The effect of stoma care training delivered using two different methods on nurses' meaningful learning self-awareness, perceived learning and stoma care skills levels: A randomized controlled study.

Simulation-based learning is widely used in pharmacy education to support the development of communication skills essential for effective patient care. Human Standardized Patients (HSPs) are a longstanding method for clinical and communication training, yet their high cost and logistical demands have prompted interest in scalable alternatives such as Virtual Standardized Patients (VSPs). This review synthesizes current literature on HSPs, VSPs, and clinical readiness in pharmacy education and examines how theoretical frameworks explain the potential of VSPs to enhance students' self-efficacy and preparedness for clinical practice. A narrative review approach was used to integrate research from pharmacy, health professions education, and simulation scholarship. Social Cognitive Theory and Constructivist Learning Theory served as guiding frameworks to analyze how simulation-based experiences contribute to confidence development. Evidence suggests that VSPs may support clinical readiness by offering repeatable, low-stakes practice with immediate feedback. Theoretical mechanisms such as performance accomplishment, experiential interaction, and reflective engagement align with VSP learning affordances. VSPs represent a promising complement to traditional HSP-based instruction. Their integration may expand access to clinical readiness while supporting self-efficacy development. Future research should evaluate long-term learning outcomes and curricular integration strategies.

Applying Motivational Interviewing to Improve Counseling on Glaucoma Management and Medication Adherence: A Pilot Study With Ophthalmology Residents.

Robotic hysterectomy: an umbrella review and regional access in the Midlands, UK - Is there inequity?

Anti-Obesity Bias Among Surgeons and Association With Clinical Decision Making.

During an initial oncologic encounter, care providers must convey information and plans with confidence and empathy. First-year medical students often lack opportunities to develop the skills necessary for these challenging encounters. We developed a novel simulation-based training designed to prepare early-level medical students to demonstrate empathy, communicate care plans, and deliver bad news during initial oncologic patient visits. Medical students in a summer research program participated. The session included a didactic, followed by 2 simulated patient encounters: a young woman with lymphoma and an older man with rectal cancer. Students rotated through roles as primary provider, secondary provider, family member, and observer. Each simulation was followed by a faculty-led debriefing. We collected postsession feedback using a mixed-methods evaluation. The activity lasted approximately 2 hours. Of the 54 participants, 49 (91%) completed the evaluation. The results were highly positive, with 100% of respondents agreeing or strongly agreeing that the simulation helped them apply knowledge practically and that they would use these skills in future practice. Qualitative feedback highlighted improvements in communication skills, the importance of empathy, and the need for adaptability. Participants identified the debriefing sessions, standardized patients, and active participation as the most valuable components. This simulation is effective for preparing medical students for the complexities of initial oncologic patient encounters. It provides a safe environment for the practice and refinement of essential clinical and interpersonal skills, fostering a more empathetic and competent approach to patient care.

A SWAT conducted by Du et al. in 2009 and a subsequent SWAT by Mattock et al. in 2020 compared a video intervention against standard patient information on trial recruitment. For each SWAT, a primary Bayesian analysis was performed using a logistic model with non-informative priors. Sensitivity analysis explored informative priors informed by meta-analysis of previous similar studies; this included an analysis of the Mattock et al. SWAT incorporating the result of the earlier Du et al. SWAT. ACCEPT curves were constructed. Results were compared with frequentist analyses. For the Du et al. SWAT, the primary Bayesian analysis gave an OR for recruitment for the video relative to standard information of 2.12, 95% CrI: 0.38-4.65 and a posterior probability of the video being effective (OR > 1) of 0.86. When taking into account results of previous SWATs by using an informative prior there remained a moderately high probability of video benefit (0.82). For the latter Mattock et al. SWAT, the primary Bayesian analysis gave an OR for recruitment for the video relative to standard information of 0.26, 95% CrI: 0.07-0.51 and the posterior probability of the video being effective was 0.0005, indicating very little chance of effectiveness; ACCEPT plots facilitated interpretation by showing the probability that the video was better than standard information for OR > 0.8 was very small (0.0032). When taking into account the results of previous SWATs using an informative prior, including Du et al., the probability of the video being effective was still very small (0.12). Bayesian methods and ACCEPT analyses offer solutions to challenges experienced in the analysis and interpretation of SWATs, which are often underpowered. Greater use of these analytical approaches within SWATs will lead to a more accessible, improved evidence base on how to effectively conduct trials.

