying the proficiency standards set by the Nursing and Midwifery Council. Addressing the complexities of mental health nursing education, as well as the barriers to learning and attainment, requires a collaborative effort and innovative solutions if HEIs are to successfully prepare future mental health nurses to meet the evolving demands of their role. The proposed solution is a 'Proficiency Directory', which provides structured resources for mental health nursing students to align learning experiences with assessment criteria, facilitating a more comprehensive and meaningful learning journey. [ABSTRACT FROM AUTHOR]

Purpose Materials and methods Results Conclusions Entrustable professional activities (EPAs) are used to support clinical skills training by providing a scaffold for practice and feedback. The aim of this study was to evaluate how written feedback provided for EPAs supports medical students' learning.The written feedback for two EPAs (admit or consult patient and discharge summary) was analysed using a mixed methods approach. Content analysis determined the types of feedback received. Qualitative analysis identified themes related to the feedback quality. Hattie and Timperley's feedback model that provides a framework for effective feedback was used as an interpretive lens for our analysis and integrated findings.Written feedback was provided for 89.5% of 997 EPAs. The proportions of feedback types to support learning were as follows: feedback related to what was done well (75.6%), areas for improvement (27.7%) and next steps (17.4%). Only 10% of EPAs received all three types of feedback. EPAs completed independently were more likely to receive any feedback. Feedback for supervised EPAs was more likely to include areas for improvement or next steps. Qualitative analysis identified two themes: effective feedback for present and future performance with detailed description of performance or targeted advice, and lack of specific guidance for improvement with affirmative statements or non‐specific directions.EPAs most often elicited feedback about what is done well without areas or strategies for improvement. Descriptive feedback and tailored advice are ideal, but uncommon. Students and supervisors need guidance on how to optimise feedback through instruction and EPA form design. [ABSTRACT FROM AUTHOR]

Background: The challenges associated with ensuring widespread system changes to enable early diagnosis and prevention of oral cancer could benefit from interprofessional practice. A needs assessment study was conducted to inform the Interprofessional Education and Collaborative Practice (IPECP) course related to oral cancer. The primary objectives of this study were 1) to establish a tool assess the knowledge attitude and practice (KAP) related to prevention and early detection of oral cancer of health professional students, and 2) to assess the same KAP of pre-licensure dental students. Additional objectives were to consider the possibility that dental students would demonstrate good scores related to early detection and prevention of oral cancer thus indicating their readiness for interprofessional learning and collaborative practice. Methods: Two questionnaires were utilized for this study which included 1) Readiness for interprofessional learning was assessed using the pre- validated tool of Readiness for Interprofessional Learning Scale (RIPLS) 2) A questionnaire to assess the KAP related to early diagnosis and prevention of oral cancer which was developed, validated, and evaluated. Statistical analysis includes, descriptive statistics, Mann–Whitney U test, Ordered logistic regression and Probit analysis. p value was set at < 0.05. Results: A total of 130 dental students (74.6% female) were included in the study. Mean scores related to KAP were 15.96 ± 1.394, 4.70 + 1.146, 7.02 ± 1.019 respectively. The mean score of RIPLS was 73.15 ± 15.961. The probability of overall samples to have good RIPLS scores was around 0.68 to 0.76 (Male 0.68—0.82 & Female 0.68 -0.74). The percentage of students having good knowledge score was 93.8%, good attitude score was around 54.6% and good practice score was around 90%. Conclusion: Knowledge and practice related to prevention and early detection of oral cancer were scored highly. Attitude scores were lower in a relatively higher proportion of participants and needed to be addressed in the curriculum. RIPLS score indicates a positive attitude towards interprofessional learning. [ABSTRACT FROM AUTHOR]

