The ratio of psychologists to the population is vastly lower in rural communities compared to urban areas, and more clinicians are critically needed in rural Australia. Other health disciplines have implemented generalist frameworks and training to encourage and prepare clinicians to remain in rural practice. Research often references rural psychology practice in conjunction with the broader allied health discipline. Though prior research has identified skills needed for rural psychology practice, further research is needed to expand and update the current understanding of rural psychology competencies. Therefore, the current study explored the competencies and skills used by rural psychologists. Qualitative interviews with 15 rural psychologists from across Australia were conducted and analysed using a reflexive thematic approach. Participants spoke of the unique skills required to manage the challenges of rural practice, identifying eight thematic competencies: clinical skills, networking, cultural responsiveness, practitioner wellbeing, ethics, risk, professional development and telehealth. Themes highlighted the need for a discipline-specific approach to supporting rural psychologists in practice. Applications of this research, particularly towards supporting and retaining psychologists in rural Australia, are discussed.

Outcomes, barriers and enablers of post-registration education for Australian registered pharmacists: A qualitative descriptive study.

How I Do It: "And That's a BINGO!" Using a Self-Directed, Gamified Instrument to Structure Learning on the Obstetrics Clerkship.

Substance use in the perinatal period is a critical public health issue in the United States. Nurses play a significant role in promoting positive maternal-infant health outcomes for women who use substances in the perinatal period. However, many nurses have deficient knowledge, skills, and attitudes (KSAs) toward perinatal substance use (PSU), which can impede their ability to care for this population. Deficiencies in KSAs should be addressed during nursing school; however, few studies have described nursing students' KSAs related to PSU. Understanding nursing students' KSAs about PSU can inform the development of educational interventions to increase KSAs and improve outcomes for women with perinatal substance use and their infants. The purpose of this study was to describe the KSAs nursing students have toward PSU. This study used a mixed-methods approach. A sample of 46 undergraduate nursing students from 2 Midwestern universities was recruited to participate in an online survey. Of those nursing students, 16 completed interviews. Survey data were triangulated with interview themes to produce a deeper understanding of nursing students' KSAs related to PSU. Survey and interview data highlighted 4 themes which were related to KSAs of nursing students, including: (1) limited knowledge of PSU; (2) varied confidence in clinical skills; (3) biased attitudes toward PSU; and (4) recommendations for nursing education. The findings indicated that nursing students have limited knowledge, moderate levels of stigma, and varied skill sets when caring for women with PSU and their infants. Nursing curricula should consider including broader coverage of PSU using various and effective educational strategies (ie, simulation; AI) which incorporate the lived experiences of women with PSU.

Urology encompasses a diverse array of pathologies with complex clinical presentations, demanding rigorous hands-on clinical practice and high-quality pedagogical training for medical interns. To overcome the limitations of traditional teaching models, which typically combines theoretical instruction with ward observation often provide limited exposure, we developed and validated a novel clinical teaching model that is based on real-world clinical cases in individualized three-dimensional imaging and evaluated its feasibility and effectiveness in urological internship teaching through prospective experiments. To evaluate the feasibility and effectiveness of a novel clinical teaching model that integrates real-world clinical cases with individualized three-dimensional imaging in urology interns. During the 2024-2025 academic year, 128 interns in the Department of Urology were randomly assigned to two groups based on student ID numbers: the traditional teaching mode (TTM) arm and the new teaching mode (NTM) arm, with 64 interns in each group. The TTM group received the conventional approach of thematic theoretical teaching alongside clinical case observation, while the NTM arm implemented the novel approach. After a 2-week internship, the educational effects of trainees were assessed by confidential questionnaire, theoretical knowledge examination, and clinical practice assessments, followed by statistical analysis of the results. Interns in the NTM group outperformed those in the TTM group (p < 0.05). Although some specific item assessments revealed no significant differences between the two groups, the overall scores of interns in the NTM group on confidential questionnaires, theoretical knowledge examinations, and clinical practice assessments were significantly higher than those in the TTM group (p < 0.05). The weighted composite score (confidential questionnaire constituted 0.2, theoretical knowledge examination constituted 0.4, clinical practice examination constituted 0.4) of the NTM group was significantly higher (79.75 ± 3.91 vs. 85.30 ± 6.03, p < 0.001). This study indicates that the NTM is well accepted by interns and those receiving clinical teaching through the NTM show superior theoretical knowledge and clinical skills over the TTM.

