Alzheimer's disease and related dementias (ADRDs) are prevalent conditions that are stressful and elevate emotional distress in couples after diagnosis. Without treatment, emotional distress may become chronic and negatively affect couples' quality of life. We report results from an NIH Stage 1A open pilot of Resilient Together for Dementia (RT-ADRD), a novel, dyadic, skills-based intervention aimed at preventing chronic emotional distress in couples early after diagnosis. We describe results from our mixed-methods single arm feasibility study, including preliminary feasibility and acceptability of the intervention, and qualitative feedback from exit interviews. We also present exploratory analyses for change in outcomes and mechanisms of action. Six couples (N = 12 individuals) were recruited within six months of ADRD diagnosis by their diagnosing providers. Participants completed baseline assessments, participated in weekly RT-ADRD sessions together, then completed post-intervention assessments and one 60-min exit interview together. RT-ADRD exceeded all a-priori feasibility and acceptability benchmarks (> 70%). Feedback from exit interviews suggested that participants had favorable impressions of the program and found the skills useful and relevant. Participants also offered perspectives on barriers and facilitators of engagement and program enhancement. In exploratory analyses, persons living with dementia exhibited significant reductions in perceived stress at post-intervention (p < .05; Cohens d > 0.8). Both persons living with dementia and their care partners exhibited statistically significant improvements in positive dyadic interactions measured by the Dyadic Relationship Scale (ps < .05); Cohens ds > 0.8). RT-ADRD shows promise as a feasible and acceptable dyadic intervention delivered early after diagnosis. Results support a future NIH Stage 1B trial of RT-ADRD to establish definitive feasibility markers of both intervention and control before formal efficacy testing. This open pilot was registered on ClinicalTrials.gov (NCT06421545) on 05/20/2024.

Studies suggest that 40% to 65% of stroke survivors develop chronic poststroke pain (CPSP), which severely affects their quality of life and mental health. Empirical evidence suggests that existing treatments often fall short, underscoring the need for innovative, integrative interventions. Virtual reality (VR) seems to provide valuable tools in stroke rehabilitation. Also, contextual-behavioral psychological approaches, such as acceptance and commitment therapy (ACT), offer promising pain management and mental health resources, which seem to be feasible in VR formats. However, their combined application in CPSP remains unexplored. This study protocol describes the VR-ACT study, which will test the feasibility and preliminary efficacy of an 8-week VR-ACT program for CPSP. This pilot randomized controlled trial (N=30) will compare a VR-based ACT intervention with a sham VR control. The study will follow a mixed methods approach. Quantitative outcomes include pain intensity, psychological symptoms, and quality of life (via self-report measures), and brain network connectivity of the Triple Network (via functional magnetic resonance imaging). Feasibility will be evaluated through adherence, engagement, and acceptability. Qualitative feedback will be collected postintervention. This study was funded by the Portuguese Foundation for Science and Technology in February 2025. Data collection is expected to start in December 2025 and end in June 2026. Results are expected to be published in the fall/winter of 2026/2027. This trial is expected to support the hypothesis that a VR-delivered ACT program is a feasible, acceptable, and potentially effective tool to support pain self-management and mental health in patients with CPSP, thereby laying the groundwork for larger multicenter trials.

