Clinical supervision is essential in promoting novice mental health providers' awareness of systemic and individual-level social injustices. Yet frameworks used by clinical supervisors often fall short of providing the needed skills to promote social justice. This is particularly problematic for the social work profession as it is set apart from sister professions by its primary commitment to promoting social change and empowering vulnerable populations. This integrative systematic review explores the extent to which social justice is addressed in clinical supervision and maps the approaches supervisors use to promote a social justice-informed practice paradigm across disciplines. The project included peer-reviewed cross-disciplinary literature published between 2010 and 2024 and followed the PRISMA guide. A SPIDER framework was used to determine the eligibility criteria of papers (N = 26) identified across four databases. Results indicate a scarcity of publications, particularly in social work-specific journals (N = 5), despite encouraging scholarship growth across disciplines. This review also shows that clinical supervision can provide the ideal space for the development of justice-informed praxis and identifies four main themes to guide supervisory approaches: (1) multicultural frames, (2) relational approaches, (3) structural oppression and injustices, and (4) critical/postmodern epistemologies. Recommendations for practice, research, and education are provided.

Pediatric hospital medicine (PHM) fellowship programs have rapidly expanded since their official designation for subspeciality certification. In this new landscape, we explore how PHM fellowship programs select and prepare attendings to work with fellows on hospital medicine teams. A national survey to explore current and ideal practices of PHM fellowship program directors (FPD) on attending preparation for fellow clinical supervision, including assessing interest for further faculty development. This survey was distributed to approximately 72 PHM FPD nationwide in February 2024. Fifty-one FPD responded to the entirety of the survey (71% response rate). Many fellowship programs reported providing training preparation materials to attendings who work with fellows (94%), and fewer programs consistently provided learner handoff (31%). FPD reported that the fewest faculty were perceived as being very capable of ensuring that fellows had an appropriate level of autonomy on clinical service. They perceived the most important topic to be included in attending preparation as promoting fellow autonomy. Almost half of the programs were interested in preparation materials to assist a faculty development curriculum for fellow clinical supervision. There is a wide range of practices in how PHM FPD prepare attendings to clinically supervise fellows. Many FPD reported interest in additional training materials to help prepare attendings in their program. Recognizing this national interest and understanding the most important topics for faculty development may help leaders in PHM fellowship programs further develop materials to ensure attendings are equipped with the skills to clinically supervise fellows.

Evaluating the concurrent validity and test-retest reliability of markerless motion capture for static postural control assessment.

From diagnostic labels to radiology reports: a unified multi-modal framework for lesion detection and segmentation

Infantile hemangiomas (IH) usually undergo spontaneous involution; however, some lesions remain visible after infancy and may cause psychosocial distress in children and their families. Evidence regarding the effectiveness of topical beta-blockers when treatment is initiated after infancy remains limited. This real-world study evaluated the efficacy of topical timolol therapy in children aged 1-5years with persistent IH. Children with IH were evaluated at a specialized vascular anomalies center in Ukraine between 2019 and 2024. Parents of children older than 1year with persistent visible IH associated with psychosocial distress were offered vascular laser therapy or topical timolol treatment. Because topical therapy could be administered safely at home under remote medical supervision during ongoing military action, all families chose this option. A short initial treatment period of 2-4weeks was used to assess the therapeutic response, and treatment was continued if improvement was observed. A total of 2419 children with IH were evaluated during the study period. Among them, 1287 patients used topical timolol as monotherapy. Treatment was initiated after the age of 1year in 113 patients with persistent lesions. Positive outcomes were observed in 1151 (98.04%) patients who started therapy before the age of 1year and in 78 (69.03%) patients who initiated treatment between 1 and 5years of age (p < 0.001). Topical timolol 0.5% demonstrated limited effectiveness in older children, whereas switching to topical timolol 1% resulted in clinical improvement. In six patients previously treated with systemic beta-blockers, topical timolol remained effective even after systemic therapy had lost effectiveness. Natural involution of IHs may be partially responsible for the positive effect observed in some of our patients. These findings suggest that topical timolol 1% may provide clinically meaningful improvement in persistent IH beyond infancy and support telemedicine-based treatment when access to in-person care is limited.