Defining diagnostic disclosure in the acute care setting: A concept analysis.

There is a recognised desire to teach amongst GP trainees yet limited formal opportunities to do this. There are known benefits of near-peer teaching to both teacher and learner, but minimal research investigating the role of GP trainees as teachers in a clinical setting. This study aims to evaluate the views of GP trainees participating in a teaching scheme piloted at the University of Manchester. This mixed-methods study was conducted over a three-year period. In years one and three, evaluation was undertaken using questionnaires comprising Likert scale items and free-text responses (n = 11). In the second year, qualitative data was collected via a focus group with GP trainees following their teaching experiences (n = 8). Subsequently, a thematic analysis was conducted. GP trainees reported benefits including improved clinical skills, job satisfaction and development of leadership skills. There was a noted impact on their teaching skills, as GP trainees demonstrated their ability to be adaptable to learners' needs and develop interactive, structured teaching sessions. The main challenges identified were organisation and time management, balancing responsibilities and adapting to student needs. Trainees unanimously felt the scheme allowed them to meet their portfolio requirements, develop their teaching skills and made them more likely to consider pursuing medical education as part of their future careers. All participants expressed a desire to continue with teaching and reported improved job satisfaction. Participation in a near-peer teaching scheme can have significant positive impacts on GP trainees' personal and professional development. Despite some challenges, trainees reported numerous benefits from undertaking the scheme. Formal teaching opportunities for GP trainees could contribute to the development of a skilled and motivated future workforce of clinician-educators in general practice.

Simulation-Based Mastery Learning in Medicine and Surgery.

Medical gaslighting is a significant barrier to care, and it contributes to delays in accurate diagnosis. Implicit bias is a factor in medical gaslighting, as is the absence or decline of caregiver empathy. Regeneration of skills such as empathy, listening, and creating psychological safety for patients is as important as maintaining more technical clinical skills. Patient advocacy is not possible if patients do not feel seen and heard.

The current expansion of Allied Health Profession training places in the UK presents significant challenges for clinical placement provision. Coaching and Peer-Assisted Learning (C-PAL) models have shown success in helping reduce placement pressure in nursing and midwifery, but there is limited evidence around how such approaches might inform traditionally one-to-one physiotherapy placements. Addressing a gap in C-PAL research, which has largely focused on nursing and midwifery, and on learner rather than educator experience, this exploratory qualitative study examined the experiences of Practice Educators (PEs) in implementing a C-PAL intervention during physiotherapy placements in one UK National Health Service trust. An exploratory qualitative study was conducted using semi-structured interviews and Reflexive Thematic Analysis. Ten PEs (seven female, three male; mean 9years PE experience) participated. All had experience of supervising learners in traditional placements. With institutional ethical approval, interviews were conducted online, recorded and transcribed. Four themes emerged: (1) 'Oversight and Management'-initial concerns about managing multiple learners diminished when PEs observed peer support creating effective self-monitoring mechanisms. (2) 'Teamworking and Learning'-a shift emerged from direct teaching to facilitating peer learning, with the collaborative environment viewed as accelerating professional development. (3) 'Patient Contact'-increased therapeutic contact time and continuity of care were highlighted, though direct supervision of clinical skills was more challenging. (4) 'Collaborative Working and Support Networks'-the intervention facilitated collaborative relationships, though required additional administrative effort. Participants found that C-PAL offered a promising alternative to traditional physiotherapy placement supervision, potentially addressing educational capacity challenges while promoting greater learner autonomy and interdisciplinary skills. They also highlighted complex challenges emerging from managing multiple learners across locations and coordinating with colleagues. Preliminary findings suggest that C-PAL approaches may offer potential for expanding placement capacity while maintaining educational quality, though this warrants investigation across a wider range of clinical contexts. Sufficient preparation time, clear role delineation, and educator development focused on facilitation skills are likely to be important enabling conditions.