Abstract Introduction Deconditioning remains a significant challenge for hospital inpatients, particularly the older patients. National campaigns such as ‘End PJ Paralysis’ and ‘Sit Up, Get Drssed, Keep Moving’ endorsed by the British Geriatrics Society, highlight the importance of maintaining mobility during hospital stays. We designed a QIP to raise awareness of deconditioning among nursing staff and resident doctors and to identify barriers preventing mobilisation. Method We conducted a QIP on a geriatric ward at Lincoln County Hospital, collecting quantitative data on the frequency of patients sitting out of bed, sitting up for meals, wearing appropriate footwear, and wearing their own clothes. Qualitative feedback was obtained through short interviews with nurses and healthcare assistants (HCAs) to explore reasons patients remained in bed. Patients receiving end-of-life care, those medically unwell (NEWS&amp;gt;5), or those with baseline immobility (i.e bed bound) were excluded. Following an initial cycle, teaching sessions were delivered to staff and resident doctors over two weeks before repeating data collection. Results In the first cycle, 69% of patients sat out of bed daily, 50% sat up for meals, 42% wore appropriate footwear, and 26% wore their own clothes. After staff education, the second cycle showed no significant improvement: 64% sat out of bed, 48% sat up for meals, 40% wore appropriate footwear, and 36%wore their own clothes. Barriers identified included patient factors (fatigue, lack of motivation and awareness), equipment shortages (e.g. recliner chairs), staffing pressures, and difficulty accessing personal clothing. Notably, some patients who could mobilise independently remained in bed. This showed that the risk of prolonged bedrest is even greater for those needs support. Conclusion Despite increased staff awareness, this QIP showed a neutral impact on outcomes, highlighting that education alone is insufficient. Multifactorial barriers, including patient factors, limited equipment, and staffing constraints, been identified and have to be addressed collectively to improve outcome.

Abstract Introduction The 2022 Geriatrics Medicine curriculum mandates that trainees demonstrate competence in leadership and management (1). The NHS Long Term Plan and Clinical Leadership Framework emphasise the need to develop clinical leaders capable of driving service improvement across the system (2, 3). However, structured leadership and Quality Improvement (QI) training within higher specialty training remains limited, as demonstrated by recent national evidence (4–5). This one-day teaching programme aimed to provide targeted training aligned with curriculum and NHS priorities. Method A one-day teaching programme was delivered to Higher Specialty Trainees in Geriatric Medicine. The lecture-based curriculum included sessions on the Clinical Directors’ strategic vision, the role of QI within a hospital, case-based discussion on how to establish a new service and how to maintain and improve an existing service. Lectures were delivered by consultant geriatricians with management experience and introduced other leadership roles within the hospital system, including a QI Director, Consultant Therapists, and Clinical Programme Group (CPG) Transformation Programme Manager. Pre-course questionnaires assessed baseline understanding; post-course feedback evaluated perceived impact and confidence. Results Pre-course data indicated low confidence (demonstrated by self-rating confidence on a 5-point Likert scale) in key domains: understanding of clinical director role (12.5%), service development (12.5%), and departmental management structures (8.3%). Post-course responses demonstrated marked improvements in understanding: clinical director role (76.5%), service development (79.4%), and management structures (76.5%). All participants found the programme helpful and relevant (100%). Practical guidance for establishing a new service such as front-door frailty were particularly well-rated. Qualitative feedback highlighted the value of real-world examples and the insight provided by a range of hospital leaders. Conclusion This programme significantly improved trainees’ confidence in leadership and service development, addressing known gaps in current postgraduate training provision. By aligning with curriculum standards and NHS leadership goals, it offers a replicable model for embedding leadership development in geriatric medicine training. There is scope for a programme such as this to be rolled out to higher specialty trainees in geriatric medicine nationwide.

ABSTRACT OBJECTIVES Paramedics in rural and wilderness environments often face prolonged transport intervals and limited resources, increasing the value of diagnostic tools like point-of-care ultrasound (POCUS). This is a prospective, quasi-experimental study with a one-group pretest-posttest design to assess the feasibility and utility of implementing extended focused assessment with sonography in trauma (eFAST) and limited cardiac ultrasound exams in these austere settings. METHODS Twenty-four paramedics from a National Park Service unit and a local emergency medical services (EMS) agency underwent a blended POCUS training program, including asynchronous modules and hands-on instruction. Knowledge, attitudes, and practices (KAP) were assessed via pre/post-training surveys and tests, with a delayed knowledge test administered at four months. Scan utility was evaluated via post-scan hand-off surveys. RESULTS Participants demonstrated a 44% increase in knowledge scores immediately post-training (p < 0.0001), with good knowledge retention at four months post-training. Although KAP scores showed minimal change, qualitative feedback reflected strong enthusiasm for and perceived utility of prehospital POCUS. Twenty-two scans were performed during routine patient care. Four scans (18.2%) were deemed clinically meaningful by receiving physicians, influencing diagnosis and transport decisions. CONCLUSIONS Point of care ultrasound training for paramedics in rural and wilderness EMS settings is feasible, well-received, and results in successful use of POCUS for patient care and transport decision-making. Broader implementation and research may provide further insight to EMS clinician satisfaction, diagnostic accuracy and impact on patient outcomes in austere environments.