Ketamine is increasingly prescribed in an off-label manner to treat psychiatric disorders, raising concerns about direct-to-consumer advertising and the proliferation of clinics offering ketamine for at-home use without direct medical supervision. We aimed to identify and characterize clinics advertising ketamine for psychiatric conditions online in the New York metropolitan area (New York, New Jersey, and Connecticut), with attention to advertising suggesting ketamine is prescribed for at-home use. In 2025, systematic web searches were conducted to identify clinics advertising prescription ketamine for psychiatric indications. Public-facing website content was reviewed to describe clinic characteristics: service delivery modality, clinician credentials, routes of administration, disorders treated, and advertising practices. A generalized linear model was used to delineate correlates of clinics advertising ketamine for at-home use. 233 clinics were located; 36.5% prescribed ketamine for at-home use. 51.5% listed a medical doctor as part of their team and 42.9% advertised oral ketamine. Depression was the most commonly listed disorder treated (94.0%) and 21.9% advertised ketamine to treat substance use disorder. In the multivariable model, advertising ketamine for at-home use was more common among clinics advertising oral ketamine (aPR = 4.10, 95% CI: 2.20-7.60) and less common among clinics listing a medical doctor (aPR = 0.54, 95% CI: 0.30-0.99). Over a third of clinics advertised ketamine for at-home use. A limitation is that we only focused on public-facing websites. Advertising practices and clinician representation suggest clinics may be advertising in a more consumer-oriented manner, underscoring the need for monitoring and clearer guidance to mitigate potential safety risks.

Junior pediatric surgeons often experience marked anxiety when undertaking independent on-call duties for the first time, largely due to limited clinical experience, high decision-making pressure, and heightened sensitivity to patient safety. Traditional lecture-based teaching models may be insufficient in preparing trainees for complex, dynamic, and high-risk on-call situations. This study aimed to investigate whether a precision teaching model combining emergency-oriented standardized patient simulation (SPS) with online case-based learning (CBL) could alleviate on-call-related anxiety and enhance self-perceived clinical competence among junior pediatric surgeons. This retrospective controlled study included junior pediatric surgeons enrolled in standardized residency training at Qilu Hospital of Shandong University who had not yet commenced independent on-call duties. Participants were assigned to an intervention or control group according to departmental teaching arrangements. The intervention group received SPS of emergency scenarios combined with structured online CBL, whereas the control group received traditional teaching primarily based on classroom lectures and routine clinical supervision. Primary outcomes included anxiety levels measured using the Self-Rating Anxiety Scale (SAS) and the Generalized Anxiety Disorder-7 (GAD-7). Secondary outcomes were assessed using the General Self-Efficacy Scale (GSES). Between-group comparisons were performed 1, 3, and 6 months after participants began independent on-call duties. A total of 25 participants were included (intervention group, n = 14; control group, n = 11). No significant differences were observed between groups in baseline demographic characteristics or anxiety scores. After the intervention, the intervention group demonstrated lower SAS and GAD-7 scores than the control group at early follow-up time points, particularly at 1 month after on-call initiation, indicating reduced anxiety levels. In addition, self-efficacy scores were significantly higher in the intervention group during the early post-on-call period. These findings suggest that the blended educational intervention had positive effects on reducing on-call-related anxiety and enhancing self-perceived clinical competence. SPS combined with online CBL may partially alleviate early on-call anxiety among junior pediatric surgeons and promote improvements in self-perceived clinical competence. This blended teaching model demonstrates good feasibility and potential for wider implementation as an educational strategy to improve on-call preparedness and psychological well-being in pediatric surgical training.