Nursing students need to be equipped with effective clinical skills to prevent ventilator-associated pneumonia (VAP) in high-risk patients in intensive care units. The study aimed to determine the effectiveness of scenario-based simulation training in developing knowledge and skills for the prevention of VAP in undergraduate nursing students. A single-group, pretest-posttest quasi-experimental study was conducted with undergraduate nursing students enrolled in an intensive care course. Scenario-based simulations and a VAP Prevention Performance Checklist were prepared for the study. The students' skill performance was assessed simultaneously by two independent observers before and after the simulation training. Pretest and posttest scores were compared with Wilcoxon, McNemar and McNemar-Bowker tests, and interrater agreement was assessed using intraclass correlation coefficients (ICC). In total, 36 students participated in the study. The content validity of the VAP Prevention Performance Checklist was assessed using the Delphi method, which resulted in expert consensus for all items in the second round (the scale-level content validity index was 1.00). There was excellent interrater agreement in the skill performance assessment (ICC = 0.982; p < 0.001). The students' VAP prevention performance scores were significantly higher in the posttest than in the pretest (38.38 ± 7.81 vs. 18.38 ± 5.06, p = 0.002, Cohen's d = 1.25). Scenario-based simulation training was shown to be effective in increasing nursing students' awareness and implementation of skills that contribute to the prevention of VAP. Scenario-based simulations can be used as an effective method to improve VAP prevention knowledge and skills during undergraduate nursing education and in-service training. Scenario-based simulations can be used as an effective method to improve VAP prevention knowledge and skills during undergraduate nursing education and in-service training.

At the start of their professions, trainees pursuing bachelor's degrees in medicine and surgery participate in a long program that constitutes mainstream medical education. The practicalities surrounding anatomical study, whether by dissection, using cadaveric specimens, or prosection, is essential. However, it requires infrastructure and enough specimens, amongst other paraphernalia, making it challenging to teach effectively in low-resource settings. This narrative review explores the importance of anatomy dissection courses for undergraduate students at the University of Rwanda and how its influences support early career involvement. Unrestricted search was conducted in Google Scholar and PubMed/MEDLINE and other online databases. This focused-on anatomy education and dissection courses for undergraduate students. The significance of utilizing the clinical skills learned of undergraduate students whilst boosting self-confidence to become future successful surgeons. Additionally, the research abilities exhibited by undergraduate students were utilized to enhance their professional development and gain knowledge of anatomical variations when writing case reports. Moreover, various obstacles coincide with the pursuit of anatomical study in Rwanda that affects students enrolling in such anatomy dissection classes. These comprise a dearth of undergraduate students, poor infrastructure of standard laboratories, and insufficient numbers of cadavers. Since there is currently evidence that early involvement has a favorable impact on a student's career, we should discover methods to include medical students in dissection courses.

Objective structured clinical examinations (OSCEs) provide a robust assessment of veterinary clinical skills competency and are often used for high-stakes examinations. For students with disabilities, OSCEs can pose challenges that may impact their ability to demonstrate their competency compared with non-disabled peers, resulting in attainment gaps. Reasonable adjustments (RAs) aim to address this problem by providing supportive interventions that allow disabled students to demonstrate their full potential in the exam, creating an equitable assessment. When providing RAs, institutions can tailor these to the individual student using a "medical model approach" or design their OSCEs to be equally accessible for disabled and non-disabled students using a "universal design approach." This article explores challenges and potential solutions to implementing RAs including additional time in OSCEs, using current evidence for both of these approaches while considering students with varied physical, sensory, processing, and anxiety needs. Due to the diverse needs of these students, current best practice is to use a blend of universal design and medical model RAs to optimize specific needs for individuals while simultaneously supporting all students, including those with undiagnosed or undeclared disabilities. The effectiveness of this approach can be monitored by looking for closure of any attainment gaps, as well as through perceived student experience of fairness in the exam. Clear communication between the institution and students regarding what is being implemented/offered, and why, is key to developing an open dialogue and inclusive culture to support fair and equitable assessment outcomes for all students.

Redefining Graduation Competency for Clinical Skills Assessment: A Conceptual Proposal Originating From Periodontal Education.

