Using the Delphi technique and critical decisions method to derive nursing student training requirements for sepsis detection in adult patients

Building better safeguarding: The Catholic Church and its institutions in Kenya

To evaluate the efficacy in residents of the EuropeaN Training in uRologY (ENTRY) training curriculum for transurethral resection of bladder tumour (TURBT) vs conventional methodology, as TURBT is one of the most performed procedures by residents and early-career urologists. We compared resident performance in TURBT trained through the ENTRY curriculum vs a conventional methodology. All residents underwent a TURBT educational rotation of 4 months supervised by uro-oncology attendings. In the conventional methodology group TURBT training was a standard tutoring in the operating room (OR). The ENTRY curriculum group underwent a pre-clinical: theoretical learning of metrics with a tutor and dry laboratory; and a surgical phase: supervised OR training by trained mentors. We evaluated 162 patients undergoing TURBT. Of these 74 (46%) TURBTs were performed by three conventionally-trained residents and 88 (54%) TURBT by three ENTRY curriculum-trained residents. Despite not being statistically different (P = 0.07), the reduction in high-grade perforation (DEpth of Endoscopic Perforation [DEEP] scale 2-3) in the ENTRY curriculum-trained group (12% vs 4.5%) was clinically meaningful. Postoperative complications was significantly lower in the ENTRY curriculum-trained group, for overall (13% vs 30%, P = 0.007), minor (10% vs 23%, P = 0.04), and major events (2.3% vs 6.8%, P = 0.1). Detrusor muscle presence was significantly higher in the ENTRY curriculum-trained group (91% vs 80%, P = 0.04). The ENTRY training curriculum for residents is effective in improving pivotal clinical outcomes in TURBT training vs conventional training. This training is a step towards standardised training and optimal outcomes in urology education.

Constructing a chemical safety training curriculum framework for shift leaders and workshop chiefs in chemical enterprises: Based on “6 flows, 3 Izes, 3 Nos”

The organization of multiple motor memories.

Simulation-based training is a critical component of robotic surgical education. While virtual reality platforms are well established for basic skills acquisition, they lack the ability to replicate tissue handling required for procedural simulation. Synthetic models have emerged as a promising alternative; however, formal validation is required prior to their integration into training curricula. This study aimed to establish the face and content validity of the International Medical Robotics Academy (IMRA) Surgical model for robotic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective content validity study was conducted using an international expert panel. Surgeons with experience in robotic TAPP repair and prior exposure to the IMRA model were recruited. A 48-item survey instrument was developed and organized across domains including anatomical fidelity, procedural relevance, haptic properties, and educational utility. Items were rated on a 4-point Likert scale. Item-level content validity indices (I-CVI) were calculated, with a threshold of ≥ 0.78 for retention. The scale-level content validity index (S-CVI/Ave) was computed, with ≥ 0.90 considered acceptable. Face validity was assessed using five global rating items (1-10 scale). Ten expert surgeons from three countries participated. The overall face validity score was 8.78/10, with all domains exceeding 8.0, including educational value (9.40) and procedural relevance (8.90). The S-CVI/Ave was 0.929. Of 48 items, 44 (91.7%) achieved I-CVI ≥ 0.78. Four items did not meet the threshold, primarily related to advanced dissection steps and model-specific anatomical features. 90% of experts endorsed the model without reservations. The IMRA synthetic simulation model for robotic TAPP inguinal hernia repair demonstrates strong face and content validity. These findings support its integration into structured robotic training programs and provide a foundation for future studies evaluating construct and criterion validity.

Communicating with empathy is an essential skill for healthcare professionals (HCPs). However, current communication training curricula fail to show how empathy communication is done, hindering the effectiveness of this training. This systematic review synthesizes applied linguistic research that shows how empathy is communicated, and what functions empathy communication serves. We included research that analysed naturalistic recorded interactions between HCPs and patients in all healthcare settings. We systematically searched five databases for studies published in English up to August 2024. We analysed results and discussion sections of included studies using aggregative thematic synthesis. We identified 1112 studies through systematic searches and included 43 studies in our review. We found eight categories of empathy communication: 1) naming emotions or characterising experiences, 2) sharing similar emotions or experiences, 3) compassionate witnessing and minimal response, 4) claiming or displaying understanding of patients' experiences and emotions, 5) displaying empathy multimodally, 6) response cries, 7) claiming of similar emotions or experiences, and 8) others. Regarding functions of empathy communication, we found four groups: 1) facilitating advice-giving or problem-solving, 2) assisting patients to work with emotions, 3) facilitating patient-centred care, 4) facilitating history-taking activities. The reviewed studies provide evidence that empathy communication can be seamlessly incorporated into healthcare consultations. Empathy enhances patient engagement, aids emotional expression, supports problem-solving and helps in situations where patients' and HCPs' views diverge, making it an essential component of healthcare.

