Assessment Of Clinical Competence Research Articles

Relationship between learning styles and clinical competency in nursing students

BackgroundThe acquisition of clinical competence is considered the ultimate goal of nursing education programs. This study explored the relationship between learning styles and clinical competency in undergraduate nursing students.MethodsA descriptive-correlational study was conducted in 2023 with 276 nursing students from the second to sixth semesters at Abhar School of Nursing, Zanjan University of Medical Sciences, Iran. Data were collected using demographic questionnaires, Kolb’s learning styles, and Meretoja’s clinical competence assessments completed online by participants. Data were analyzed using SPSS version 16, employing descriptive statistics and inferential tests (independent T-test, ANOVA, Pearson correlation) at a significance level 0.05.ResultsThe predominant learning styles among nursing students were divergent (31.2%), and the least common was convergent (18.4%). The overall clinical competency score was 77.25 ± 12.65. Also, there was a significant relationship between learning styles and clinical competency, so the clinical competency of students with accommodative and converging learning styles was higher. (P < 0.05).ConclusionThe results of this study showed the association between learning styles and clinical competence in nursing students. It is recommended that educational programs identify talented students and provide workshops tailored to strengthen various learning styles associated with enhanced clinical competence.

Compare the Effectiveness of Objective Structured Clinical Evaluation (OSCE) versus Checklist in Demonstration of Antenatal Abdominal Examination among Final Year G.N.M. students.

The OSCE is an approach to the assessment of clinical competence in which the components of competence are assessed in a planned or structured way with attention being paid to the objectivity of the evaluation” Harden, 1988 .The Objective Structured Clinical Exam (OSCE) is a performance- based exam. During the exam, trainees are observed and evaluated as theygo through a series of stations where they interview, examine and treat standardized patients presenting with some type of problem. An OSCE is: • Objectivity, because examiners use a checklist for evaluating the trainees. • Structured, because every trainee sees the same problem and performs same tasks in the same time frame. • Clinical based, because the tasks are representative of those faced in real clinical situations • An evaluation method II – Materials and Methods Comparative research design was used with group I &amp; group II to assess the effectiveness of objective structured clinical evaluation (OSCE) versus checklist in demonstration of antenatal abdominal examination among final year G.N.M students. The study conducted on 30 samples in each group. Data was collected using Objective Structured Clinical Evaluation and checklist for assessing performance of G.N.M final year students on abdominal examination. III – Results The overall mean and S.D. of OSCE was 11.03 with a percentage mean of 91.39% and 16.59 whereas the overall mean and S.D. of Checklist was 55.73 with a percentage mean of 79.62% and 11.24. The calculated ‘t’ value was higher than the table value (t58 = , P&lt; 0.01). Hence, the null hypothesis was rejected and research hypothesis was accepted and it was inferred that in the present study there was significant difference between the effectiveness of demonstration on antenatal abdominal examination during pregnancy assessed by Objective Structured Clinical Evaluation (OSCE) &amp; checklist among G.N.M final year students. Comparing the mean percentage of OSCE and Checklist 91.39% and 79.62%, it is inferred that the mean percentage of OSCE i.e. 91.39% is higher than the mean percentage of Checklist i.e. 79.62%. Therefore, it can be concluded that the OSCE is more effective than the checklist for evaluating the demonstration of abdominal examination during pregnancy. IV – Conclusion This study concluded that in comparison to, OSCE was found to be a more effective assessment tool than traditional method checklist. Use of OSCE as formative tool will help in modifying teaching- learning strategies so that both, the teachers as well as the students can derive maximum benefit

Virtual assessment in Physiotherapy: Examining perceptions, constructs, and tool characteristics

