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.

Family Nurse Practitioner (FNP) programs often lack structured preclinical competency verification, which delays identification of learning needs and creates patient safety risks. Although registered nurses demonstrate sophisticated clinical judgment within team-based practice, FNP practice demands autonomous diagnostic reasoning, generating differential diagnoses and formulating management plans. This shift requires intentional educational support through formative assessment. At one Western United States public university FNP program, students entered practicum without standardized preclinical evaluation. Faculty observed wide variation in preparedness, from overconfidence to hesitation. This single-cohort, mixed methods pilot educational program evaluation implemented a formative preclinical Objective Structured Clinical Examination for 12 FNP students to evaluate confidence in primary care assessment and diagnostic reasoning while exploring curriculum integration feasibility. Students rated confidence using the Simulation Effectiveness Tool-Modified; faculty used the Lasater Clinical Judgment Rubric. Structured debriefings and surveys captured qualitative data. Two 30-minute standardized patient encounters, an adult and pediatric wellness visits incorporating anemia recognition, followed International Nursing Association for Clinical Simulation and Learning standards. Prebriefing, encounters, documentation, and debriefing integrated Kolb's experiential learning and Tanner's clinical judgment frameworks. Students reported moderate confidence in primary care assessment (M = 2.32) and diagnostic reasoning (M = 2.26), with lower confidence in clinical decision making (M = 1.70). Faculty ratings paralleled student self-assessments: highest in noticing (M = 2.7), lowest in reflecting (M = 2.0). Students (M = 3.90) and faculty (M = 4.89) rated the Objective Structured Clinical Examination as educationally valuable and appropriate; however, faculty expressed sustainability concerns (M = 2.44). The preclinical Objective Structured Clinical Examination provided structured opportunity for diagnostic reasoning practice and identification of learning needs before practicum entry, demonstrating feasibility within competency-based FNP education.

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.

Simulated medical scenarios are useful for evaluating and developing clinical competencies but scheduling them is expensive and time-consuming. Large language models show promise in role-playing tasks. We investigated the fidelity with which ChatGPT can mimic patients, clinicians and examiners in educational settings. To determine the realism with which ChatGPT can portray patient, doctor and examiner roles, and the utility of these agents in clinical education. We selected four paediatric scenarios from mock objective structured clinical examinations (OSCEs) and set up separate patient, doctor and examiner ChatGPT agents for each. The patient and doctor agents conversed with each other in written format. The examiner agent marked the doctor agent based on this conversation. Patients and clinicians familiar with the OSCE assessed the dialogues. The patient agent was judged to be true to character most of the time and good at expressing emotion. The doctor agent was reported to be an effective communicator but occasionally used jargon. Both agents tended to produce repetitive responses which undermined realism. The examiner agent had good correlation with human clinicians. There was moderate support for using the simulated interactions for educational purposes. Although the realism of the agents can be improved, ChatGPT can generate plausible proxies of participants in medical scenarios and could be useful for complementing standardised patient-based training.

Effective physician-patient communication is essential for high-quality medical care. However, digital transformation and the increasing use of tools based on artificial intelligence (AI) require new competencies that are not yet systematically integrated into medical curricula. Blended learning formats may offer a promising approach to addressing both patient-centered and technology-related communication skills. In this pilot study, sixth- and eighth-semester medical students (n = 6) participated in an NKLM-based blended learning elective course. The course combined H5P online modules on narrative and AI-related communication with face-to-face sessions involving standardized patients and structured feedback. A mixed-methods evaluation was conducted to assess feasibility and explore learning outcomes. This included a pre-post questionnaire assessing subjective competence gains and an objective structured clinical examination (OSCE) comparing intervention participants with a control group. The blended learning format was successfully implemented and completed by participating students. Pre-post analyses showed increases across all assessed domains, with larger absolute gains in competencies related to digital innovations than in narrative communication skills. In the OSCE, communication competencies were generally demonstrated across both groups, with the largest performance differences observed in AI-related counselling tasks and consultation closing. This pilot study supports the feasibility and acceptability of the integrated blended learning course. Exploratory findings suggest potential benefits for both narrative and digital communication competencies, with the strongest gains observed in digital communication competencies. These findings highlight the need to integrate AI- and technology-related communication skills more systematically into medical curricula. Given the exploratory design and small sample size, results should be interpreted as hypothesis-generating.