Considerable diversity in cardiology training and credentialing pathways exist within the Asia-Pacific. We aimed to map these variations and report similarities and disparities with a view to understanding needs in cardiology curricula development in the region. A 42-item online questionnaire was distributed to credentialed cardiologists serving as representatives from various regions within the Asia-Pacific, allowing obtainment of region-specific data as of December 2023. Responses were derived from a total of 23 regions. All regions required specialist qualification to practise cardiology. Overall, 69.6% have a single training pathway, while 21.7% and 8.7% have two or three pathways, respectively. Majority (91.3%) had structured cardiology training curricula with assigned supervisor and regular assessments. The majority (91.3%) required mandatory training in internal medicine prior to cardiology. The total training duration inclusive of medicine and cardiology varied across regions (range 3-8years) with 26.1% lasting 5years and 43.5% lasting 6years. All programmes had mandatory clinical cardiology training; 82.6% had interventional cardiology, 73.9% had electrophysiology, 73.9% had cardiac imaging training. However, 47.8% of regions had no training in cardiac computerized tomography (CT) and 56.5% had no cardiac magnetic resonance (CMR) imaging. 73.9% required mandatory research for board certification. In addition, 95.1% had an exit exam at completion of training (local in 95% cases). Board certification was mandatory for general cardiology practise in 69.6% of regions. Separate subspeciality fellowships were mandatory in 73.9% of regions. Significant regional variations in cardiology training and credentialing pathways exist, presenting opportunities to harmonize and improve training metrics regionally. Key message What is already known on the topic? Cardiology training within the Asia-Pacific region has considerable variation in terms of duration, curriculum, training, and exit requirements. What this study adds? This study outlines the similarities and differences of cardiology training between different countries within the Asia-Pacific region. How this study might affect research, practise or policy? Results from this study provide insights that may inform the development of harmonized and contextually appropriate cardiology curricula in the Asia-Pacific region. Establishing common standards for cardiology training could facilitate a more uniform and coherent curriculum across Asia, ensuring consistency in trainee competencies and clinical practise.

The development and integration of geriatric medicine into national health care systems vary widely across countries. While a robust care workforce requires providers from several disciplines, including nursing, social sector, rehabilitation, psychiatry, neurology, and others, a strong core of highly qualified geriatricians is essential to delivering older person-centred and integrated care. The number and professional profile of geriatricians, along with the status of the specialty, are important to informing efforts to reshape health care systems in response to the global ageing scenario. WHO developed and distributed a structured questionnaire to representatives of national geriatrics and gerontology societies beginning in March 2025. The survey collected data on the status of the geriatric medicine specialty, including its formal recognition at the country level, the estimated number of practising geriatricians, and information on training curricula, professional environments, and systemic challenges. A total of 48 national societies completed the survey. Recognition of geriatric medicine ranged widely, from full specialty status in some countries to subspecialty or non-recognition in others. The number of practicing geriatricians per 100,000 persons aged 60 years and older ranged from <0.1 to >30 across countries, illustrating marked workforce disparities and some severe shortages. Where the geriatric medicine specialty is formally available, pre-service training durations ranged from 24 to 96 months. Geriatricians worked in diverse settings, though integration into primary care and public health was limited. Training in and exposure to geriatric medicine principles during undergraduate and postgraduate medical training were minimal in many countries. Key challenges included workforce shortages, fragmentation of care, and undervaluation of the speciality's role in informing health care for older people. Strategic priorities reported by respondents included investment in training, policy development, and institutional support. The survey highlights disparities in geriatric medicine across countries and identifies several challenges and priorities. Strengthening education, policy, and workforce development is essential to meet the needs of ageing populations and support healthy ageing worldwide. At the same time, countries should also think of innovative approaches and building capacity of existing other health occupations to improve geriatric care. Future updates of this survey will provide longitudinal insights into workforce evolution. These findings provide a global evidence base to guide workforce planning and policy under the United Nations Decade of Healthy Ageing (2021-2030).