Low-income settings such as Uganda bear a disproportionately high burden of diseases such as HIV/AIDS, but contribute little to knowledge production to address their health challenges. The training of health professionals traditionally focuses on clinical skills with less emphasis on research; yet, in practice, health professionals are expected to do operational research. In this study, we evaluate the impact of a micro-research model on building the capacity of undergraduate health professions students to conduct locally relevant biomedical, behavioral, clinical, and operations research on HIV and its co-morbidities. This study was within the Health Professional Education Partnership Initiative - Transforming Ugandan Institutions Training Against HIV/AIDS (HEPI-TUITAH; 2018-2024), using a sequential explanatory mixed methods design. We collected quantitative data on sociodemographic, number of trainings, concepts and written manuscripts. Thereafter, we conducted in-depth interviews and analyzed them using a thematic content approach. We used the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to evaluate the impact (number trainings, protocols written, manuscripts written, publications, and change in attitudes) of the HEPI-TUITAH micro-research model. Of the 24 participants that were interviewed, 15 (62.5%) were male, aged 24-63 years (mean age, 35.3 years). Despite the challenges associated with the COVID-19 risk management measures, 41 (57%) out of the expected 72 manuscripts were published. Most participants expressed satisfaction with the recruitment process and the opportunities provided by the program. The process was described as transparent, competitive, and inclusive, allowing participation of multiple disciplines within the health professions training domains. The multi-disciplinary approach to team formation enriched the research process by leveraging diverse perspectives and expertise. Our data show that effective mentorship was a key driver of program success, facilitating skill development, fostering strong relationships, and ultimately contributing to the advancement of both mentees and mentors in their academic and professional pursuits. Training and mentorship sessions encompassed proposal development and manuscript writing. There was a general positive outlook regarding the sustainability at participating institutions. The micro-research model is a successful model for building research capacity for undergraduate health professions students. This model is highly recommended for integration into curricula for health professions programs.

Peer teaching is an established pedagogical approach in medical education; yet, traditional methods face challenges including inconsistent knowledge support, variable teaching quality, and limited scalability. Artificial intelligence (AI) large language models offer potential to augment peer teaching by providing on-demand access to medical knowledge and clinical reasoning support. However, AI integration within structured peer teaching has not been systematically evaluated in clinical education. This study aims to evaluate the effectiveness of AI-assisted peer teaching compared to traditional peer teaching in orthopedic clinical education, with respect to knowledge acquisition, clinical skills development (particularly clinical reasoning), student engagement, and 3-month knowledge retention. This historical cohort study compared 2 consecutive cohorts of medical students (aged 20-27 years, 108/190, 56.8% male) at the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. All eligible students from each cohort were enrolled. The control group (2021 cohort, n=96, taught in 2024) received traditional peer teaching; the intervention group (2022 cohort, n=94, taught in 2025) received AI-assisted peer teaching with access to DeepSeek-V3. Primary outcomes were assessed using a validated 50-item multiple-choice examination (0-100 points) and a 4-station Objective Structured Clinical Examination (OSCE; 0-100 points) with standardized rubrics (intraclass correlation coefficient>0.85). Secondary outcomes included student engagement and satisfaction (5-point Likert scales) and AI usage metrics. Assessments were conducted at baseline, postintervention (8 weeks), and 3-month follow-up. Analysis of covariance adjusted for baseline knowledge, prior AI experience, and learning interest to address observed baseline imbalances. Using independent samples t tests (α=.05, 2-tailed), the AI-assisted group demonstrated significantly higher postintervention knowledge scores (mean 79.69, SD 8.41 vs mean 75.33, SD 9.26; mean difference=4.36, 95% CI 1.84-6.87; P<.001; Cohen d=0.49). OSCE total scores were significantly higher (mean 80.95, SD 7.57 vs mean 76.24, SD 9.23; mean difference=4.71, 95% CI 2.31-7.11; P<.001; d=0.56), with clinical reasoning showing the largest effect (mean difference=2.22, 95% CI 1.18-3.25; P<.001; d=0.61). Analysis of covariance adjusted results remained significant for all primary outcomes (adjusted knowledge difference=3.52, P=.002; adjusted OSCE difference=4.52, P<.001). At 3-month follow-up (174/190, 91.6%), the AI-assisted group maintained higher knowledge scores (mean 77.36, SD 8.60 vs mean 72.84, SD 10.42; mean difference=4.52, 95% CI 1.68-7.36; P=.002; d=0.47), with similar knowledge decay rates between groups. This study provides the first systematic evidence that integrating AI tools within structured peer teaching enhances orthopedic clinical education across multiple domains, including knowledge acquisition, OSCE performance, and student engagement. Unlike prior studies examining AI as a stand-alone learning tool, this work demonstrates the synergistic potential of combining AI knowledge support with peer teaching's social learning benefits, with particularly strong effects on clinical reasoning. These findings support scalable, cost-effective implementation of AI-augmented peer teaching, though randomized controlled trials are needed to confirm causality and determine optimal implementation strategies.

Virga and the future of motivational interviewing: Issues in training counseling skills.