Background: In South Africa, newly qualified physiotherapists transition to the workplace during community service, often in diverse healthcare settings, attending to patients with complex ailments. The transition is complicated by the shortage of rehabilitation personnel, especially in rural and peri-urban areas. While higher education curricula should prepare students for the workplace, the roles and expectations of new therapists remain unclear. Assessing how well current curricula, built around the CanMEDS framework, equip students with the competencies needed for entry-level community service practice will help to improve physiotherapy training practices. This study investigated the experiences of community service physiotherapists to inform curriculum design and graduate outcomes. Methods: A descriptive qualitative study was conducted. Graduates were purposefully sampled during their community service year via a class group contact, with a snowball approach to recruit diverse participants. Semi-structured interviews were conducted over MS Teams, recorded, and transcribed. Reflexive deductive coding was used to interpret the data, which was analysed around the CanMEDS roles and graduate outcomes, as well as curriculum constraints and enablers to the workplace transition. Results: Ten community service physiotherapists placed in five different provinces participated. Most identified strongly with their core role as clinicians and felt prepared in terms of clinical skills. However, aspects of roles linked to advocacy, leadership, and professionalism were more complex to navigate. The contexts of placements and the nuances of how the healthcare system operated in each province impacted their experience. Conclusion: The study highlighted varied readiness levels among community service physiotherapists. While many felt competent in specific clinical tasks, there are significant gaps in their preparation for broader community practice challenges. Participants noted their undergraduate training adequately prepared them for the clinician role but not for roles integrating collaboration, communication, patient and professional advocacy. Quality clinical placements and the role of educators were crucial, yet the protective nature of these placements limited exposure to real-world scenarios. Insufficient mentorship and support contributed to feelings of isolation. To enhance preparedness, the curriculum should integrate more experiences addressing real-world challenges, which value multiple competencies and outcomes. Future research should examine the development of context-appropriate competency frameworks and long-term effects of community service on career development. [ABSTRACT FROM AUTHOR]

Background: Traditional pharmacy education often relies on fragmented, subject-centered curricula, which may inadequately prepare students for the complexities of advanced healthcare. This study evaluates the effectiveness of an integrated pharmacy education approach in enhancing foundational knowledge and practical skills. Methods: An integrated course focused on respiratory diseases was developed and implemented for final-year pharmacy students at Tabriz University of Medical Sciences. The course utilized case-based learning and incorporated elements from various disciplines such as pharmacology, medicinal chemistry, and pharmaceutics. An educational controlled trial was conducted, comparing an intervention group (integrated course) with a control group (traditional course). Results: Survey results revealed that over 60% of students reported substantial improvements in their ability to manage respiratory cases. The intervention group demonstrated significantly higher clinical decision-making skills, with an average test score of 31.4 compared to 15.75 in the control group (p < 0.05). Student feedback highlighted the value of integrated education, advocating for its broader inclusion in the curriculum and the addition of more diverse topics and case studies. Conclusions: Integrated pharmacy education, through a case-based approach, significantly enhances student competency and practical skills, better preparing them for real-world pharmacy practice. The study supports the implementation of integrated courses across pharmacy schools to develop curricula and improve educational outcomes. Future recommendations include continuous curriculum integration and expansion of topics to further enrich pharmacy education. [ABSTRACT FROM AUTHOR]

Background: Considering the global shortage of nurses, leaders in the field must understand the strengths and weaknesses of various nursing specialties in order to retain professionals within the field. Occupational prestige reflects the perceived contribution of an occupation 'to society', and measures its desirability, benefit and values. Understanding how experienced nurses view the prestige of nursing specialties may help to explain why some specialties are more desirable than others. We conducted a cross-sectional study to examine the prestige of nursing specialties among nurses taking post-graduate in-training courses. Methods: The study questionnaire examined nurses' perceived prestige of nine nursing specialties, the perceived extent of autonomy and authority, the unique knowledge and clinical skills required for each specialty, and participants' demographic and professional characteristics. Results: A total of 101 nurses (90% females, mean age 35.4 ± 9.39 years) completed the questionnaire. Intensive care (4.67 ± 0.59) and neonatal intensive care (4.57 ± 0.74) were perceived as having the highest prestige, whereas physical activity consultation (2.67 ± 0.98) and sleep consultation (2.71 ± 0.92) were perceived as having the lowest prestige. These specialties were also perceived as requiring the most and least unique knowledge and clinical skills, respectively. In contrast, authority and autonomy were ranked highest in breastfeeding consultation (4.50 ± 0.81), followed by intensive care (4.10 ± 0.87), while congestive heart failure received the lowest score (3.48 ± 0.84). Principal component analysis showed that higher prestige is attributed to acute care specialties, while chronic care specialties or ones involving consultation have lower prestige. Conclusions: Nursing specialties with lower scores should be rebranded to encourage nurses to enter these fields. [ABSTRACT FROM AUTHOR]