This study investigates how effectively Higher Educational Institutions (HEIs) in India, particularly in the Lucknow region, prepare engineering and management students with employability skills. While situated in a specific regional context, the research offers broader theoretical and practical insights into curriculum–industry alignment, pedagogical disparities between disciplines, and the role of institutional support in skill development—issues relevant to HEIs in emerging economies worldwide. Using a mixed-methods approach, the research combines quantitative survey data and qualitative feedback from students and educators. The survey assessed students’ perceptions of curriculum emphasis on employability-related skills-technical, soft, and practical using a Likert scale. Data analysis included descriptive statistics, comparative analysis, and t-tests, while qualitative responses were thematically coded. Findings indicate that students generally have a positive self-perception regarding soft skills such as teamwork, social interaction, self-concept, and self-control. However, they express low confidence in job search skills like resume writing and interview preparation. Notably, 55% of students felt inadequately prepared by their academic curriculum for current industry demands, indicating a misalignment between academic training and market expectations. While students reported supportive teacher engagement in areas like communication, self-management, and independent learning, gaps remain in problem-solving, creativity, and ICT proficiency. This research is among the first post-NEP 2020 studies focusing on employability in the Lucknow region. It highlights the need for HEIs—especially engineering programs—to integrate more hands-on learning, internships, industry partnerships, and career support compared to management curricula to enhance graduate employability.

Background: Clinical Ethics Consultation (CEC) helps healthcare professionals, patients, and families address ethically complex situations in clinical practice. Since 2016, requests for CEC at the Fondazione Policlinico Universitario “A. Gemelli” IRCCS (FPG) have been entered into the hospital IT system like other consulting services. This has increased both the number of requests and the need to monitor and evaluate the service. Aims: This qualitative study investigates how the CEC service at FPG is perceived in terms of its value, role, and impact, and further aims to identify appropriate strategies for evaluating the service. Methods: Semi-structured interviews were conducted with 28 healthcare professionals who had used or taken part in the service within the previous two years. Data were examined using reflective thematic analysis, leading to the development of codes and themes. Results: Five main themes emerged: (1) Role and identity of the clinical ethics consultant the, (2) Benefits of CEC for clinical practice, (3) How to evaluate the CEC Service, (4) HCPs’ Evaluation, and (5) CEC Service Improvement Strategies. Participants saw the consultant as an “active third party” who combines ethical, clinical, and communication skills to mediate conflicts, support teamwork, and guide shared care planning. The service was viewed as strengthening patient-centered care by improving communication with patients and families, clarifying treatment proportionality, and reducing clinicians’ decisional isolation. Interviewees emphasized the need for structured evaluation tools that include both quantitative indicators and qualitative feedback. Satisfaction with the service was consistently high, with recommendations to expand consultant availability, improve timeliness, and enhance training. Conclusions: CEC appears to serve as a clinical, relational, and training resource that fosters ethically grounded, collaborative, and person-centered care.