Relapsing-remitting multiple sclerosis (RRMS) may remain clinically and radiologically active despite sequential exposure to high-efficacy disease-modifying therapies. In carefully selected patients with highly active inflammatory RRMS, autologous hematopoietic stem cell transplantation (AHSCT) has demonstrated superior inflammatory control and durable rates of no evidence of disease activity, with low treatment-related mortality rates in experienced centers. AHSCT promotes immune renewal through high-dose immunoablation followed by autologous stem cell rescue, aiming to restore immune tolerance. Here, we describe a structured institutional standard-of-care protocol for AHSCT in RRMS, developed to support safe referrals and harmonize neurology-hematology collaboration within a Brazilian tertiary center. By consolidating a transparent and safety-focused care pathway aligned with national and international guidance, this manuscript aims to facilitate standardized patient selection, optimize risk mitigation, and strengthen multidisciplinary communication between referring neurologists and transplant teams.

Confidence in dentist-patient communication is essential for building trust, supporting treatment adherence, and improving oral health outcomes. However, many dental residents feel underprepared for sensitive or complex conversations. Traditional communication training methods, such as standardized patients and role-play, are effective but resource-intensive and difficult to scale. AI-powered virtual standardized patients offer a flexible alternative by enabling simulated practice supported by automated, real-time feedback. This pilot study explored the feasibility and preliminary educational impact of SOPHIE, an AI-powered virtual patient platform, in enhancing dental residents' confidence in clinical communication. Ten dental residents from a perinatal dental clinic participated. Residents completed a 30-min orientation and a baseline self-efficacy in patient-physician communication (SE-12) survey, followed by engagement with five virtual patient scenarios providing AI-generated communication feedback. Residents completed the SE-12 survey and the System Usability Scale (SUS) after the practice. A semi-structured focus group explored user experience and perceived educational value. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Residents reported increased confidence in managing challenging patient conversations and valued the opportunity for repeated, low-stakes practice. SUS scores indicated strong usability and positive learner experience. AI-generated metrics suggested improvements in conversational balance and use of open-ended questions. Qualitative findings reinforced these outcomes, highlighting the platform's support for empathetic, patient-centered communication. SOPHIE was well accepted and demonstrated promising potential to strengthen communication confidence among dental residents, particularly in perinatal care. Future work should enhance conversational realism, emotional responsiveness, and nonverbal feedback.

Chemical eye burns remain one of the most severe ophthalmic emergencies, capable of causing irreversible vision loss and disability. The annual incidence reaches approximately 51 cases per million population, predominantly affecting working-age males, with occupational injuries accounting for 45–52% of cases. This review systematizes data from the literature published between 2013 and 2025 on the key aspects of the problem: pathogenesis (differences in injury mechanisms between alkali and acid burns, the role of limbal stem cell deficiency), evolution of classification systems (from Roper-Hall to the Dua classification and the global consensus on LSCD), current approaches to emergency care and medical therapy (including biological agents — autologous serum, platelet-rich plasma, anti-angiogenic agents), surgical rehabilitation (amniotic membrane transplantation, limbal stem cell transplantation, keratoprosthesis), and emerging directions (cell-based therapies, nanotechnology-based drug delivery systems). A dedicated section addresses quality of life and psychological consequences: chemical burns are shown to be accompanied by a marked decline in vision-related and overall quality of life, a high prevalence of anxiety-depressive disorders, and post-traumatic stress disorder. The need tointegrate psychological screening into standard patient management protocols is substantiated. Key unresolved challenges are identified: the conduct of large multicenter randomized trials, standardization of treatment protocols, and the development of pharmacological methods to stimulate residual limbal stem cells.

Effect of a thermo-mechanical action device on symptoms, signs and tear lipid profile in patients with evaporative dry eye disease.