Introduction: Dental caries is a prevalent oral disease, and fissure sealants are effective preventive measures. Dental students play a crucial role in influencing public acceptance of this treatment. This study aimed to assess the knowledge, attitude, and self-reported practice regarding fissure sealants among senior dental students at Tehran University of Medical Sciences (TUMS). Materials and Methods: This cross-sectional study was conducted in 2023. A census sampling method was employed to recruit all eligible senior dental students (N = 163). The participants included fifth- and sixth-year dental students from both campuses of the School of Dentistry, TUMS. Data were collected using a validated, anonymous questionnaire comprising four sections: demographics, knowledge (11 questions), attitude (8 questions), and self-reported practice (14 questions). Statistical analysis was performed using SPSS version 26 via the Mann-Whitney test, Spearman’s correlation, and multiple linear regression analysis. Results: Out of 163 distributed questionnaires, 117 were completed (response rate: 72%). The participants included 61 (52.1%) males and 56 (47.9%) females. The mean scores were 8.4±1.7 (out of 11) for knowledge, 28.8±3.5 (out of 40) for attitude, and 9.9±1.7 (out of 14) for self-reported practice. Male students showed significantly higher knowledge scores compared to females (P = 0.02). Fifth-year students also scored significantly higher in knowledge than sixth-year students (P = 0.04). A significant positive correlation was found between self-reported practice and both knowledge (P = 0.02) and attitude (P = 0.003). Conclusion: Senior dental students demonstrated an acceptable level of theoretical knowledge regarding fissure sealants. However, their attitude and self-reported practice fell short of expected standards, highlighting the need for educational reinforcement and practical training in the dental curriculum.

ABSTRACT This qualitative study explores the readiness of master’s-level counselling students, particularly those specialising in substance abuse, to engage effectively in HIV prevention work with people living with HIV (PLHIV). Given the complex intersection between substance abuse and HIV transmission, the study examines students’ educational preparation, perceived competence, and attitudes towards HIV-related counselling. Data were collected through semi-structured interviews focusing on curriculum content, training experiences, practicum exposure, and students’ self-assessed readiness. The findings reveal persistent HIV-related stigma, gaps in curriculum coverage, limited experiential learning opportunities, and variability in students’ confidence and preparedness. Attitudinal factors, including fear, uncertainty, and empathy, emerged as central influences on readiness. The study offers recommendations for strengthening counselling curricula through targeted training, experiential learning, and attitudinal development to better prepare future counsellors for comprehensive HIV prevention practice.

Rheumatology and immunology nursing involves complex, long-term patient care. However, the effectiveness of current training in supporting early-career nurses remains unclear. Therefore, this study aimed to explore stakeholders' perspectives on training experiences and perceived learning needs, and to identify key implications for competency-based continuing professional development, with a focus on enhancing sustained patient safety. This descriptive qualitative study employed semistructured interviews with 26 participants (15 trainees and 11 trainers) from six county-level hospitals in Ningxia, China. Data were analyzed using Braun and Clarke's reflexive thematic analysis, and reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Three main themes emerged: (1) Trainees reported misalignment between training content and daily clinical demands, insufficient support for safe routine practice, and limited opportunities for supervised skill development; (2) Trainers highlighted gaps in preparation and educational resources, resulting in primarily didactic approaches and variable training quality, which may hinder the development of patient safety-related competencies; (3) Trainers emphasized the need for a structured, progressive training framework integrated with clinical practice. Shared priorities included clearly defined competency progression, contextually relevant content, experiential learning strategies such as case discussions and supervised practice, and the integration of psychological support, humanistic care, and lifelong learning awareness and methods. Faculty development and standardized teaching materials were considered essential to ensure consistent and safe practice standards. Strengthening specialist nursing capacity in resource-limited county hospitals requires not only structured, practice-integrated training curricula but also sustainable continuing professional development pathways that support progressive competency development. Embedding competency-based learning within routine clinical practice, alongside investment in trainer capability and standardized educational resources, may help reinforce patient safety competencies and promote sustained professional growth across the early stages of nursing careers.

Worldwide Survey on Interventional Pulmonology Training Programs.

A paediatrician is a specialist medical practitioner committed to the health and well-being of infants, children and young people. However, curricula for training in paediatrics are predominantly process and content focussed, with some emphasis on professional behaviours, but because of their length do not distil the essence of what it is to be a paediatrician. In this paper, I explore some of the history of paediatrics to build a modern conception of this most marvellous vocation.

ABSTRACT The study of Thai social work has a significant knowledge gap in its historical development, particularly around 1954, when the Thammasat University Faculty of Social Administration was founded. For several decades, the dominant historical narrative has focused on royal benevolence and traditional charity. However, social work education has largely overlooked external influences, specifically the internationalization of training curricula and the League of Nations Child Welfare Committee. There is also a lack of critical inquiry into how Thai intellectual elites conceptualized social work before the 1950s. The findings indicate contested origins, showing how Thai elites assimilated Western knowledge into a domestic nationalist agenda through a cultural welfare strategy. This article contests the prevailing narrative by illuminating unrecognized historical phases and hitherto invisible early international social work in Thailand. It draws upon primary archival evidence from the United Nations Library and Archives and the National Archives of Thailand. Thus, it reevaluates the epistemological foundations of Thai social work, arguing that early development was not a simple transfer of Western knowledge, but a complex process of political and cultural negotiation designed to harmonize with indigenous power structures.