Background: In today’s dynamic healthcare environment, Changi General Hospital (CGH) has positioned staff wellbeing and engagement as fundamental priorities that underpin workforce sustainability and quality care delivery. Recognizing that allied health professionals (AHPs) face unique emotional demands and potential empathy fatigue, the CGH Allied Health Division (AHD) uses three strategic pillars: individual empowerment, leaders as key stewards and institutional support systems to address staff wellbeing and engagement. This paper will evaluate the outcomes of implementing the programs and identifying the barriers and enablers to achieving staff wellbeing and engagement. Methods: It adopts a mixed-methods approach using both quantitative survey data and qualitative feedback. Results: A total of 314 AHPs participated with a mean employment duration of 8.89 years. While 95% agreed that their work was meaningful and 76.8% reported happiness at work, 40.8% did not experience being recognized by the organization and approximately 30% did not find higher management responsive to their needs or transparent in their communication. Qualitative analysis revealed concerns about psychological safety of sharing one’s opinions and concerns, and a desire for better renumeration and career progression. Conclusions: AHPs reported happiness and meaningfulness in their clinical work. However, issues with organizational recognition, higher management responsiveness and transparency, as well as psychological safety were elicited. Working towards addressing fostering psychological safety and enhancing recognition and communication with management are important in order to develop and sustain a thriving healthcare workforce capable of high-quality patient care. Overall, the findings reinforced AHD direction of putting employee wellbeing and engagement as a strategic priority.

A diagnosis of breast carcinoma or atypia is stressful and often life-altering for patients. Institutional goals for all cancer centers include rapid access to oncology care and optimal patient experience. Collaboration among doctorally prepared advanced practice clinicians (APCs) may contribute to enhanced clinical operations and affect patient satisfaction. The objective was to decrease time between breast biopsy and initial clinician visit by implementing an expedited APC-led visit within days of diagnosis. PhD- and DNP-prepared leaders designed a pilot project in response to delays in scheduling new patient appointments, which was implemented from September 2024 to February 2025. Patients were scheduled with breast oncology APCs prior to seeing oncology surgeons. Patient access metrics highlighted earlier appointment availability with increased uptake in APC visits, breast magnetic resonance imaging, and genetic services. Monthly patient satisfaction scores improved, and qualitative patient feedback noted reduced anxiety as well as gratitude for immediate access to care and navigation.

Older adults with type 2 diabetes (T2D) face an elevated risk of falls due to combined physical and cognitive impairments. The DiaActive feasibility study evaluated the safety, feasibility, and acceptability of a novel fall-prevention exercise program integrating multitask rhythm-based movement, activities of daily living (ADL) exercises, and a structured social component. Eight community-dwelling adults (≥ 65 years) with T2D participated in two 60-minute physiotherapist-led sessions per week for four weeks (total 480min). The program combined rhythm-based (Rythma) and ADL exercises with structured social interaction. Feasibility outcomes included adherence, safety, satisfaction, and overall acceptability. Adherence was high, with a median attendance of 88% (range 75-100%) and 100% questionnaire completion. No injuries or adverse events occurred, indicating good safety and tolerability. Participants reported that session difficulty progressed appropriately, shifting from "too easy" early on to "appropriately challenging" by week four. Satisfaction increased over time, with most rating sessions as "satisfactory" or "very satisfactory." Qualitative feedback evolved from exercise-focused comments to broader reflections on body awareness and social connectedness. The positive group atmosphere and structured social elements were key motivators supporting adherence and engagement. The DiaActive protocol-combining rhythm-based, ADL-focused, and social components-was safe, feasible, and well accepted by older adults with T2D. High adherence, absence of adverse events, and increasing satisfaction support progression to a fully powered randomized controlled trial to assess clinical efficacy and long-term adherence.

Background: Healthcare professionals face significant stress due to long hours, emotional demands, and critical decision-making. Chronic stress leads to burnout, reduced job satisfaction, and compromised patient care. Mindfulness and stress management strategies are increasingly recognized as effective interventions to support mental health and enhance resilience among healthcare workers. Methods and Materials: This capstone project implemented a six-week workshop series combining educational content with experiential learning. Sessions included lectures, guided mindfulness practices (e.g., meditation, breathwork, body scans), and group discussions. Data collection utilized a mixed-methods approach: quantitative measures (Perceived Stress Scale, Mindful Attention Awareness Scale, and Maslach Burnout Inventory) and qualitative interviews and focus groups were conducted pre- and post-intervention to assess impact. Results: Participants demonstrated measurable improvements in stress reduction, emotional regulation, and mindfulness awareness. Qualitative feedback highlighted increased empathy, better team communication, and reduced feelings of isolation. Attendance remained consistent across both in-person and virtual sessions, confirming the feasibility of delivering such interventions within demanding healthcare schedules. Conclusion: The workshop series effectively addressed the psychological needs of healthcare professionals by equipping them with sustainable, evidence-based coping strategies. Mindfulness and stress management practices contributed to improved well-being and professional performance, suggesting that such interventions should be integrated into institutional wellness programs across healthcare settings.