Background/Objectives: Type 1 diabetes mellitus (T1DM) in primary school children presents unique challenges due to developmental dependence on adults, limited self-care abilities, and the need for continuous medical supervision. These factors may adversely affect health-related quality of life (HRQoL), particularly in early educational settings. Although diabetes-specific HRQoL assessment is essential for comprehensive pediatric diabetes care, no validated Croatian language instrument has previously been available. This preliminary study aimed to evaluate the initial validity, reliability, and factor structure of the Croatian version of the Pediatric Quality of Life Inventory (PedsQL) 3.2 Diabetes Module. Methods: This cross-sectional preliminary study was conducted in a clinical pediatric diabetes care setting in Croatia and included 70 children with T1DM, aged 7–14 years, and their parents or caregivers, recruited using convenience sampling. HRQoL was assessed using the Croatian versions of the PedsQL 4.0 Generic Core Scales and the PedsQL 3.2 Diabetes Module, which was translated using a forward-backward translation procedure. Reliability was evaluated using Cronbach’s α and test–retest reliability using the intraclass correlation coefficient (ICC). Construct validity was examined using Spearman’s correlation analysis and exploratory factor analysis. Results: Children with T1DM reported higher overall HRQoL than parent proxy reports, except for the Diabetes symptoms scale of the PedsQL 3.2 Diabetes Module and the School functioning scale of the PedsQL 4.0 Generic Core Scales. Internal consistency was satisfactory across all scales (Cronbach’s α = 0.71–0.85). Spearman’s correlations between subscales and total scores were strong (ρ = 0.61–0.92). Test–retest reliability was excellent (ICC = 0.982–0.996). Exploratory factor analysis supported construct validity: Bartlett’s test of sphericity was significant for both child (χ2 = 1398.57, p &lt; 0.001) and parent reports (χ2 = 1302.74, p &lt; 0.001), and the Kaiser–Meyer–Olkin measure indicated acceptable sampling adequacy (child = 0.65; parent = 0.68). Extracted factors explained 66.30% of the variance in child reports and 61.80% in parent reports, with factor loadings ranging from 0.41 to 0.89 and 0.41 to 0.85, respectively. Conclusions: The Croatian version of the PedsQL 3.2 Diabetes Module is an initial valid, reliable, and feasible instrument for assessing diabetes-specific HRQoL in Croatian primary school children with T1DM. Its use may support systematic HRQoL monitoring and improve family-centered pediatric diabetes care.

Dental students experience high levels of stress, which may negatively affect wellbeing, learning and clinical performance. Although stress in dental education is well documented, fewer studies have explored students' perspectives alongside their views on educational practices using mixed-methods approaches. A mixed-methods cross-sectional study was conducted among third-, fourth- and fifth-year undergraduate dental students at an Australian dental school. A validated questionnaire assessed sociodemographic characteristics, perceived sources of stress, and satisfaction with educational practices. Quantitative data were analysed using non-parametric statistical tests and correlational analysis. Free-text responses were analysed using invivo coding and integrated with quantitative findings. Eighty students participated (response rate 62%). Examinations, managing complex treatment plans and fear of making mistakes on patients were the highest-rated stressors. Fourth-year students reported the highest overall stress, particularly related to clinical supervisory feedback. Stress was negatively correlated with satisfaction with educational practices (ρ = -0.26, p = 0.02). Qualitative findings reinforced the importance of assessments, clinical responsibility and supervisory support as key stress-related themes. Undergraduate dental students experience substantial stress, particularly during the transition to clinical training. Institutional factors, especially clinical supervision and feedback, appear to influence students' stress and educational experiences. Addressing these areas may support student wellbeing and optimise the clinical learning environment.

Objective: Despite the World Health Organization's 2002 call for competency-based sexology training worldwide, the Asia–Oceania region lacks a systematic overview of its professional education landscape. While Europe and North America have established mature certification systems, no integrated regional mapping has been conducted. Embedded in the World Association for Sexual Health (WAS) Professional Education in Sexology Committee (PES) global project, this study examines program characteristics, regulatory frameworks, and clinical-practice challenges across Australia, Taiwan, Mainland China, Hong Kong, and Malaysia. Methods: An explanatory sequential mixed-methods design was employed. The 2024 revised WAS-PES questionnaire was distributed via email and regional academic networks between March 2023 and June 2026. Sixteen valid program responses were analyzed using descriptive statistics and frequency distributions; six open-ended responses underwent reflexive thematic analysis. Results: Findings reveal a pronounced "high academia–low clinic" orientation: 75% of programs are university-based and 50% confer graduate degrees, yet only 31% require sexuality-focused clinical supervision. No surveyed jurisdiction reported a legally protected professional title of "sexologist," although Australia maintains voluntary accreditation through the Society of Australian Sexologists. Curricular emphases cluster around research (33%), education (27%), and clinical sexology (20%). Despite 88% of respondents acknowledging an urgent national need for clinical sexology training, substantial gaps persist in statutory credentialing and labor-market integration. Qualitative analysis identified four core challenges: supervision scarcity, a two-tier training need, regulatory invisibility, and cultural localization. Conclusions: As the first regional mapping of its kind, this study offers an empirical foundation for policy and curriculum reform. Recommendations include harmonizing curricular tiers across jurisdictions, mandating sexuality-focused clinical supervision, advocating for public-sector recognition of certified sexologists, and developing cross-national credentialing frameworks aligned with international standards.