Introduction: Objective structured clinical examinations have traditionally been used to assess clinical skills. However, these face-to-face clinical assessments were hindered by physical and social restrictions imposed during COVID-19. This created a need to develop novel approaches for reliable assessment of clinical skills. We explored and evaluated a virtual exercise teleconsultation assessment (VETA) to replicate a teleconsultation setting where physiotherapy students were assessed on exercise prescription and coaching skills. Methods: We conducted a cross-sectional mixed-methods study using convenience sampling. A VETA was implemented for 172 physiotherapy students via Zoom to allow synchronous interaction with standardised patients (SPs). 67 students and 9 SPs completed two separate post evaluation surveys on themes relating to administration, support, authenticity, effectiveness, and value of the VETA. Likert-type responses were categorised as positive, neutral, or negative while coded qualitative responses were consolidated into themes by inductive content analysis. Results: 76% of students agreed that the assessment was authentic while 93% felt that the SPs were realistic and believable. Responders also highlighted important challenges including the limited camera viewing angle, time and space constraint, adequacy of equipment and reliability of connectivity. Exploratory factor analysis of responses revealed three latent constructs: (1) clarity of assessment, (2) clinical relevance, and (3) value of assessment. Conclusion: Despite the technical challenges, VETA demonstrated clarity and value as an alternative assessment and showed relevance to future telehealth practice, which is increasingly pervasive in clinical settings. This paper demonstrates a feasible approach for the virtual assessment of clinical competencies. Keywords: Health Sciences Education, Virtual Assessment, Clinical Skills, OSCE, Physiotherapy, Exercise Prescription

Implementation of nurse’s clinical competency: A scoping review

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;em&gt;:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Nursing care provided to patients, especially in hospitals, is expected to be of high quality, and its implementation is in accordance with the nurse's clinical competence. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;&lt;strong&gt;Objectives:&lt;/strong&gt; This scoping review aimed to assess the implementation of the clinical competence of nurses in hospitals so that a clear picture of the implementation of these competencies is obtained. In addition, this study can be evidence-based and related to implementing these clinical competencies. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;This literature review used PICO framework to develop articles questions (P: nurses, I: not applicable, C: not applicable, and O: application of clinical nursing competency). Articles search for literature review was conducted during April and May 2023. &lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;This study used Pubmed and ScienceDirect Databases and other sources. The keywords that used in this scoping review was &lt;/em&gt;&lt;em&gt;“nursing competency” OR “clinical nursing competency” AND “evaluation” OR “implementation” AND “hospital”.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;There were 1,150 articles from the search results, but only seven were included for review. One article is a descriptive comparative study using a qualitative approach, and six articles are cross-sectional studies. The articles are publications within five years (2019-2023). In its implementation, the average clinical competency of nurses is at a low to moderate level, and only one study found was at high nurse competency. The results of the supervisor's clinical competency assessment were significantly lower than those assessed by oneself and the group. In addition, &lt;/em&gt;&lt;em&gt;the nurse competency level was moderate, and there was no significant difference in the clinical competency of nurses before and during the COVID-19 pandemic.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;strong&gt;&lt;em&gt;Conclusions: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;The implementation of nurses' clinical competence has yet to be optimal, so hospital management needs to improve nurses' clinical competence so that nurses can provide higher quality and professional nursing care in the hospital.&lt;/em&gt;

The validity of the selection methods for recruitment to UK core psychiatry training: cohort study.

Selection into core psychiatry training in the UK uses a computer-delivered Multi-Specialty Recruitment Assessment (MSRA; a situational judgement and clinical problem-solving test) and, previously, a face-to-face Selection Centre. The Selection Centre assessments were suspended during the COVID-19 pandemic. We aimed to evaluate the validity of this selection process using data on 3510 psychiatry applicants. We modelled the ability of the selection scores to predict subsequent performance in the Clinical Assessment of Skills and Competencies (CASC). Sensitivity to demographic characteristics was also estimated. All selection assessment scores demonstrated positive, statistically significant, independent relationships with CASC performance and were sensitive to demographic factors. All selection components showed independent predictive validity. Re-instituting the Selection Centre assessments could be considered, although the costs, potential advantages and disadvantages should be weighed carefully.

Cross-Sectional Survey of Student and Faculty Experiences with Feedback and Assessment of Clinical Competency on Final Year Rotations at American Association of Veterinary Medical Colleges (AAVMC) Member Institutions

The clinical experiences, feedback, and assessment that veterinary students receive during final year rotations have a significant impact on whether they will achieve entry-level competency at the time of graduation. In this study, a cross-sectional survey was administered to American Association of Veterinary Medical Colleges (AAVMC) member institutions to collect baseline data about current feedback and assessment practices to identify key target areas for future research and educational interventions. Responses were received from 89 faculty and 155 students distributed across 25 universities. The results indicated that there are significant gaps between evidence-based approaches for delivering feedback and assessment and what was being implemented in practice. Most feedback was provided to students in the form of end-of-rotation evaluations sometimes several weeks to months after the rotation finished when faculty were unlikely to remember specific interactions with students and there were limited opportunities for students to demonstrate progress towards addressing identified concerns. Although the most valuable type of feedback identified by students was verbal feedback delivered shortly after clinical experiences, this method was often not used due to factors such as lack of time, poor learning environments within veterinary teaching hospitals, and lack of faculty training in delivering effective feedback. The results also indicated potential challenges with how non-technical domains of competence within the AAVMC Competency-Based Veterinary Education (CBVE) Framework are currently evaluated. Finding avenues to improve feedback and assessment processes in final year clinical settings is essential to ensure that veterinary students are adequately prepared for practice.