Abstract Background Improving the quality of maternity care is essential for reducing maternal mortality. However, gaps in confidence in using clinical skills may affect the quality of maternity care in low-resource settings. This study aimed to assess the status of maternity care practice and confidence in skill use among maternity care providers (hereafter referred to as healthcare professionals) in Dhading district, Nepal, and identify associated factors. Methods We conducted a quantitative cross-sectional study using self-administered questionnaires distributed to 129 healthcare professionals working in 62 health facilities for childbirth in Dhading district, Nepal. The collected information included maternity care experience, training and technical support, and maternity care practice and confidence. Multiple linear regression analysis was used to identify factors associated with confidence in maternity care practice. Results Participants reported relatively high confidence in managing postpartum hemorrhage and eclampsia but lower confidence in abnormal and advanced procedures, with the lowest median confidence scores observed for vacuum extraction and manual vacuum aspiration. Higher confidence was significantly associated with Skilled Birth Attendant (SBA) training attendance, higher total score for maternity care provided within the past 3 months, and better understanding of national maternal and newborn health (MNH) strategies/programs. Conclusions Low confidence was linked to limited Skilled Health Personnel/SBA training, scarce recent experience with high‑risk cases, and weak understanding of national MNH strategies. In low‑volume districts like Dhading, strengthening routine SBA training, providing structured rotations, and integrating simulation‑based training, particularly for high‑urgency emergency skills, may help build confidence and improve maternal care quality.

BackgroundThe number of 1-year Accreditation Council for Graduate Medical Education (ACGME) fellowships continues to grow. The ACGME recommends a holistic curriculum with nonclinical areas, inclusive of educational sessions. Given the competing demands between clinical skill development, educational pursuits, and work-hour restrictions, we propose an andragogic curriculum using pediatric anesthesiology as the model fellowship.ObjectiveThe primary objective was to improve fellows’ perceptions of their educational experience during their fellowship year after implementing an andragogic holistic curriculum. Secondary objectives assessed improvements in diversity, equity, and inclusion (DEI) training and resources.MethodsThis was a single-center educational improvement project completed at Lucile Packard Children’s Hospital Stanford. Data were collected between 2014 and 2024. The new curriculum was introduced in 2021‐2022 and involved 12 different teaching modalities rooted in andragogic principles. A statistical process control p-chart was used to analyze the primary outcome based on the ACGME annual program evaluation. Outcomes were analyzed using censored regression modeling or a t test, depending on the presence of ceiling effects.ResultsFrom 2014 to 2024, 58 of 60 pediatric anesthesiology fellows completed the ACGME survey. A break in the statistical process control p-chart for educational content scores occurred during 2021‐2022, when the new curriculum was introduced. The mean difference was 0.89 (P<.001). Scores in DEI improved (mean difference 0.52; P=.03), and no difference was noted in resources (mean difference −0.13; P=.98).ConclusionsIntroduction of an andragogic curriculum into a pediatric anesthesiology fellowship program was associated with more favorable perceptions of educational content and DEI training.

The rapid expansion of telemedicine has increased the relevance of teleconsultations in everyday clinical practice. However, the manner in which teleconsultation competencies are conceptualized, taught, and assessed in undergraduate medical education remains unclear. A narrative review was conducted using a transparent methodology to identify and select studies. Several bibliographic databases were searched using predefined eligibility criteria, focusing on educational interventions that specifically targeted teleconsultation competencies among undergraduate medical students. The selection process emphasized conceptual clarity, curricular intent, and the inclusion of empirically reported educational outcomes. The eligibility criteria were intentionally designed to identify studies that explicitly conceptualized teleconsultation as a distinct undergraduate clinical competency. The search process yielded 199 records. After screening and comprehensive full-text evaluation, only one study explicitly conceptualized teleconsultation as a distinct undergraduate clinical competency and met all predefined eligibility criteria. This study details a structured educational intervention that frames teleconsultation as a distinct clinical competency. The outcomes concerning communication, clinical reasoning in virtual environments, technical aspects of teleconsultation, and components of remote physical examination were reported. The principal finding was the identification of substantial evidence gaps in the conceptualization, assessment, and longitudinal teaching of teleconsultation competencies. Current evidence regarding the instruction of teleconsultation competencies in undergraduate medical education is limited. The prevailing literature addresses telemedicine primarily as a mode of care delivery rather than emphasizing teleconsultation as a distinct clinical skill. These observations highlight a discrepancy between contemporary clinical practice and undergraduate training, emphasizing the need for well-defined educational frameworks that incorporate teleconsultation competencies.