While large language models (LLMs) have shown promise in diagnostic dialogue1, their capabilities for effective management reasoning-including disease progression, therapeutic response, and safe medication prescription-remain under-explored. We advance the previously demonstrated diagnostic capabilities of the Articulate Medical Intelligence Explorer (AMIE)1-3 through a new LLM-based agentic system optimized for multi-visit clinical management and dialogue. To ground its reasoning in authoritative clinical knowledge, AMIE leverages Gemini's long-context capabilities4, combining in-context retrieval with structured reasoning to align its output with up-to-date clinical practice guidelines and drug formularies. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) study, AMIE was compared to 21 primary care physicians (PCPs) across 100 multi-visit case scenarios designed to reflect UK NICE Guidance and BMJ Best Practice guidelines. AMIE was non-inferior to PCPs in management reasoning as assessed by specialists and scored better in both preciseness of treatments and investigations, and in its alignment with and grounding in clinical guidelines. To benchmark medication reasoning, we developed RxQA, a multiple-choice question benchmark derived from two national drug formularies (US, UK) and validated by board-certified pharmacists. Though AMIE and PCPs both benefited from the ability to access external drug information, AMIE outperformed PCPs on higher difficulty questions. While further research would be needed before real-world translation, AMIE's strong performance across evaluations marks a significant step towards conversational AI as a tool in disease management.

Emergency trauma care in the "golden hour" can reduce the fatality rates by 20%-50%. Imparting trauma care training in the undergraduate Indian medical graduate curriculum can prepare graduates as first responders for both prehospital and hospital setup management. However, teaching these skills for managing acute traumas in a competency-based medical education curriculum is challenging. These skills can be taught on a standardized patient (SP), allowing the learner to achieve higher clinical competency and better communication skills. However, since SP availability is limited, a video demonstration (VD) of such skills is an easy and reliable teaching-learning method. This study aims to evaluate the effectiveness of using an SP vs VD for teaching psychomotor skills to undergraduate students in the management of spinal injury. A prospective interventional comparative study was performed in the orthopedics department of a teaching hospital from September 2024 to February 2025, with institutional ethics committee approval. Thirty undergraduate students posted in the orthopedics department were divided into 2 groups (15 each) based on their even and odd roll numbers (systematic sampling). One group was shown a VD of the skills like application of an improvised cervical collar and log rolling maneuver for the management of a patient with spinal injury in a primary setting, while the other group was taught on an SP. The students were assessed by an objective structured clinical examination (OSCE), and maneuvers were performed on mannequins. Pretest and posttest evaluations with peer-validated questionnaires along with students' feedbacks were obtained. The data were analyzed using unpaired 2-sided t test for OSCE scores and paired 2-sided t test for pretest and posttest scores with statistical significance set at P<.05 (95% CI). Student feedback questionnaires based on a 5-point Likert scale were evaluated. The mean OSCE scores obtained by the VD group (15.47) were significantly different from those obtained by the SP group (18.27) (P=.004). However, the mean OSCE scores obtained in individual skill demonstration stations for log rolling maneuver and cervical spine immobilization of the VD group were 2.27 and 3.20 and those of the SP group were 2.33 and 3.27, respectively. This difference was not significant (P=.74 and .79, respectively). The student feedback showed that teaching with an SP was marginally more interesting and effective, giving them more confidence to apply these skills in a primary setting. Both VD and SP methods are equally effective for teaching lifesaving psychomotor skills for the management of spinal injury. However, SP group students had better student engagement. Hence, a blended approach, where VD is used to teach large groups or can be given to students prior to the sessions, followed by teaching or assessing on SPs for application of these skills will lead to optimum results and save time.

Construction and evaluation of an OSCE-based standardized training model for outpatient pharmacists: A single-center study.