Despite growing awareness of the importance of integrating gender knowledge into medical education, gender stereotypes persist and may influence patient assessment and management. This study investigates gender inequalities in clinical reasoning among medical students to identify areas for improvement in medical education. The study was conducted at the University of Lausanne in Spring 2021, using the Objective Structured Clinical Examination (OSCE) to assess fifth-year medical students. Students were evenly assigned to interactions with either a male or female standardised patient (SP) presenting with unintentional weight loss. Evaluation covered history taking, physical examination, and clinical management. A total of 105 students (57.1% female, 42.9% male) were assessed. Results indicate potential gender bias at various stages of clinical reasoning, with patterns depending on the gender of both the SP and the student. During history-taking, female students were less likely to ask female SPs about alcohol consumption than male SPs (56.3% vs. 78.6%, p = 0.07). Regarding occupational history, a compelling trend was also observed among male students, who asked female SPs less often (30.4% vs. 59.1%, p = 0.05), whereas female students showed more consistent rates. Additional compelling trends emerged during physical examinations: male students performed cardiac auscultation less often on female SPs (56.5% vs. 86.4%, p = 0.02). Although diagnostic hypotheses and differential diagnoses were similar, female SPs were more often prescribed laboratory tests (63.6% vs. 26.0%, p < 0.001). Gender bias permeates multiple stages of clinical reasoning among medical students, leading to under-recognition of key health risk factors, differences in examination thoroughness, and increased prescription of laboratory tests in female patients. Addressing gender bias through sustained integration of gender into core medical education is essential for diagnostic accuracy and high-quality patient care. Specifically, systematic inquiry into occupational and alcohol histories in female patients, improved cardiovascular auscultation, and enhanced communication with male patients are needed.

Ambient artificial intelligence (AI) scribes can reduce the burden of administrative documentation. Prior evaluations have been vendor specific and not focused on measures of documentation quality. To compare the quality of AI-generated clinical notes with that of human-produced notes. Cross-sectional evaluation of notes generated from standardized primary care clinical cases. Veterans Health Administration (VHA). 11 AI scribe tools, 18 human note takers, and 30 human raters. Five standardized primary care cases were audio recorded using standardized patients (for example, new patient, back pain, chest pain, pharmacy, and nurse care manager). Vendors and human clinicians generated encounter notes from the audio files. Blinded raters assessed all notes using the modified Physician Documentation Quality Instrument (PDQI-9), which measures 10 domains of note quality on a 5-point Likert scale (maximum score 50). Across all 5 clinical cases, human-generated notes received higher overall modified PDQI-9 scores than AI-generated notes. The largest difference was seen in the acute low back pain case (human: 43.8 [95% CI, 37.4 to 50.3] vs. AI: 20.3 [CI, 15.4 to 25.2]; difference -23.5 [CI, -29.2 to -17.9]). Pooled domain analysis showed lower AI scores across all 10 domains, with the largest deficits in domains related to being thorough (-1.23 [CI, -1.82 to -0.65]), organized (-1.06 [CI, -1.65 to -0.47]), and useful (-1.03 [CI, -1.61 to -0.44]). Cases were simulated; human-generated notes were not generated under real-world constraints. Notes generated by AI had lower-quality scores than human-generated notes across 5 standardized care cases. Although ambient AI scribes hold promise for reducing clinician burden, independent, vendor-neutral evaluations of note quality are essential before large-scale clinical deployment. VHA.

History-taking is essential for the diagnosis of oral mucosal diseases, and subsequent medical record writing is a fundamental clinical skill for dental students. While standardized patients (SPs) have traditionally been used to improve these abilities, their application requires considerable human, material, and time resources. This study aimed to evaluate an AI-based virtual SP system-integrated with lesion images and examination results-as a convenient and feasible alternative for teaching oral mucosal disease history-taking and medical record writing. Fourth-year undergraduate dental students attended an oral mucosal disease course and, after each lecture, completed simulated interviews with an AI-based virtual SP using voice interaction. Lesion photographs and auxiliary examination results were provided to aid diagnosis. Students wrote medical records online within 20min based on the collected history. A comprehensive assessment was conducted at the end of the course. Performance in history-taking and medical record writing during the first AI-based session (T1) was compared with the final assessment (T2) using paired analyses. Student satisfaction with the system was assessed via an online questionnaire. Paired comparisons showed a significant mean improvement in history-taking scores (+18.64 points; 95% CI: 15.42-21.87). Overall medical record writing scores also increased, particularly in completeness and format standardization. Most students agreed that integrating the AI-based virtual SP into the curriculum improved their oral mucosal disease history-taking and medical record writing skills, and they supported its application in dental education. Incorporating AI-based virtual SPs into oral mucosal disease teaching can effectively improve key clinical documentation skills while offering a time- and resource-efficient solution for dental education. Approved by the Fourth Military Medical University IRB protocol number #2024YB31.