Background: Regional anesthesia (RA) can improve patient outcomes and reduce perioperative complications including deaths. Despite its benefits, RA is less utilised in low-resource settings. The purpose of this study was to assess practice and challenges related to RA in Amhara Regional Hospitals, Northwest-Ethiopia. Methods: A web- based survey was distributed among 360 anesthetists working in Amhara Regional Hospitals, Northwest-Ethiopia from November 15 - January 30, 2023. An English, semi-structure, self-administered questionnaire was disseminated by email and telegram following ethical clearance. The survey included questions about the use of RA, socio-demographic characteristics of anesthetist, types of practiced regional blocks, and barriers to perform RA. All volunteer respondents who filled online questionnaire during study period were included. The data were coded and analyzed using statistical package for social Sciences (SPSS) software-version 20. Both inferential and descriptive statistics were used to describe the results. Results: The overall response rate was 63.3% (223 out of 360 completed surveys). A total of 132 respondents (36.7%) did not provide a response, and 5 respondents (1.4%) submitted incomplete) surveys. The most frequently self-reported barriers to performing peripheral nerve blocks were a lack of equipment (regional procedure kit including block needle, ultrasound, nerve stimulator, or epidural set) 185 (82.9%), lack of knowledge 171(76.7%), lack of practical skills 112 (50.2%), and lack of drugs/medication 50 (22.4%). Conclusions: The principal findings indicate that all respondents perform spinal anaesthesia, while the practice of peripheral RA varies. Reported barriers to performing RA are related to knowledge and training, as well as a lack of equipment (there aren't enough regional procedure kits available that include an epidural set, block needle, nerve stimulator, and ultrasound). A more stringent approach with specific requirements, distinguishing between neuraxial and peripheral blocks, enhance training opportunities for peripheral nerve blocks are required in Ethiopia. [ABSTRACT FROM AUTHOR]

Aim: Objective structured clinical examinations have long been used in dietetics education. This observational study aims to describe the development, deployment, feasibility and validity of assessment using an oral interview in place of traditional objective structured clinical examinations, and to determine the ability of this assessment to identify students who are either not ready for placement or may require early support and/or remediation. Methods: Student assessment data were collected over a two‐and‐a‐half‐year period and used to test the predictive ability of an oral interview to determine dietetic placement outcomes and highlight a need for early remediation. Descriptive statistics as well as a between‐group one‐way ANOVA was used to describe results. Results: A total of 169 students participated in the oral interview and subsequent medical nutrition therapy placement over the study period. Significant differences in oral interview score were seen between students who passed placement and students who passed with remediation or those who failed. Oral interview performance was able to predict placement outcome, yet required less resources than traditional objective structured clinical examinations. Conclusion: An oral interview may provide the same utility as the objective structured clinical examination in dietetics education. [ABSTRACT FROM AUTHOR]

Aim: To (i) evaluate structured postgraduate part‐time programs in periodontology, including those addressing peri‐implant diseases, among members of the European Federation of Periodontology (EFP), (ii) the impact of the 2018 classification scheme and EFP clinical practice guidelines and (iii) propose a framework for periodontal vocational education and training. Materials and Methods: A summary of relevant European guidelines for vocational education and training was compiled. In a survey and in a systematic review, current part‐time programs in continuing professional education in periodontology as well as in prevention and management of peri‐implant diseases were examined. The implementation and dissemination of the 2018 classification scheme and the EFP clinical practice guidelines were assessed by literature analysis. Based on these findings, a framework for periodontal vocational education and training was generated. Results: Part‐time programs for professional development in periodontology are established in nine EFP member countries. The systematic review identified lack of knowledge in prevention and management of peri‐implant diseases among dental practitioners and hygienists. Continuing professional development was found to be important for education in prevention, classification and management of periodontal as well as peri‐implant diseases. The proposed European framework consists of an escalator model with three levels (certificate, diploma and master). Discussion: Considering the identified variation in the national programs, there is a need to improve education in periodontal and peri‐implant diseases. The proposed framework will help harmonize the national structures. Conclusion: The proposed framework for part‐time professional development is expected to enhance professional qualification. [ABSTRACT FROM AUTHOR]