The authors describe Nebraska's implementation of $25.5 million in State and Local Fiscal Recovery Funds of the American Rescue Plan Act through the Behavioral Health Education Center of Nebraska, a state-funded workforce center housed in an academic medical center. Funds were allocated across four workforce priorities: training and education, tele-behavioral health, COVID-19 workforce projects, and financial incentives for clinical supervision. Embedded program evaluation, technical assistance, and an equity-focused application review process enabled rapid administration, accountability, and statewide reach. The findings demonstrate how academic medical centers can translate one-time federal relief funding into coordinated, evidence-informed workforce efforts with long-term policy relevance.

This study aimed to cross-culturally adapt and gather validity evidence for two instruments-the Self-Regulated Learning Microanalytic Assessment (SRL-MA) and the Assessment of Reasoning Tool-Reconstructed (ART-R)-for assessing dental students' baseline self-regulated learning (SRL) skills and diagnostic reasoning performance during an authentic clinical task. In addition, it analyzed associations between baseline SRL skills and task performance, and explored SRL processes during diagnostic reasoning. A mixed-methods design was implemented with fourth-year dental students during surgery clinical activities. The SRL-MA captured students' task-specific planning, monitoring, and self-evaluation processes, while the ART-R assessed diagnostic reasoning across five domains. Cross-cultural adaptation procedures and multiple sources of validity evidence were examined for both instruments. Quantitative data were analyzed using descriptive statistics, Pearson correlations, paired-samples t-tests, and structural equation modeling, while open-ended responses were thematically analyzed. Forty-two students and eight clinical supervisors participated. Both adapted instruments supported valid interpretations and reliable measurement in this population. Task satisfaction showed the strongest association with post-task self-efficacy, while prioritization of differential diagnoses was significantly associated with global diagnostic reasoning performance. Qualitative findings revealed variability in students' SRL processes, including frequent use of non-specific strategies, limited strategic planning, and strong reliance on external cues, particularly supervisor feedback, to guide self-assessment. Both instruments provide complementary information on students' baseline SRL skills and diagnostic reasoning performance. Students' reliance on supervisor input and their limited use of specific self-regulatory strategies suggest the need to strengthen clinical supervision through faculty development focused on explicit SRL support during diagnostic reasoning tasks.

ABSTRACT Objective To examine Chinese supervisors’ and supervisees’ perceptions of using session transcripts in clinical supervision, including requirements, practices, benefits, and challenges, and to consider implications for supervision elsewhere. Method Semi-structured interviews were conducted with 11 supervisors and 16 supervisees from two Chinese counselling training programs. Supervisors averaged 13.5 years of counselling and 5.4 years of supervisory experience; supervisees averaged 108.1 hours of counselling experience. Data were analyzed using reflexive thematic analysis. Results Most supervisors (90.9%) required transcripts for every supervision session, usually from 15-minute therapy segments, often accompanied by recordings and reflections. Four major benefits emerged: direct access to therapy interactions, learning through transcription, more concrete supervisory feedback, and greater efficiency. Challenges included the time required, supervisee self-criticism and motivation difficulties, and limited capture of nonverbal communication. Speech-to-text technology was commonly used but raised concerns about data security. Conclusions Session transcripts provide important educational and supervisory benefits despite implementation challenges. Findings highlight the need for clear expectations, emotional support for supervisees, and attention to ethical issues in technology use, particularly when training novice therapists.