Competency in medical training: current concepts, assessment modalities, and practical challenges.

In the past two decades, competency-based medical education (CBME) has rapidly become the cornerstone of medical training and accreditation programmes worldwide. It has increasingly replaced traditional time-based educational approaches which were often rigid, fragmented, and overly emphasized clinical content knowledge over practical skillsets and attitudes. CBME adoption was in the hope of better preparing medical graduates for the demands and responsibilities of real-world clinical practice. For all the supposed merits of CBME, there hitherto remains difficulties in arriving at comprehensive and practical 'competency' definitions, and actual challenges with implementation of clinical competency assessment modalities pertaining to construct validity, reliability, and applicability with the use and interpretation of evaluation metrics. Therefore, in this article, we describe the various conceptualizations of 'competency' in medical education literature and attempt to refine its usage in practice to meet the evolving needs and expectations of healthcare stakeholders, as well as incorporate emerging concepts in the medical education discourse. We herein propose that clinical 'competencies' should be defined as multi-domain clinical expertise, comprising medical knowledge, skills, attitudes and metacognitive capabilities that reflects the prevailing needs of healthcare stakeholders, and is inferred from performance evaluations of medical trainees. In order to attain 'competence', there must then be a process of integrating multi-domain competencies into meaningful professional identity formation that is commensurate with the context and stage of medical training. In addition, we review the current competency assessment modalities, including common pitfalls with their usage, and sought to provide practical strategies to mitigate the identified challenges.

Assessment of clinical competence of graduating medical students and associated factors in Ethiopia

BackgroundEthiopia has scaled up medical education to improve access to healthcare which presented challenges to maintaining training quality. We conducted a study to assess the clinical competence of graduating medical students and the associated factors.Methods and materialsA pretest assessment of a quasi-experimental study was conducted in 10 medical schools with a sample size of 240 students. We randomly selected 24 students per school. Clinical competence was assessed in a 12-station objective structured clinical examination. The clinical learning environment (CLE), simulation training, and practice exposure were self-rated. Mean scores for clinical competence, and satisfaction in the CLE and simulation training were calculated. Proportions of students with practice exposure, and who agreed on CLE and simulation items were done. Independent t-tests were used to look at competence differences among subgroups. Bivariate and multiple linear regression models were fitted for the outcome variable: competence score. A 95% statistical confidence interval and p-value < 0.05 were used for making statistical decisions. A 75% cut-off score was used to compare competence scores.ResultsGraduating medical students had a mean competence score of 72%. Low scores were reported in performing manual vacuum aspiration (62%), lumbar puncture (64%), and managing childbirth (66%). Female students (73%) had a significantly higher competence score than males (70%). Higher cumulative grade point average (CGPA), positive appraisal of the CLE, and conducting more clinical procedures were associated with greater competence scores. Nearly half of the students were not satisfied with the clinical practice particularly due to the large student number and issues affecting the performance assessment. About two-thirds of the students were not satisfied with the sufficiency of models and equipment, and the quality of feedback during simulation training. Nearly one-third of the students never performed lumbar puncture, manual vacuum aspiration, and venipuncture.ConclusionsMedical students had suboptimal clinical competence. A better clinical learning environment, higher cumulative GPA, and more practice exposure are associated with higher scores. There is a need to improve student clinical practice and simulation training. Strengthening school accreditation and graduates’ licensing examinations is also a way forward.

Evaluation of the objective structured clinical examination by the nursing students

The objective structured clinical examination (OSCE) represents a pivotal innovation in the assessment of clinical proficiency within nursing education. This method is crucial as nurses are anticipated to exhibit competence across diverse healthcare settings, ensuring comprehensive, safe, and high-quality care throughout the patient's lifespan. A key challenge in evaluating clinical competence lies in the inherent subjectivity and complexity of the task. This demands educators to perpetually seek and refine tools apt for gauging nursing competence. Our study, a descriptive cross-sectional analysis encompassing 150 undergraduate nursing students, utilized a modified standardized survey questionnaire to appraise student perceptions of their OSCE experiences. Findings indicate a predominant classification of the OSCE as "good," with a notable preference for the planning phase over the implementation phase. Pre-test orientation was highly valued, whereas the provision of materials was critiqued. Gender and academic year were identified as significant variables influencing OSCE evaluations, particularly in the implementation phase and regarding examiner roles. This research offers foundational insights for future studies aiming to enhance OSCE methodology and substantiates the necessity of integrating OSCE into nursing curricula for robust clinical competence assessment.