Aim: To update the competences and learning outcomes and their evaluation, educational methods and education quality assurance for the training of contemporary specialists in periodontology, including the impact of the 2018 Classification of Periodontal and Peri‐implant Diseases and Conditions (2018 Classification hereafter) and the European Federation of Periodontology (EFP) Clinical Practice Guidelines (CPGs). Methods: Evidence was gathered through scientific databases and by searching for European policies on higher education. In addition, two surveys were designed and sent to program directors and graduates. Results: Program directors reported that curricula were periodically adapted to incorporate advances in diagnosis, classification, treatment guidelines and clinical techniques, including the 2018 Classification and the EFP CPGs. Graduates evaluated their overall training positively, although satisfaction was limited for training in mucogingival and surgical procedures related to dental implants. Traditional educational methods, such as didactic lectures, are still commonly employed, but they are now often associated with more interactive methods such as case‐based seminars and problem‐based and simulation‐based learning. The evaluation of competences/learning outcomes should employ multiple methods of assessment. Conclusion: An update of competences and learning outcomes of specialist training in periodontology is proposed, including knowledge and practical application of the 2018 Classification and CPGs. Harmonizing specialist training in periodontology is a critical issue at the European level. [ABSTRACT FROM AUTHOR]

The article discusses the specialty of geriatric medicine that extends well beyond single medical conditions and calls for interdisciplinary team care. Topics covered include medical students' low interest in the specialty and maintenance of specialty certification, and healthcare advances in the field as of 2024. Also noted are recommendations for renewed interest in the specialty like practitioners' need to lay claim to their clinical domain, and the improvement of fellowship training.

Clinical reasoning is considered one of the most important competencies but is not included in most healthcare curricula. The number and diversity of patient encounters are the decisive factors in the development of clinical reasoning competence. Physical real patient encounters are considered optimal, but virtual patient cases also promote clinical reasoning. A high-volume, low-fidelity virtual patient library thus can support clinical reasoning training in a safe environment and can be tailored to the needs of learners from different health care professions. It may also stimulate interprofessional understanding and team shared decisions. Implementation will be challenged by tradition, the lack of educator competence and prior experience as well as the high-density curricula at medical and veterinary schools and will need explicit address from curriculum managers and education leads. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of pharmacokinetics, drug calculations and off-label drug use in children and young people • To remember that pharmacokinetics vary according to the patient’s age and stage of development • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Medicines management in children and young people presents specific challenges because children differ from adults in their response to medicines. The way in which medicines work inside the human body, or pharmacokinetics, varies according to age and stage of development. Accurate drug calculations for a child rely on the careful consideration of a series of factors, such as weight and height, pharmacokinetics and drug characteristics. This article focuses on three fundamental aspects: pharmacokinetics, drug calculations, and unlicensed and off-label drug use. [ABSTRACT FROM AUTHOR]

Bereavement counseling is often offered as a referral following an adverse event or after identification of lingering grief. This article proposes the value of prospective bereavement counseling when a person can reasonably anticipate loss to support anticipatory grief and facilitate supportive continuous care planning for patients experiencing loss. This article positions bereavement counseling as care aimed at finding peace by offering a framework of dimensions of peace, opportunities to foster peace in clinically important moments, and guiding questions to facilitate this clinical outcome in health care settings. [ABSTRACT FROM AUTHOR]