ABSTRACT In a Consensual Qualitative Research design, the authors explored Black doctoral psychology trainees’ experience with race and culture in individual and group supervision with Black and White supervisors. Nine students (six women, three men; mean age = 27 years, range = 24–30) were interviewed. Five themes emerged: I.) Concerns about a safe space to discuss race and racism, II.) Racial strategies of supervisors, III.) Avoidance of discussing racial issues by supervisors, IV.) Racial/Cultural competence of supervisors, and V.) A need for refuge – creating a Black space. Findings suggest that White supervisors must better address cultural and racism-related issues.

Exploring the clinical supervision that Black men trainees in psychology receive can illuminate whether these trainees are being prepared to provide culturally responsive clinical services to individuals and communities of color. However, there are limited studies on Black men's clinical supervision experiences, particularly those that are perceived as growth-promoting and attentive to racial issues. Using semistructured interviews from 27 Black men enrolled in counseling psychology doctoral programs, this study examined Black men's perceptions of growth-promoting, race-inclusive multicultural supervision that they received in their training. Findings revealed one overarching theme of race matters in supervision, with three subthemes of (a) identity congruence contributes to shared racial understanding, (b) supervisor's race and race-inclusive multicultural competence matter, and (c) overcoming cultural/racial mistrust. Regardless of the racial background of the supervisor, multiple themes were consistently identified in participants' descriptions of growth-promoting, race-inclusive multicultural supervision. These elements included (a) positive perceptions of race talk quality, (b) integration of supervisees' salient identities, (c) integration of supervisors' salient identities, and (d) connection to professional resources and opportunities. These findings suggest that there are specific strategies that clinical supervisors can implement when supervising Black men to enhance their race-inclusive multicultural competence. Implications for research and training are discussed to improve Black men's experiences in clinical settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BackgroundSelf-medication, defined as the use of medicines without prior professional consultation, is a widespread public health concern. When practiced inappropriately, particularly through the misuse of antibiotics, it contributes to adverse drug reactions and the growing threat of antimicrobial resistance (AMR). Medical students represent a population of particular interest, as their clinical knowledge may predispose them to self-treat conditions such as upper respiratory tract infections (URTIs), which are predominantly viral and self-limiting. This study aimed to assess the prevalence of self-medication for URTIs and to evaluate the knowledge, attitudes, and practices of clinical-phase medical students toward this behavior.MethodsA cross-sectional study was conducted among 165 clinical-phase MBBS students, including third-, fourth-, and fifth-year students and interns, selected by simple random sampling. Data were collected using a structured, self-administered questionnaire adapted from World Health Organization guidelines, covering sociodemographic characteristics and knowledge, attitudes, and practices regarding self-medication for URTIs. Statistical analysis was performed using SPSS version 25 and included descriptive statistics, chi-square tests, and correlation analyses, with statistical significance defined as p < 0.05.ResultsThe mean age of participants was 23.5 ± 2.25 years, with a nearly equal gender distribution. Three-quarters of students (74.5%) reported having self-medicated for URTIs, with community pharmacies serving as the primary source of medicines (71.5%). Only 21.2% of participants demonstrated good knowledge, while 54.5% showed moderate knowledge. Although 79.4% recognized the link between antibiotic misuse and AMR, 27.9% still believed antibiotics to be effective against viral URTIs, and 21.2% admitted to not completing prescribed antibiotic courses. Despite the majority (77.6%) holding negative attitudes toward self-medication in principle, unsafe practices remained prevalent. The year of study was significantly associated with both knowledge level and self-medication practices (p < 0.05).ConclusionSelf-medication for URTIs is highly prevalent among clinical-phase medical students, revealing a concerning disconnect between knowledge, attitudes, and actual clinical behavior. Addressing this gap will require reinforcing antimicrobial stewardship within medical curricula, strengthening clinical supervision, and implementing stricter regulation of over-the-counter antibiotic availability, all of which are essential steps toward promoting rational drug use and mitigating the escalation of antimicrobial resistance.

Nearly one in ten individuals in Switzerland receives antidepressant treatment, yet more than half discontinue it within six months, most often without medical supervision. Antidepressant discontinuation syndrome is a common but still underrecognized consequence of treatment interruption and is often mistaken for depressive relapse. Reported incidence rates vary widely in the literature (15-55%), reflecting considerable methodological heterogeneity across studies. A consensus nevertheless supports gradual, individualized, and often hyperbolic tapering strategies, adapted to the drug's half-life and the patient's clinical profile. Close clinical follow-up and clear patient information remain essential to ensure a safe and well-tolerated discontinuation process.