Assessment of Clinical Competencies for Internship Nursing students Condensed Program

Assessment of Clinical Competencies for Internship Nursing students Condensed Program

Effectiveness of Participatory Teaching Methods in the Standardized Training of Respiratory Medicine Residents

Objective: To explore and analyze the application effect of participatory teaching method in the standardized training of respiratory medicine residents. Methods: The study period was from May 2022 to May 2023. 20 doctors in the standardized training of respiratory medicine residency in our hospital were taken as research subjects and grouped into the participatory group (n = 10) and the routine group (n = 10) by using the random number lottery method. The participatory group practised participatory teaching methods, and the routine group practised routine teaching methods. The results of discharge assessment, teaching evaluation, and mini-Clinical Evaluation Exercise (mini-CEX) assessment were compared between the groups. Results: The theoretical assessment, operational assessment, and total scores of the participatory group were significantly higher than those of the routine group, and the difference was statistically significant (P &lt; 0.05). The teaching evaluation of independent learning, theoretical mastery, teamwork, clinical thinking, communication, and learning interest of the participatory group was significantly higher than that of the routine group, and the difference was statistically significant (P &lt; 0.05). The mini-CEX assessments of history inquiry, organizational effectiveness, professionalism, physical examination, clinical diagnosis, communication skills, and overall clinical competence of the participatory group were significantly better than those of the routine group, and the difference was statistically significant (P &lt; 0.05). The teaching satisfaction of the participatory group was significantly higher than that of the routine group, the difference was statistically significant (P &lt; 0.05). Conclusion: Participatory teaching methods can improve the overall level of doctors in the respiratory medicine residency standardized training, and the teaching satisfaction is improved.

Assessments Used for Summative Purposes during Internal Medicine Specialist Training: A Rapid Review

Assessments used for summative purposes of patient-facing clinical competency in specialist internal medicine training are high-stakes, both to doctors in training, as it is a prerequisite for qualification, as well as their community of prospective patients. A rapid review of the literature evaluated methods of assessments used for summative purposes of patient-facing clinical competency during specialist internal medicine training in Australia. Four online databases identified literature published since the year 2000 that reported on summative assessment in specialist medical training. Two reviewers screened and selected eligible studies and extracted data, with a focus on evidence of support for the criteria for good assessment as set out in the 2010 Ottawa Consensus framework for good assessment. Ten eligible studies were included. Four studied the mini-clinical evaluation exercise (mini-CEX), two the Royal Australasian College of Physicians short case exam, three a variety of Entrustable Professional Activities (EPAs) or summative entrustment and progression review processes, and one a novel clinical observation tool. The mini-CEX assessment demonstrated the most evidence in support of the Ottawa criteria. There was a paucity of published evidence regarding the best form of summative assessment of patient-facing clinical competency in specialist internal medicine training.

‘Authentic’ Assessment of Clinical Competence: Where We Are and Where We Want to Go in Future

The assessment of clinical competence is one of the most difficult tasks facing medical education. Teaching and assessment need to be meaningful for the students and their relevance in real life context and challenges should be apparent. Ideally, assessment tasks should require students to use the same competencies, or combinations of knowledge, skills, and attitudes that they need to apply in their future professional life. However, for the medical teachers of our country the term “authentic assessment” is very new, as most of them are very stick to traditional assessment while running a course or training students in different medical colleges. Clinical competence is an extremely complex construct and one that requires multiple, mixed, and higher order methods of assessment. As we have experienced a recent pandemic situation, it seems that plenty of questions remain in relation to clinical competence assessment in medical colleges for now and near future. In authentic assessment, students will go beyond the textual reproduction of fragmented and low order content and move towards understanding, establishing relationships between new ideas and previous knowledge, linking theoretical concepts with everyday experience, deriving conclusions from the analysis of data, allowing them to examine both the logic of the arguments present in the theory, as well as its practical scope. That is why we are moving away from traditional, limited test formats to new, more complex, yet innovative, mixed methods of ‘authentic’ assessment – from faculty observation ratings and paper-and-pencil examinations to online MCQ tests, SBA questions, experimentation with advanced OSPE and OSCE, and project-based assessment supplemented with clinical reasoning. These moves are expected to bring not only several challenges but also great educational rewards for the measurement and advancement of clinical competence among students. We would like to continue to work on those progressions. Mugda Med Coll J. 2023; 6(1): 37-43

Computer-Based Clinical Examination (CCE) in Surgery: Would It Complement or Replace the OSCE in the Post-COVID-19 Era?