Script Concordance Tests (SCT) are widely used to assess clinical reasoning in medical education, but their use in high-stakes examinations raises concerns related to ambiguity, reliance on expert panels, and limited acceptability among students. To address these issues, we developed the Probabilistic Reasoning Test (PRT), a simplified format designed to assess normative probabilistic reasoning within clinical scenarios using a single predetermined correct answer and a three-point response scale. We conducted a study including fifth-year medical students, pediatric residents, and pediatricians. Participants completed matched triads of SCT, PRT, and multiple-choice questions (MCQs) based on identical clinical scenarios. Student Objective Structured Clinical Examination (OSCE) scores were collected. Outcomes included concordance between SCT and PRT responses, internal consistency, relations with other assessment modalities, score interpretation across experience levels, and participant acceptability. A total of 575 participants were analyzed (538 students, 19 residents, 18 pediatricians). Concordance between SCT and PRT responses was high (agreement 91.4%, weighted κ = 0.91). Internal consistency was modest and similar for both formats (Cronbach's α = 0.63 for PRT; 0.62 for SCT). PRT scores correlated strongly with SCT, moderately with MCQs, and weakly with OSCE scores (p < 0.05). Unlike SCT, PRT did not significantly discriminate between levels of clinical experience. Satisfaction was consistently higher for PRT, with 90% of participants preferring it over SCT for examinations. The PRT showed strong directional concordance with SCT and higher acceptability in undergraduate settings but limited differentiation across experience levels. It may represent a pragmatic candidate format for undergraduate summative assessment of normative probabilistic reasoning.

Introduction Effective clinical communication is a core competency in dental education, yet traditional teaching methods often fail to provide authentic, repeatable practice with immediate feedback. Artificial intelligence (AI)-based virtual patients offer a promising alternative, but evidence in dental education remains limited. This study evaluated the effectiveness of an AI virtual patient system for developing clinical communication skills in dental undergraduates. Methods A prospective, single-blind, randomized controlled trial was conducted with 60 fourth-year dental students randomly allocated to an intervention group (n = 30) using an AI virtual patient system for 8 weeks of self-directed inquiry training or a control group (n = 30) receiving traditional peer role-play training. Outcomes included Objective Structured Clinical Examination (OSCE) assessments of inquiry completeness and communication skills, Jefferson Scale of Empathy (JSE) scores, and self-reported learning motivation and clinical confidence. Assessments were conducted at baseline, immediately post-intervention, and at 3-month follow-up. Semi-structured interviews with 12 intervention participants provided qualitative insights into learning experiences. Results The intervention group demonstrated significantly higher OSCE inquiry completeness (86.4 ± 5.2 vs. 73.8 ± 6.1, p < 0.01), communication skills (89.1 ± 4.8 vs. 76.3 ± 5.9, p < 0.01), and self-reported empathic orientation (JSE scores: 112.4 ± 8.3 vs. 103.7 ± 9.2, p < 0.05) post-intervention, with effects sustained at 3 months. Learning motivation and clinical confidence were also significantly higher in the intervention group (p < 0.05). Qualitative analysis revealed that AI training fostered deliberate practice, reduced communication anxiety, and enhanced reflective learning through immediate feedback. Conclusion An AI-mediated training package, integrating structured practice with automated feedback, effectively enhances dental students’ clinical communication skills, self-reported empathic orientation, and learning motivation, with effects sustained at 3 months. This approach, which integrates established learning theories into a scalable digital format, may help address longstanding challenges in communication training and offers particular value for competency-based curricula and resource-constrained settings. Practice points AI-based virtual patient training significantly improves dental students’ clinical communication skills compared to traditional peer role-play. The immediate, objective feedback from AI systems fosters deliberate practice and reflective learning. AI training enhances student self-reported empathic orientation and learning motivation, with educational gains sustained at 3-month follow-up. This scalable approach offers a practical solution for communication training, particularly in resource-constrained settings.