The integration of artificial intelligence (AI) into clinical decision support systems (CDSSs) for mechanical ventilation in intensive care units (ICUs) holds great potential. However, the lack of transparency and explainability hinders the adoption of opaque AI models in clinical practice. Explanation user interfaces (XUIs), incorporating explainable AI algorithms, are considered a key solution to enhance trust and usability. Despite growing research on explainable AI in health care, little is known about how clinicians perceive and interact with such explanation interfaces in high-stakes environments such as the ICU. Addressing this gap is essential to ensure that AI-supported CDSS are not only accurate but also trusted, interpretable, and seamlessly integrated into clinical workflows. This study aimed to evaluate the first iteration of the design and evaluation phase of an XUI for an AI-based CDSS intended to optimize mechanical ventilation in the ICU. Specifically, it explores how different user groups-ICU nurses and physicians-perceive and prioritize explanation concepts, providing the empirical foundation for subsequent refinement iterations. A midfidelity prototype was developed using the prototyping software Justinmind, based on existing guidelines, scientific literature, and insights from previous user-centered design (UCD) phases. The design process followed ISO (International Organization for Standardization) 9241-210 principles for UCD and combined qualitative and quantitative feedback to identify usability strengths, design challenges, and role-specific explanation needs. The prototype was evaluated formatively through 2 usability walkthroughs (walkthrough 1: 4 resident physicians and walkthrough 2: 4 ICU nurses), which included guided group discussions and Likert-scale assessments of explanation concepts in terms of understandability, suitability, and visual appeal. The XUI was structured into 2 levels: a first level displaying high-level explanations (outlier warning and output certainty) alongside the CDSS output, and a second level offering more detailed explanations (available input, feature importance, and rule-based explanation) for users seeking deeper insight. While both user groups appreciated the first level, physicians found the second level of the XUI useful, whereas ICU nurses found it overly detailed. Thus, the structure was able to address the differing needs for explanations. The layered design helped balance transparency and information overload by providing initially concise explanations and more detailed ones on demand. The evaluation further strengthened evidence for role-dependent explanation needs, suggesting that nurses prefer actionable, concise insights, whereas physicians benefit from more granular transparency information. This study underscores the importance of UCD in designing XUIs for CDSS. It highlights the differing information needs of physicians and ICU nurses, emphasizing the value of involving users early in the development of suitable XUIs. The findings provide practical guidance for designing layered, role-sensitive explanation interfaces in critical care and form the basis for future iterative evaluations and experimental studies assessing their impact on decision-making and clinician trust.

Newly hired perioperative staff members (nurses and surgical technologists) often find it challenging to adapt to the high-pressure environment of the OR, resulting in decreased job satisfaction and higher turnover. An academic Level 1 trauma center implemented a structured Perioperative Mentorship Program to tackle these challenges. The program was based on the five stages of the mentoring process, Benner's Novice to Expert Theory, and Bandura's Social Learning Theory. It featured monthly one-on-one mentoring, bimonthly group meetings, and continuous communication. Both quantitative (eg, turnover rates, satisfaction scores) and qualitative (eg, reflective journals, open-ended feedback) metrics were used. Over three years, 21 newly hired staff members participated in the program. Staff member turnover dropped from 10.46% to 5.6%, while job satisfaction scores rose from 3.88 to 4.04 on a 5-point scale. Qualitative feedback indicated enhanced clinical confidence, team integration, and professional development. Structured mentorship enhances perioperative nursing retention, satisfaction, and clinical readiness.