Objectives: Surgical clinical assessment of medical students is confronted by many challenges particularly the increasing numbers of students with limited resources, and pandemics. The search for new tools of assessment continues. Our objectives were: (1) To develop a computer-based clinical exam (CCE) and identify its characteristics (2) To assess its acceptability of the students. Method: The study was conducted at the Surgical Department, Alzaiem Alazhari University (AAU) between February and August, 2017. We used the modular objectoriented dynamic learning environment (MOODLE) program as a platform to upload and deliver the exam. The exam consisted of 45 questions (stations). Each consisted of a clinical scenario accompanied by a photograph (of a patient or investigation) or short video followed by multiple choice questions (MCQs). A questionnaire was designed to get the students’ feedback. We analyzed the questionnaire and scores obtained by the students and compared them to their performance in other tools of the surgical exam, using SPSS statistical program. Results: The study included 188 final year medical students. There was a highly significant correlation of the CCE scores of each student with their final result (r= 0.67), and with other tools of the surgery exam particularly the objective structured clinical examination (OSCE). Students’ acceptability was high. Conclusion: The CCE is valid and practicable. It saves time and is popular with the students and tutors. It complements the OSCE in the assessment of clinical competency and allows wide coverage of the curriculum. It is expected to gain importance and popularity in the post-COVID-19 era.

Developing entrustable professional activities for general dentistry at the University of North Carolina.

As part of curriculum innovation, the University of North Carolina (UNC) Adams School of Dentistry identified core entrustable professional activities (EPAs) that graduates must demonstrate for practice readiness. This paper describes the development of the UNC EPAs and the perceptions of the general dentistry faculty. Upon establishing a blueprint of knowledge, skills, and attitudes of UNC graduates, using a distributed leadership approach, faculty teams developed EPAs focused on the patient care process. The American Dental Education Association Compendium of Clinical Competency Assessments and Commission on Dental Accreditation Standards informed the team's work. Perceptions of the assessment framework were examined using a questionnaire completed by 13 general dentistry faculty considering the importance, accuracy, and agreement of each EPA, associated domains of competence, and encounter management on a 6-point rating scale. Distributed leadership was a useful strategy in EPA development to disperse decision-making and build ownership. Through multiple iterations, four EPAs (assessment, plan of care, collaborative care, and provision of care) with associated sub-EPAs emerged. EPAs included a description, required knowledge and skills, and rubrics for assessment. The general dentistry faculty reported a high level of importance, accuracy, and agreement with EPAs, domains of competence, and encounter management. EPAs provide a standardized manner to describe the comprehensive work dentists perform, shifting away from individual competencies. The UNC EPAs provide the foundation for longitudinal measures of competence preparing graduates for independent practice. With limited EPAs frameworks available in dentistry, we aim to inform the development and implementation of EPAs across dental education.

Evaluating the performance of ChatGPT in clinical pharmacy: A comparative study of ChatGPT and clinical pharmacists.

To evaluate the performance of chat generative pretrained transformer (ChatGPT) in key domains of clinical pharmacy practice, including prescription review, patient medication education, adverse drug reaction (ADR) recognition, ADR causality assessment and drug counselling. Questions and clinical pharmacist's answers were collected from real clinical cases and clinical pharmacist competency assessment. ChatGPT's responses were generated by inputting the same question into the 'New Chat' box of ChatGPT Mar 23 Version. Five licensed clinical pharmacists independently rated these answers on a scale of 0 (Completely incorrect) to 10 (Completely correct). The mean scores of ChatGPT and clinical pharmacists were compared using a paired 2-tailed Student's t-test. The text content of the answers was also descriptively summarized together. The quantitative results indicated that ChatGPT was excellent in drug counselling (ChatGPT: 8.77 vs. clinical pharmacist: 9.50, P = .0791) and weak in prescription review (5.23 vs. 9.90, P = .0089), patient medication education (6.20 vs. 9.07, P = .0032), ADR recognition (5.07 vs. 9.70, P = .0483) and ADR causality assessment (4.03 vs. 9.73, P = .023). The capabilities and limitations of ChatGPT in clinical pharmacy practice were summarized based on the completeness and accuracy of the answers. ChatGPT revealed robust retrieval, information integration and dialogue capabilities. It lacked medicine-specific datasets as well as the ability for handling advanced reasoning and complex instructions. While ChatGPT holds promise in clinical pharmacy practice as a supplementary tool, the ability of ChatGPT to handle complex problems needs further improvement and refinement.