Reliable hygienic hand-disinfection is essential for infection prevention and control. It remains unclear whether a short VR training module improves objectively assessed procedural performance compared with conventional instruction. This single-center, parallel-group randomized controlled trial examined first-opportunity hand-disinfection performance in an Objective Structured Clinical Examination (OSCE) after VR training versus a video control. In 2025, first-year nursing students at a single Austrian University of Applied Sciences were randomized (1:1) to a 20-minute VR training module with contamination visualization feedback or a time- and headset-matched instructional video control without interactivity. Randomization used block allocation (blocks of six); instructions were standardized via audio playback. Three days later, students completed a routine five-station OSCE. Hygienic hand-disinfection was required at the beginning of each of five OSCE stations and was documented within routine station checklists. Hand-disinfection ratings from the five stations were extracted from routine OSCE checklists and coded (0 = incorrect, 1 = partially correct, 2 = correct). The preregistered primary endpoint was station 1 performance. The primary hypothesis was tested with adjusted proportional-odds regression, adjusting for age, gender, and prior hygiene-course grade as a baseline indicator of hygiene-related academic performance; all other analyses were exploratory. Of 128 randomized students (VR n = 65; control n = 63), all had available station 1 hand-disinfection scores, which constituted the primary outcome. One value was missing for the prior hygiene-course grade covariate, yielding N = 127 for adjusted models. At station 1, fully correct performance occurred in 52/65 (80.0%) in VR versus 15/63 (23.8%) in control. VR training was associated with markedly better first-opportunity performance (adjusted OR = 11.16, 95% CI [4.95, 25.14], p = 5.9 × 10- 9), supported by a binary pass/fail sensitivity analysis (adjusted OR = 6.06, 95% CI [1.84, 19.92]). Exploratory analyses suggested higher performance across stations, with group differences varying by station. No harms or adverse events were observed during the trial. A short VR training module for hand-disinfection with contamination visualization was associated with better first-opportunity OSCE hand-disinfection performance compared with a headset-delivered instructional video control. This suggests that short, feedback-rich VR training may support immediate procedural readiness under standardized assessment conditions. This study was preregistered within a larger longitudinal project and later registered as a stand-alone study in the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/3B6SC). Not applicable.

Pre-hospital obstetric emergencies are unpredictable and time-sensitive, requiring competent and well-trained emergency personnel. Limited preparedness in managing such events can lead to preventable maternal and neonatal complications. This study aimed to investigate the knowledge and clinical skills of pre-hospital emergency personnel in providing obstetric services, offering an integrated overview of the current state at the Tehran Emergency Center. This cross-sectional study was conducted in March 2022 at the Tehran Emergency Center. A total of 97 pre-hospital emergency personnel were selected through simple random sampling from the operational staff list. Data were collected using a self-reporting knowledge and clinical skill (SRKCS) questionnaire, a knowledge test, and four objective structured clinical examination (OSCE) checklists. Data were analyzed using SPSS version 26 with Pearson's correlation, independent t-test, repeated measures, and Kruskal-Wallis tests. Participants demonstrated moderate knowledge (mean ± SD = 46.6 ± 10.9%) and clinical skill levels (mean ± SD = 58.4 ± 8.7%). Among the OSCE stations, personnel performed best in managing cardiac arrest in pregnant women (mean ± SD = 83.2 ± 11.1%) and weakest in handling childbirth and postpartum hemorrhage (mean ± SD = 33.3 ± 14.0%). A significant positive correlation (P < 0.05) was observed between OSCE performance and both actual and self-reported knowledge and skill levels. The findings highlight critical gaps in pre-hospital readiness for obstetric emergencies, particularly in childbirth and postpartum bleeding management. Incorporating structured, simulation-based training and interdisciplinary collaboration with midwifery educators into emergency personnel education programs could substantially enhance preparedness and improve maternal outcomes in pre-hospital settings.

The objective structured clinical examination (OSCE) is a key method of assessing clinical competency in advanced practitioner education in the UK. Despite its widespread use, research exploring the perceptions of reliability and validity of the OSCE among student advanced practitioners is limited. A mixed-methods exploratory survey was distributed nationally to student advanced practitioners who had completed an OSCE assessment. Quantitative data were analysed using descriptive statistics, while qualitative data underwent inductive thematic analysis. Students generally perceive the OSCE as an appropriate assessment approach that provides valuable opportunities to demonstrate clinical skills. However, issues such as examination-related anxiety, variation in structure and assessor roles as well as limited realism of scenarios were identified. Preparation through formative OSCE, access to skills laboratories and peer support were critical to student confidence. Ethical concerns surrounding video recording without explicit consent were also raised. OSCEs remain a vital assessment tool in advanced practice education, yet improvements are needed to enhance realism, standardise structure, ensure ethical practice and better support students. Further research is recommended to examine the impact of formative OSCEs and alternative assessment models on student development. This article is the second of three; the first considered educators' views of using OSCEs and the third is to consolidate and provide an in-depth discussion of findings.