Background. By 2023, 1,080,000 cases of COVID-19 have been reported in Harris County. Systemic inequity and vaccine hesitancy have contributed to COVID-19 disparities. Community Health Workers provide health education and instrumental support to alleviate health disparities among vulnerable communities. We conducted an analysis of Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis in June 2022 among a broad coalition of Community Health Work stakeholders to better understand the local landscape in the context of the COVID-19 pandemic. Methods. We recruited 33 community health workers and industry stakeholders in Harris County, Texas, to participate in the SWOT analysis. Participants were asked to describe their opinions on the SWOT facing the Community Health Work landscape and then rank the outcomes of the analysis to prioritize action. Results. A total of 19 themes were identified. Weaknesses included lack of respect and resources for Community Health Workers and poor coordination and capacity among the workforce infrastructure. Limited funding and lack of appreciation for Community Health Workers were deemed important threats. Diversity and community connection were critical strengths, and strong education, training, and raising awareness for community health work were considered opportunities to overcome identified weaknesses and threats. Discussion. Increased funding, greater coordination, greater respect, and amplified training can improve capacity for Community Health Workers and, therefore, improve public health outcomes for respiratory illness and viral infections such as COVID-19. This analysis helps fill an important research gap on the topic Community Health Workers responding to public health crises with racially disparate outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to examine the relationship between public health nurses' holistic nursing and social justice advocacy competencies in terms of their attitudes toward sustainable development goals. Design: Cross‐sectional survey. Sample: The study sample consisted of 384 public health nurses. Measurements: Data were collected with the personal information form, the Attitudes toward Sustainable Development Scale, the Holistic Nursing Competence Scale, and the Social Justice Advocacy Scale. Results: The sub‐dimensions of environment, public, education, and economy were found to significantly affect social justice advocacy, and the indirect effects of 0.191, 0.222, 0.205, and 0.201 were found to be statistically significant with the inclusion of holistic nursing competence in the model, respectively. It was found to explain 32%, 30%, 29%, and 22% of the total effect, respectively. Conclusion: It supports the claim that developing public health nurses' holistic nursing competence and social justice advocacy skills is an important criterion for achieving sustainable development goals. [ABSTRACT FROM AUTHOR]

Objectives: Over 70% of the disease burden in Europe is the result of chronic diseases caused by lifestyle. Lifestyle counseling can improve lifestyle habits and thereby health. However, according to research, there are several barriers to healthcare personnel carrying out counseling. The aim of this study was to explore nurses' experiences of conducting lifestyle counseling. Design: A qualitative descriptive study was conducted in southern Sweden between August 2021 and December 2021. Sample: Eleven nurses were recruited from both inpatient and outpatient care in northeastern Sweden through a combination of purposive and snowball sampling. Measurements: Individual semistructured interviews were performed digitally using an interview guide. The interviews were analyzed via qualitative content analysis. Results: The nurses experienced several challenges in performing lifestyle counseling. However, knowledge gaps, sensitive topics, organizational dynamics, and time constraints were balanced using strategies. The theme of their responses can be explained by the following categories: "Collaboration with patients is key," "From self‐interest to teamwork," and "The organization can assist or hinder." Conclusions: Lifestyle counseling needs to be prioritized within healthcare. Nurses need tools and knowledge to be able to feel comfortable with the task. All healthcare organizations need to work with lifestyle counseling in a structured way according to national guidelines. [ABSTRACT FROM AUTHOR]

Aim: To construct a popularization of an emergency science capacity index system for nurses based on the iceberg model. Design: A mixed‐method research design incorporating quantitative and qualitative components was used. Methods: In this study, the first draft of the questionnaire was developed through literature analysis and semi‐structured interviews. According to the Delphi expert inclusion criteria, 20 experts with rich experience in the field of science popularization were selected, and the system of emergency science popularization ability of nurses was ultimately developed through two rounds of consultation according to the Delphi method. The weights of various indicators were determined through hierarchical analysis. Results: Following two rounds of Delphi surveys, a total of 3 primary, 6 secondary, and 26 tertiary indicators were identified. The indicators were found to be highly significant, with variation coefficients ranging from 0.063 to 0.140. The Kendall's harmonization coefficients for the primary, secondary, and tertiary indicators were 0.350, 0.341, and 0.146, respectively. The popularization of the emergency science capacity system has a certain scientific and practical significance, which is of guidance to the competency of nurses in public health emergencies. Patient or public contribution: No patient or public contribution. This study did not involve patients, service users, caregivers, or members of the public. [ABSTRACT FROM AUTHOR]