Comparison of the clinical competency of nurses trained in competency-based and object-based approaches in the Democratic Republic of the Congo: A cross-sectional study.

In the Democratic Republic of the Congo (DRC), the object-based approach (OBA) still remains mainstream in the basic nursing education program, despite the intention of the Ministry of Public Health to expand the competency-based approach (CBA) nationwide. This study aimed to compare the clinical competency of nurses trained with CBA and OBA. A cross-sectional, mixed study was conducted. We developed a self-assessment questionnaire consisting of an individual demographic information, a clinical competency assessment scale and the General Self-efficacy Scale. Nurses trained with CBA or OBA and currently working in health facilities with two to five years of clinical experience were purposively selected from ten cities across nine provinces in the DRC. We also conducted key informant interviews with the clinical supervisors at health facilities. In a comparison of 160 nurses trained with CBA and 153 with OBA, 3 competency domains ("establishing professional communication", "making decisions about health problems", and "performing nursing interventions") of the 5 domains required for nurses had significantly higher scores in the CBA group. The key informant interviews supported these results while revealing various issues in the basic nursing education program. The results support the strategic direction of the Ministry of Public Health in the DRC to expand CBA. Collaboration among education institutions, health facilities, and administrative bodies is crucial for clinical nurses to fully engage their competencies for the population. Other low- and middle-income countries with scarce resources can refer to the developed and implemented competency assessment method applied in this study.

Perception of Students and Faculties for OSCE as A Tool for Assessment of Clinical Competence in Summative Examination of General Medicine

Perception of Students and Faculties for OSCE as A Tool for Assessment of Clinical Competence in Summative Examination of General Medicine

Can trauma leagues contribute to better cognitive performance and technical skills of medical students? The experience of the Unicamp trauma league.

Trauma leagues (TLs) are extracurricular programs that offer medical students supervised exposure to trauma and acute care surgery, mentorship, and participation in other academic activities. TLs are fully approved medical schools, and currently, over 100 TLs exist in Brazil. We hypothesized that the performance/competence of medical students who participated in TLs was superior compared to non-participants. This study evaluated and compared the cognitive performance and technical skills of the two groups. This retrospective cohort study evaluated the performance of TL medical students to non-TL alumni from 2005 to 2017, using the students' academic performance coefficient, Clinical Competence Assessment, and Progress Test results. SigmaPlot 12.0 software was used to perform statistical analyses, including Mann-Whitney comparison tests and the Kruskal-Wallis test to confirm the data. Of the 1366 medical students who graduated from a Brazilian university, 966 were included, with 17.9% having participated in TL. Compared to non-TL participants, TL students demonstrated better cognitive performance according to the performance coefficient (p = 0.017) and Progress Test result (p < 0.001), and higher achievement in the Clinical Competence Assessment (p < 0.001). The academic performance of TL students was superior to that of non-TL students at the University of Campinas (Unicamp), suggesting a positive impact of TL in the preparation of future doctors. The study findings suggest that participation in TL at Unicamp was beneficial in preparing better doctors and should be considered by medical schools worldwide. II (Retrospective cohort).

The Assessment of Clinical Rehabilitation Counseling Competencies

The Assessment of Clinical Rehabilitation Counseling Competencies (ACRCC) is an evaluation tool intended to assess clinical rehabilitation counseling trainees’ developing competencies, specialty-specific skills, and learning outcomes. In response to the 2017 merger between the Council for Accreditation of Counseling and Related Educational Programs (CACREP) and the Council on Rehabilitation Education, we developed the ACRCC to align with the CACREP (2016)Standards. In our manuscript, we review (a) the developmental needs of rehabilitation counseling trainees, (b) the importance of comprehensive and specialty-specific clinical evaluation measures, (c) the development of the ACRCC, and (d) the opportunities for future research and implications for counseling preparation programs.