Artificial intelligence (AI) is rapidly reshaping clinical education by embedding assessment and feedback into everyday learning activities. Medical students can now use machine learning dashboards, generative AI, large language models, and emerging agentic systems to practice clinical reasoning, communication, and procedural skills while receiving individualized feedback within seconds. However, the availability of more data and more feedback does not necessarily produce better learning. This Viewpoint is intended for clinical educators, assessment leaders, curriculum committees, faculty developers, and institutional leaders who must decide how AI should be used in formative activities without reducing education to automated scoring. AI-assisted formative assessment is defined in this paper as the intentional use of AI tools to generate, organize, and support interpretation of performance information for learning rather than grading. Its distinctive contribution lies in the scale, adaptivity, conversational simulation, pattern detection, and possible autonomy of AI systems. However, AI outputs become formative only when learners and educators interpret them critically, judge their trustworthiness, and translate them into a small number of focused follow-on learning actions. This paper synthesizes the current evidence base while noting that much of it remains early, heterogeneous, and concentrated in short-term or single-setting studies. It examines key risks, including hallucination, automation bias, epistemic overtrust, hidden curricular effects, and broader concerns related to professional identity, power asymmetries, data privacy, and inequitable access. It also presents context-specific implementation examples for preclinical case-based learning, communication and objective structured clinical examination preparation, procedural skill laboratories, clerkship learning, and programmatic assessment portfolios, together with practical implications for faculty development, institutional governance, and phased local implementation. As a Viewpoint rather than an empirical study or systematic review, the framework and examples should be interpreted as evidence-informed design propositions that require local evaluation and validation. Overall, the value of AI-assisted formative assessment depends less on the volume of AI-generated feedback than on educational designs that preserve learner agency, professional judgment, and human accountability.

Background and aims The COVID-19 pandemic prompted an Australian osteopathy program to develop a hybrid face-to-face and digitally enabled objective structured clinical examination (OSCE) using videoconferencing for remote assessment. This study aimed to explore the opportunities and challenges associated with the hybrid OSCE. Methods and participants This pragmatic multiphase study evaluated reliability of asynchronous grading and explored participant perceptions using a survey. Ninety-one osteopathy learners undertook a summative assessment where synchronous grading (T1) occurred. Asynchronous grading (T2) was conducted 5 months later, total OSCE scores and individual criteria scores were compared. Analysis of correlation, agreement and test-retest reliability was performed to determine reliability. Survey data from 17 learners and three examiners were gathered using a modified Student Perceptions of e-Assessment Questionnaire (SPEAQ). Results Moderate agreement (κw = 0.45, p < .001) and strong correlation (r = 0.69, p < .001) between total scores was achieved. Statistically significant correlation was achieved on only five of the 16 station criteria (ρ = 0.41–0.44, p < .001) and both agreement and test-retest reliability were poor. This indicates total OSCE scores showed a consistent pattern between T1 and T2, although this consistency did not extend reliably to individual scoring criteria. Survey mean scores ranged from 3.75 to 4.84 (SD = 0.36–1.29) with the highest mean ratings being for affective, practicality and pedagogy domains. Conclusions Results indicate asynchronous video-based grading may be feasible, but reliability was not consistently demonstrated within the constraints of this study. Positive perceptions were reported by learners and examiners indicating the digitally enabled OSCE was acceptable and offered pedagogical benefits that were unique to the hybrid format.