ABSTRACT This study examines the efficacy of integrating gamified interactive digital storytelling (DST) into marketing education to enhance student engagement, critical thinking, and professional skill development. Grounded in Self-Determination Theory and Kolb’s Experiential Learning Theory, the intervention was tested with undergraduate marketing students (N = 60) at a Vietnamese university. Students were assigned to either a control group receiving traditional instruction or an experimental group participating in a semester-long narrative-based marketing simulation with embedded game elements. Quantitative measures assessed engagement, critical thinking, and applied professional skills, while qualitative reflections provided contextual insights. Results showed that students in the gamified DST group reported significantly higher engagement, achieved stronger critical thinking scores, and delivered superior marketing project outcomes compared to the control group. Qualitative feedback further highlighted creativity, immersion, and collaborative problem-solving as key benefits. The findings demonstrate that gamified DST not only supports autonomy, competence, and relatedness but also operationalizes experiential learning cycles in applied marketing contexts. The study contributes novel evidence for gamified storytelling as an innovative pedagogy that engages digital-native students and enhances professional preparation. While limited to a single institution and timeframe, the results offer promising directions for longitudinal studies, cross-cultural replications, and integration with AI-driven adaptive storytelling.

ABSTRACT Clinical relevance Clear, evidence-based guidelines support optometrists in diagnosing and managing age-related macular degeneration, a leading cause of vision loss in older adults. This condition is an increasing focus of clinical care due to expanding treatment options and evolving imaging technologies. Background Clinical practice guidelines support consistent, evidence-based care in optometry and play a critical role in guiding the diagnosis and management of chronic eye diseases. This paper discusses the methodological approach used to develop age-related macular degeneration guidelines, emphasising the modified Delphi approach used to refine and formally establish recommendations. Methods Recommendations were developed from a literature review and draft guideline. An expert working group of optometrists (n = 9) participated in a three-round Delphi process, rating their agreement with the draft recommendations using a 6-point Likert scale across two survey rounds, followed by a virtual meeting to discuss and re-vote on unclear or contentious items. Quantitative and qualitative measures during the first two rounds of the Delphi survey guided recommendation refinement and inclusion for discussion in round 3. Consensus for inclusion was defined as a mean score ≥5 and ≥80% agreement. Results Out of 37 initial recommendations, 25 (68%) were accepted and included in the final guideline. Consensus was achieved for recommendations concerning clinical classification, assessment and management strategies. Round 3 discussions helped resolve uncertainties and refine recommendations wording, particularly regarding nutritional supplements and clinical biomarkers for progression. Adoption of the Delphi approach demonstrated the value of both quantitative and qualitative feedback. Conclusion The feasibility and value of using a modified Delphi method to develop optometric clinical practice guidelines is demonstrated. The process supported the inclusion or exclusion of recommendations in a systematic way with the final guideline offering contemporary, practice-relevant guidance for the diagnosis and management of age-related macular degeneration.

Patient satisfaction is a key determinant of healthcare quality; however, its assessment in stroke prevention clinics (SPCs) remains inadequate. This quality improvement (QI) project aimed to establish a baseline for patient experience at an SPC in Northeastern Ontario. Our QI team developed a satisfaction survey based on the Donabedian Model. Conducted over 30 days in July 2025, 43 of 51 invited patients completed the survey, resulting in an 84% response rate. Qualitative feedback was gathered for the thematic analysis. Patients reported high satisfaction across the Donabedian framework domains, with over 90% understanding their care steps and feeling dignified. Pareto analysis identified discharge education as a key area for improvement. Despite an 88% satisfaction rate, this domain was prioritized to enhance post-discharge patient preparedness, potentially reducing readmission risk. A limitation of this study was the small, single-site, and brief data collection period. This initiative established a baseline for patient experience and highlighted post-discharge education as a critical area of improvement.

Outcomes from a combined cognitive behavioral therapy for insomnia (CBT-I) and sleep-related medication and substance use reduction treatment.