Clinicians frequently encounter workplace verbal violence from patients and caregivers. We created Simulation Addressing Verbal Escalation (SAVE) training for hospital-based staff to practice managing verbal escalation in a safe learning environment while reinforcing available hospital resources. This curriculum included a 1-hour session with 2 scenarios, each involving interprofessional ad hoc teams simultaneously managing a pediatric patient (manikin) experiencing sepsis with decreased responsiveness, and a verbally escalating caregiver (standardized patient). A debriefing reinforced the BEAR (Bond, Engage, Assess, Reinforce) communication framework, sepsis management, and hospital resources for caregiver support. Training was evaluated using a checklist documenting team actions, and a learner feedback survey (4-point scale; 1 = nothing/not at all, 4 = quite a bit). From October 2024 to April 2025, 860 clinicians participated in SAVE training. There were significant increases from scenario 1 to scenario 2 in team implementation of the full BEAR communication tool (35% to 77%, p < .0001), the Bond (67% to 94%, p < .0001) and Reinforce (56% to 83%, p < .0001) components, and SWIFT (Social Work Intervention for Families and Teams) utilization (1% to 6%, p = .014). Among survey respondents (n = 610), mean ratings were 3.55/4, 3.73/4, and 3.88/4 for learning, engagement, and facilitator effectiveness, respectively. Relevant takeaways included supporting families, considering patient care team dynamics, applying communication strategies, and accessing hospital resources. SAVE training provided a meaningful experience for practice and discussion about emotional clinical situations. Hospital-wide training empowers staff to leverage resources to support patients' caregivers.

Construct a workshop for emergency medicine (EM) residents to learn ultrasound-guided regional anesthesia (UGRA) procedures and build confidence in performing those procedures. Use pre- and post-workshop knowledge and confidence surveys to determine workshop effectiveness. We created a workshop using prosected donors, ultrasound (US) scanning on standardized patients, and needling technique on a phantom model to increase residents' knowledge and confidence for eight UGRA procedures. Pre- and post-workshop assessments are used to measure confidence and knowledge gains. Forty-four EM residents participated in the workshop. Residents scored significantly higher on the post-workshop (n = 29) knowledge assessment compared to the pre-workshop (n = 39) knowledge assessment (12.0 ± 2.0 vs. 8.44 ± 2.45; p < 0.001). Confidence increased significantly on the post-workshop (n = 40) assessment compared to the pre-workshop (n = 28) assessment (p < 0.001). "Extremely confident" and "very confident" statements increased from 11.1% to 45.1% of responses. The self-efficacy gained by residents in this workshop can lead to increased patient safety as opioids are avoided in the emergency department. Workshops such as the one described in this manuscript provide residents and attendings opportunities to learn skills and knowledge for UGRA procedures. This workshop provides EM faculty with an effective environment in which to teach their residents proper skills for UGRA and can be easily replicated at other institutions. Future workshops should include assessment of clinical competency following training.

Empathy is fundamental to patient-centered care but frequently diminishes during clinical training. To inform medical education, we conducted a systematic review (PRISMA-2020-compliant) of interventions aimed at augmenting empathy in healthcare learners. We searched the PubMed, EMBASE, PsycINFO, CINAHL, ERIC, and Cochrane CENTRAL databases from the beginning of time until January 2026 for trials and pre- and post-studies that looked at empathy outcomes. Two reviewers evaluated the studies (κ = 0.86) and extracted data regarding participants, intervention format, and outcomes. Our initial search yielded 2056 records. After removing duplicates, 1250 titles and abstracts were screened, resulting in the inclusion of 43 studies from 2010 to 2026. The majority of studies reported improvements in empathy post-intervention, based on both self-report measures and observational assessments. Interventions that included active learning methods like role-playing, standardized patient encounters, narrative medicine, art workshops, and mindfulness led to much better improvements in empathy than passive, lecture-based methods. Long-term, multimodal programs that included communication skills training, reflective exercises, and patient contact were better than classes that only met once. Nonetheless, many studies used different, sometimes untested, empathy measures, and the follow-up period was often short. Our review demonstrates that empathy can be imparted through evidence-based curricular approaches. We advocate for the incorporation of prolonged, experiential empathy training into health professions education, alongside the standardization of outcome assessment. These results make it clear which teaching methods work best and point out areas where more research is needed.