Ultrasound is an essential educational tool for anatomy, physiology, diagnosis, and procedure in medical education. Various educational cases have been reported to date, yet novice experiences in non-traditional, resource-constrained contexts remain underexplored. This study explores Korean Medicine (KM) students' perceptions of introductory ultrasound education, learning experiences, and the process of learning transfer. We analysed students' learning portfolios from an introductory musculoskeletal ultrasound training program for KM students. Quantitative data included self-assessment of goal achievement, pre- and post-training self-efficacy, self-directed learning indicators, and objective structured clinical examination (OSCE) scores. Qualitative data comprised reflective narratives that were analysed using framework analysis and subsequently interpreted alongside quantitative data. Qualitative analysis identified four themes: "perceptions of the learning environment," "challenges and insights during training," "assessment and further learning," and "application and transfer." Correlation and multiple regression analyses showed that self-assessment, self-efficacy change, and self-video activity were not significantly associated with OSCE performance. Students valued instructor's supportive guidance and portable ultrasound practicality in the learning environment. Ultrasound skill acquisition enhanced equipment operation, probe proficiency, anatomical recognition, and diagnostic competency, leading students to reappraise ultrasound as "a real-time anatomical visualization and safe acupuncture guidance tool." Students' self-efficacy increased significantly after training (p < .001), primarily due to perceived improvements in performance speed and accuracy and greater confidence in procedural performance. Students' plans for further learning varied, from short-term practice to future certification acquisition. In terms of 'application and transfer,' they identified clinical barriers including insurance ineligibility, high equipment costs, and the limitations of portable devices. Musculoskeletal ultrasound training integrated into the KM curriculum may enhance students' self-efficacy and support the integration of anatomical knowledge with clinical application. Although no significant quantitative predictors of OSCE performance were identified, the findings suggest important pedagogical implications regarding novice students' cognitive load, self-assessment difficulties, and the potential role of structured feedback and longitudinal educational support in ultrasound learning. Future KM ultrasound education may benefit from more longitudinal and educationally integrated approaches that support the development and sustained application of ultrasound competency in resource-sensitive educational contexts.

BackgroundAmbient artificial intelligence (AI) scribes for chart documentation have seen rapid adoption in clinical practice, but their educational impact on medical students has not been described.ObjectiveThe purpose of this study was to determine the impact of an AI scribe on preclerkship medical student note writing.MethodsIn this prospective nonrandomized pretest-posttest study, all first-year medical students (N=104) at a single US medical school submitted “human-only” notes based on a summative objective structured clinical examination station in May 2025. An AI scribe generated independent AI notes after the objective structured clinical examination from recorded audio. A subgroup of students (n=47) consented to complete a second “hybrid” note by revisiting their human-only notes and incorporating AI notes as perceived necessary, followed by a brief survey about the AI notes. Trained, blinded fourth-year medical student raters were randomly assigned to score all notes on 10 elements using QNOTE acceptability criteria (0=“unacceptable,” 50=“partially acceptable,” and 100=“fully acceptable”). A post hoc, exploratory element-level review was then conducted.ResultsAcross all elements, median evaluation scores of human-only notes were high (range 81.3-100) and similar between students who submitted “hybrid” notes and those who did not. In paired analyses between “human-only” and “hybrid” notes, the only notable element-level change was a decline in “chief complaint” scores (P=.05). Symptom duration was mentioned in the chief complaint section in 17% (8/47) of the AI notes. No score differences were observed in QNOTE elements requiring documentation of pertinent findings and prioritized lists. Participants agreed that the AI note “was more concise than my note” (37/47, 78.7%) and would be “helpful as a first draft” (31/47, 66%); 55.3% (26/47) agreed that the AI note “left out important details,” and 21.3% (10/47) agreed that the AI note “may reduce my ability to learn how to write a good note.”ConclusionsInteraction with AI notes among preclerkship medical students had little impact on the quality of “hybrid” notes. Chief complaint scores likely declined due to conciseness in AI notes that often omitted symptom duration. Our findings suggest that, among students who predominantly wrote close to fully acceptable “human-only” notes, there was no detriment to clinical reasoning, and students were discerning in balancing AI’s conciseness and its omissions. The lack of impact on note quality may have been due to the workflow used in this study, in which students were required to generate independent judgments before exposure to AI-generated content. Future work must explore longitudinal use of such tools using standard workflows observed in clinical settings, where AI notes serve as true first drafts. AI scribes could enhance students’ own note writing, especially for lower-performing students, although educational safeguards are necessary given the potential for harm due to overreliance on automated systems.

Evaluating the Impact of an Orientation Program on General Surgery Junior Residents Using Objective Structured Clinical Examination (OSCE) Assessment Tool in a Tertiary Teaching Hospital in India.

Responding to experienced and anticipated discrimination training for health professionals working in mental health services (READ-MH): an international multisite pre-post mixed methods feasibility study

Development of a new competency-based comprehensive training program for vision screeners.