Relatively little is known about social workers in interprofessional primary healthcare (PHC) teams, despite social work being one of the largest health and social service professions. Understanding the experiences of social workers in PHC teams will help strengthen the integration of social workers in these settings. The research question guiding this study was: "What are the experiences of social workers working in interprofessional PHC teams in Ontario, Canada?" This was a descriptive qualitative study and the authors conducted focus groups with social workers embedded in PHC. Fifty-seven social workers participated in 10 focus groups that were recorded and transcribed verbatim. Thematic analysis guided an inductive analysis of the data. Seven themes in the data were identified: (1) social work is valued by the team, (2) social work enhances the team, (3) the pandemic disrupted team relationships, (4) team collaboration requires intention and opportunity, (5) lack of physical space, (6) limited influence on decision making, and (7) clinical supervision mitigates isolation. While social workers feel valued by their team members, opportunities to contribute to organizational decision making remain limited. Addressing the tacit hierarchies that facilitate these challenges through shared leadership practices or adoption of collaborative competency frameworks is recommended.

The purpose of this article is to identify promising technologies that can enhance core regional anesthesia training, competence, and global implementation, which will lead to both expansion in patient access and improvements in perioperative outcomes. Artificial intelligence software embedded in ultrasound equipment can now generate real-time anatomical overlays to assist nonexpert clinicians performing peripheral nerve blocks. Large language models offer scalable support for curriculum development and learner self-study but carry risks of fabricated content. Head-mounted virtual and augmented reality devices have facilitated procedural skill acquisition comparable to in-person instruction. Hybrid curricula combining online didactics with telementored clinical supervision have successfully introduced ultrasound-guided regional anesthesia in resource-limited settings, and emerging telementoring technologies, including remote video annotation and haptic feedback over high-bandwidth networks, are extending expert oversight across geographic boundaries. Emerging technologies in regional anesthesia education, paired with the curricular focus provided by the Plan A blocks framework, offer a pathway towards widespread, safe adoption of high-value regional techniques worldwide. Realizing this potential will require equitable access to technology, faculty trained in virtual instruction, and support for local champions in lower-resourced environments.

Background: The perioperative context is characterized by high complexity and a significant risk of adverse events, requiring highly developed technical and non-technical competencies. Structured clinical supervision has been identified as a relevant strategy for professional development and for promoting the quality and safety of care, although the specific evidence in this context remains dispersed. Objective: To analyze the available scientific evidence on the impact of structured clinical supervision on nurses' professional development and on the quality and safety of care delivered in the perioperative setting. Methods: A systematic literature review was conducted in accordance with PRISMA 2020 recommendations. The search was performed in the PubMed, Web of Science, EBSCO, SciELO, BVS, and CONSENSUS databases and included studies published between January 2020 and October 2025 in Portuguese, English, or Spanish with full-text availability. The research question was structured according to the PICO strategy. Study selection was carried out in multiple stages (duplicate removal, screening by title and abstract, and full-text review), performed by two independent reviewers. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklists. Data synthesis was conducted through thematic narrative analysis, given the methodological heterogeneity of the included studies. Results: Twelve studies were included, predominantly qualitative and observational in nature, as well as psychometric validation studies, one Delphi study, and one quasi-experimental study. The findings show consistent convergence regarding the association between structured clinical supervision and the development of technical and non-technical competencies, namely communication, leadership, teamwork, situational awareness, and decision-making. The use of structured assessment instruments demonstrated good psychometric reliability and improved the quality of supervisory feedback. Organizational factors, such as protected time, specific training for supervisors, and role clarification, were identified as determinants of the effectiveness of the supervisory process. However, the predominance of non-experimental designs and the scarcity of objective clinical outcomes limit direct causal inference between structured supervision and measurable reduction in adverse events. Conclusions: The available evidence suggests that structured clinical supervision is a relevant component for the professional development of perioperative nurses and for strengthening the safety culture in the operating room. Despite the high conceptual consistency of the findings, the overall strength of evidence is moderate, and experimental and longitudinal studies are needed to consolidate the impact of supervision on objective clinical indicators of care quality and safety.