Thyroid surgery remains one of the most frequently performed endocrine procedures worldwide, offering definitive management for benign multinodular goiter, toxic thyroid disorders, and differentiated thyroid malignancies. Despite advances in surgical techniques, anesthesia, and perioperative care, post-operative complications continue to influence patient recovery, length of hospital stay, and long-term functional outcomes. The present prospective study was conducted in a tertiary care hospital to systematically evaluate the incidence, pattern, and determinants of post-operative complications following thyroidectomy and to identify modifiable risk factors that may improve surgical safety and patient prognosis. Over a defined study period, patients undergoing total, subtotal, or hemithyroidectomy were enrolled and followed from the immediate post-operative phase through subsequent outpatient visits. Detailed demographic, clinical, biochemical, and intraoperative parameters were recorded, including age, gender, indication for surgery, gland size, duration of operation, and intraoperative blood loss. Post-operative monitoring focused on early and late complications such as hypocalcemia, recurrent laryngeal nerve palsy, hematoma formation, surgical site infection, seroma, and hypothyroidism. Standardized clinical assessment protocols and biochemical testing were utilized to ensure consistent detection of complications. The analysis revealed that transient hypocalcemia was the most common early complication, particularly among patients undergoing total thyroidectomy and those with extensive gland dissection. Most cases were biochemical and resolved with calcium supplementation within a few weeks. Transient voice changes attributable to neuropraxia of the recurrent laryngeal nerve were observed in a smaller subset of patients, while permanent nerve injury was rare. Post-operative hematoma occurred infrequently but required prompt recognition and intervention due to the risk of airway compromise. Surgical site infections and seroma formation were uncommon, reflecting adherence to sterile protocols and meticulous hemostasis. Statistical evaluation demonstrated significant associations between complication rates and factors such as extent of surgery, underlying pathology, and operative duration. Larger gland size and malignancy-related procedures were linked to increased risk of hypocalcemia and nerve-related complications. However, no significant correlation was observed between patient age or gender and major adverse outcomes. Importantly, structured perioperative planning and careful identification of parathyroid glands and recurrent laryngeal nerves contributed to favorable surgical outcomes. This prospective analysis underscores that thyroid surgery, when performed in a tertiary care setting with experienced surgical teams, is generally safe and associated with low rates of permanent morbidity. Early detection and timely management of complications remain critical to optimizing recovery. The findings emphasize the importance of standardized operative techniques, vigilant monitoring, and patient education to minimize preventable adverse events. Future multi-center studies with longer follow-up may further refine risk stratification models and enhance evidence-based perioperative protocols.

The pelvic organ prolapse quantification system (POP-Q) can be difficult to learn, but visual aids can facilitateits learning. We aimed to evaluate the Interactive Pelvic Organ Prolapse (iPOP) model as a teaching tool for residents learning the POP-Q and hypothesized that training with the iPOP model would enhance learner confidence and proficiency in conducting POP-Q examinations. This was a pre-post intervention exploratory study. Obstetrics and Gynecology (OB/GYN) residents from one institution were surveyed regarding their understanding, comfort, and confidence teaching the POP-Q examination. They completed a POP-Q examination on iPOP models demonstrating prolapse. After an education session with iPOP models, residents again performed POP-Q examinations on the same models and completed a survey regarding their experience with the POP-Q examination. A subset of residents performed a POP-Q examination on a standardized patient. Paired t tests were conducted to evaluate improvements in overall POP-Q scores from the baseline assessment. All eligible OB/GYN residents (n = 18) participated in the study. Compared with their baseline response, participants significantly improved their understanding of the POP-Q OR = 11.08, p < 0.001), comfort performing the POP-Q (OR = 7.10, p < 0.001), and confidence teaching the POP-Q (OR = 13.53, p < 0.001). There was overall improvement in POP-Q grid scores for the stage 1 (mean difference = + 3.00) and stage 3 (mean difference = + 2.83) models. The iPOP model is a useful educational tool that allows resident learners to be more confident and adept at performing POP-Q examinations.

Integrative Review of Simulation-Based Pain Management Education in Undergraduate Nursing Programs.