Building a strong public health nursing (PHN) work‐force capable of advancing population health and reducing inequities is critical. Though undergraduate nursing education is expected to provide introductory knowledge and practice of PHN in Canada, this is not always sufficient to adequately prepare nursing graduates for the complexity of PHN practice. To be practice ready for the full scope of PHN roles and interventions, new baccalaureate nurses and new registered nurses in public health are required to apply PHN competencies, theory, and knowledge of nursing and public health sciences, and to practice within the mandates of provincial and territorial public health legislation. To advance practice readiness a formal continuing education program is essential to foster these critical roles in PHN. This article describes the development of a postgraduate continuing education program for preparation to practice in PHN. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated caregivers' job image, abilities, and educational needs, which are rapidly increasing owing to an aging society. Design: A self‐administered written survey was conducted at 12 general hospitals in Korea from February 1, 2022 to March 15, 2023. Sample: A total of 451 caregivers participated in the survey as subjects of analysis, and 560 nurses participated as external observers. Measurements: The caregivers' self‐assessment results regarding job performance, educational needs, and retraining needs were compared with those of external observers. Results: Caregivers evaluated themselves significantly higher in all areas of job performance compared to the evaluations of external observers. In particular, the caregivers' self‐evaluation of their abilities in "Recording and Reporting," "Basic Resuscitation," "Safety and Infection Control," and "Understanding Major Illnesses" was different from the evaluation of nurses. Both the caregivers and external observers agreed on the need for caregiver retraining, with 1–2 hours of supplementary training every 12 months being the most preferred amount of retraining. Conclusions: There was a significant difference between caregivers' self‐evaluations of their capabilities and the external observers' evaluations. Therefore, systematic professional caregiver retraining is necessary. [ABSTRACT FROM AUTHOR]

Background: The optimal selection process for basic physician trainees (BPTs) is unclear. Aims: To assess an adult BPT selection process, including a standardised recruitment interview assessing clinical decision‐making and situational judgement. Methods: A retrospective multi‐year cohort study of applicants who were selected for interview during the annual recruitment for 2011–2015 clinical years in an adult basic physician training network in NSW. The predictive capacity of the final recruitment assessment score was compared with success in the Royal Australasian College of Physicians (RACP) adult medicine clinical examination within 2 years. Results: Four hundred thirty‐six applicants were selected for interview (84–91 in each year). Summary mean post‐interview scores ranged from 1.25 to 10, with the median ranging between 7 and 8. Median scores were higher in those who passed the examination than those who did not (7.75 vs 6.43, P < 0.0001). Those who did not sit for the examination in the relevant year or never sat for the examination had similar median scores (7 vs 6.75, P = 0.11). Those not deemed eligible for recruitment were less likely to pass the clinical examination within 2 years than those on the eligibility list (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.25–0.57). Applicants with mean scores lower than 8 were less likely to pass than those in the top band (8.1–10); scores between 6.1 and 8 OR 0.42 (95% CI = 0.26–0.68), 4.1–6 OR 0.23 (95% CI = 0.13–0.41) and 2.1–4 OR 0.24 (95% CI = 0.10–0.60). Conclusion(s): The predictive capacity of the selection process for success in the RACP clinical examination within the minimum time period is high. [ABSTRACT FROM AUTHOR]

Purpose: Therapeutic alliance (TA) is critical to rehabilitation outcomes for adults with acquired brain injuries (ABIs). The purpose of this viewpoint article is to review factors that contribute to TA and to suggest ways speechlanguage pathologists (SLPs) can integrate these factors into their ABI rehabilitation practice. Method: We evaluated literature describing client and clinician factors shown to affect—or not affect—TA in ABI rehabilitation and mapped findings onto suggested practices that SLPs may use to actively promote TA with their clients. Informed by our findings and TA frameworks, we integrated findings into a novel clinician self-reflection tool: the Therapeutic Alliance Reflection Checklist. Conclusions: TA is a key ingredient in ABI rehabilitation. We contend that SLPs can, and should, actively facilitate TA with clients; the self-reflection checklist can assist. We advocate for continued TA research and improved measurement across rehabilitation settings. We further contend that training in active TA-promoting skills is a critical component of speech-language pathology education. [ABSTRACT FROM AUTHOR]