Mental health is a crucial component of overall well-being, yet it remains an overlooked aspect of community health in Indonesia. This study aimed to improve community mental health by providing training on early detection of mental disorders and Psychological First Aid (PFA) for prospective mental health cadres at the Dlingo II Community Health Center, Bantul Regency, Yogyakarta. Using a quasi-experimental design with a pretest-posttest approach, the intervention involved psychoeducation, practical workshops, and role-play sessions on mental health literacy, early detection using the Self-Reporting Questionnaire (SRQ-20) and SIJIWA application, and basic psychological first aid skills. Data was collected from 29 participants and analyzed using paired sample t-tests. Results showed a significant increase in cadres’ knowledge and skills after the intervention (p &lt; 0.05). Qualitative feedback indicated improved confidence and readiness to support community members experiencing psychological distress. The study concludes that early detection and PFA training can effectively empower community health cadres to play an active role in mental health promotion and prevention. Further integration of structured cadre programs within primary care systems is recommended to enhance sustainability.

Effective debriefings in simulation-based education require accurate observation of team interactions, yet facilitators face challenges due to cognitive load, observer bias, and the complexity of team dynamics. Generative artificial intelligence (AI) tools offer a potential means to support this process by analyzing verbal communication and providing structured feedback. This study explored how AI tools can contribute to teamwork observation and debriefing in immersive medical simulations. We conducted a qualitative, exploratory study using thematic analysis of simulation participants' and debriefers' experiences with AI-generated teamwork reports. Forty-one participants (anesthesia nurses, residents, and attendings) participated in immersive scenarios at the University Hospital Zurich simulation center. Verbal interactions were transcribed with AI-assisted speech recognition and analyzed using two large language model-based systems (Isaac and ChatGPT-4o) guided by a prompt based on the Team-FIRST framework. Structured reports were generated for each scenario and reviewed by four simulation experts. Semi-structured interviews captured learners' perspectives on being observed by AI tools. A total of 26 AI-generated reports and 27 learner interviews were analyzed. Experts valued the detailed transcripts and illustrative quotes, which supported structured feedback and captured observations that might otherwise be missed. Limitations included inaccuracies in categorization, misattribution of speakers, overly generalized interpretations, and the absence of contextual or nonverbal information. Learners expressed openness and optimism about AI's potential benefits: efficiency, objectivity, and enhanced perception, while also raising concerns about transparency, data protection, interpretation errors, and risks of overreliance. Both groups emphasized the necessity of human oversight. Generative AI tools can complement simulation debriefings by structuring communication data and highlighting teamwork patterns, supporting reflective practice. Current limitations highlight the need for multimodal approaches, refined prompting strategies, and integration with expert facilitation to ensure AI functions as a support tool rather than a replacement in simulation-based education. BASEC ID: Req-2024-01642.

Abstract In the rapidly evolving Fast-Moving Consumer Goods (FMCG) industry, consumer feedback has emerged as a strategic asset for product development, innovation, and long-term brand sustainability. This study explores the role of consumer feedback analysis in improving product performance, with special reference to Pagariya Consumer Food Pvt. Ltd., Nagpur. The research aims to measure consumer satisfaction, identify key determinants influencing loyalty, and recommend practical strategies for product improvement based on customer insights. A mixed-method research design was adopted. Primary data was collected from 100 consumers through structured questionnaires and supported by qualitative feedback from open-ended questions. Secondary data was obtained from journals, research articles, and company sources. Statistical tools such as percentage analysis, mean, correlation, and regression were used to analyze quantitative data, while qualitative content analysis helped identify recurring themes in customer suggestions. The results reveal that product quality, taste, reasonable pricing, and product availability are the primary drivers of customer satisfaction. Packaging, labeling transparency, and brand trust also influence buying behavior. However, consumers expressed the need for improvement in packaging durability, distribution expansion, and introduction of innovative product variants. The study concludes that systematic integration of consumer feedback into product development enhances competitiveness, customer loyalty, and brand reputation. This research provides a practical framework for regional FMCG firms to adopt consumer-driven improvement strategies. Keywords: Consumer Feedback, Product Improvement, Customer Satisfaction, FMCG, Voice of Customer, Product Development.