Psychobiography or the in-depth interpretation of the life and experiences of a single individual who made a significant impact on society has a long history in academic psychology. In psychological practice, similar methods are often employed to write a case formulation. Yet, the infusion of psychobiography into professional psychology training continues to lag, even though there are apparent overlaps between psychobiography and clinical work. This article delineates these overlaps. One such overlap is the psychobiography focus on the individual within the socio-cultural context, regarded as important in making sense of the individual. Similar to this is the focus within training on socio-cultural context in understanding the client, a clinical skill which forms part of case formulations. This article proposes the integration of the psychobiography into professional psychology training in clinical and counselling psychology adopting practices such as (i) anchoring students in their professional identity and history; (ii) learning different theories of psychology in applied and interesting ways; (iii) stimulating interdisciplinary learning and ethical awareness; (iv) enhancing clinical skill development; (v) supporting methodological pluralism; and (vi) enhancing multicultural, social justice, and multilingual competence. We further suggest how the integration of psychobiography into the training may occur through a short course or merging it into existing modules within the training curriculum. To this end, professional psychology training could be transformed by the introduction of psychobiography with its focus on history, culture as context, personality theory, theory development, and the links between these fields in understanding the individual as client. [ABSTRACT FROM AUTHOR]

Objective: The aim of this project was to investigate the provision of counselling in adult audiological rehabilitation and to highlight training barriers and needs. Design: A service evaluation in which respondents completed a survey in which they rated their knowledge, confidence and competence in addressing the hearing, social and emotional needs of their patients. They were also asked to define counselling. Sample: 64 UK practising audiologists in adult audiological rehabilitation, aged 20–>60 years (84% females, 16% males), with a range of years in clinical practice. Results: Counselling definitions fell into three main categories: the audiologist as the doer, the audiologist as the facilitator, and the audiologist and patient as partners. Respondents reported feeling more able to counsel the hearing related needs of their patients, than emotional or social needs. There were significant positive statistical associations between counselling training completed and self-rated counselling abilities for managing emotional needs. Clinical experience was not associated with self-rated counselling. Lack of supervision and training were identified as some of the main barriers to providing emotional support. Almost all respondents reported a desire for further training in delivering emotional support, with the belief that this would improve services and patient outcomes. Conclusions: UK audiologists demonstrated person-centred thinking through their definitions of counselling. However, they reported significant barriers in being able to support the needs of adults with hearing loss. Training needs around emotional support in audiology counselling are not currently being met. It is important for clinical training programmes to address this gap by incorporating more counselling courses into their curricula. [ABSTRACT FROM AUTHOR]

Background: As the needs and curricula of surgical residencies evolve, recent studies have focused on identifying factors that may be related to faster and more efficient surgical skill acquisition, such as experience with playing video games, sports, and other dexterous activities. The aim of this study was to elucidate the relationship between instrumental musical experience and laparoscopic surgical skill performance as well as to provide an overview of the available literature on this topic. Methods: A query from database inception to January 2023 of the PubMed database for literature discussing the association of musical experience and surgical skills was conducted. One hundred and twelve publications were sorted for relevance, yielding 16 included studies. The details of these studies were organized in a table and further analyzed. Study participants answered several questions regarding their personal instrumental musical experience and rotated through two minimally invasive surgery (MIS) skills stations. Participants received a score for each station based on level of performance. Descriptive statistics as well as non-parametric analyses and Spearman's correlations were calculated when appropriate to determine any associations between musical experience and laparoscopic surgical skill performance. Results: One hundred individuals participated in the study. Fifty-one of the participants indicated that they played at least one musical instrument, and twelve (9.0%) of these individuals played more than one instrument. There was no statistically significant difference or correlation in scores between individuals that played an instrument and those that did not (p > 0.05). Playing a greater number of instruments did not significantly correlate with increased performance (p > 0.05). There was also no statistically significant difference or correlation in scores within the group that played instruments based on instrument type or number of years playing an instrument (p > 0.05). Conclusions: Experience playing musical instruments did not confer an advantage in MIS skills tested in the present study. [ABSTRACT FROM AUTHOR]