Laser enucleation of the prostate (LEP) has become a standard treatment for benign prostatic obstruction, yet its adoption is limited by a steep learning curve and a lack of validated training models. This study aimed to evaluate the face and content validity of a bench-top simulator specifically developed for LEP training within the framework of the European School of Urology (ESU) Lower Urinary Tract Endoscopy Working Group. Fourteen expert endourologists assessed the simulator during the European Urology Residents Education Programme (EUREP) 2025. Face and content validity were evaluated using 4-point Likert questionnaires, structured using the ESU validation framework. Descriptive statistics and content validity indices (I-CVI, S-CVI/Ave, S-CVI/UA) were calculated to assess agreement across anatomical, procedural, and educational domains. Face validity scores were high across all items (mean 3.57-3.86; ≥90% agreement). The overall S-CVI/Ave was 0.85 and S-CVI/UA 0.47. Domain-specific analysis showed strong content validity for procedural steps (S-CVI/Ave = 0.89) and educational/global domains (0.95), moderate validity for essential anatomy (0.81), and lower ratings for intraoperative conditions (0.69), primarily due to the absence of bleeding simulation. When restricted to core domains (procedural + educational), S-CVI/Ave improved to 0.91. The simulator demonstrated strong face and content validity. Expert ratings indicated favorable perceptions of its realism, procedural similarity, and educational utility. These findings suggest that the simulator may be a useful component of a structured transurethral procedural training curriculum, although further construct validation is needed.

Humans often learn better when problems are broken down into parts, but this phenomenon has eluded explanation at the computational level. Here we study how differing training curricula help or hinder learning in a classic probabilistic cue combination task. Training curricula that 'divide and conquer' by presenting one cue at a time facilitate later performance on test trials involving multiple cues. This effect is captured by a hybrid learning framework that arbitrates between two different learning strategies: a marginal updating process, which assigns credit to each cue independent of every other, and a joint updating process, which distributes credit across cues on the basis of their joint presence. We use this theory to generate new 'skewed distribution' multi-cue curricula that should and should not successfully promote human learning. It makes accurate predictions, demonstrating that we can use computational insights of learning to accelerate human probabilistic learning.

The World Health Organization has identified the long-term care system as a critical area for enhancing the health and quality of life of older adults. Within this system, case management is a prevalent service delivery model implemented by interdisciplinary teams comprising professionals from various sectors. However, the absence of a comprehensive transdisciplinary competency framework applicable across different disciplines obstructs the development of relevant training programs and hinders workforce capacity building and professionalization. This studywasconducted in the context of Hong Kong's long-term care system and aimed to establish a transdisciplinary competency framework through expert consensus to advance case management practices. This study employed an online five-stage participatory Delphi approach, with two rounds of questionnaire surveys and three roundtable discussions. The expert panel featured 40 health and social care professionals in the long-term care field. Their task was to develop a list of essential competencies for the long-term care workforce in case management. To determine the list of competencies, metrics such as the percentage of agreement, mean rating scores for each statement, and interquartile range were assessed using a 5-point Likert scale that measured clarity, relevance, and importance. The panel reached consensus on a comprehensive transdisciplinary framework that includes 49 competencies organized into six key domains: overarching values; knowledge of long-term care and case management practices; assessment skills; analytical and intervention skills; communication skills and teamwork; and advocacy. Experts highlighted that this framework can significantly improve the capacity-building efforts of interdisciplinary teams involved in long-term care case management. The competencies are further organized into three progressive levels-basic, intermediate, and advanced-to support the growth of practitioners' professional skills. The proposed transdisciplinary competency framework provides a foundation for developing and implementing training curricula for frontline professionals in the long-term care sector. Governments can utilize this framework to create career progression pathways that attract more talent to the field and enhance the supervision and evaluation of practitioners' competencies. This approach will help ensure the quality of long-term care services.

ABSTRACT Over the last 25 years, school psychology has made improvements in developing and implementing more culturally responsive school-based practices through updated ethical guidelines, training curricula, and an increase in peer-reviewed publications focusing on social justice. We sought to explore how researchers have addressed Ingraham’s call to action in 2000 for school-based consultation research to focus on how to effectively support culturally and linguistically diverse students. Through a systematic literature review using a consensual qualitative approach, we coded 17 articles that meaningfully cited Ingraham’s seminal article on the Multicultural School Consultation (MSC) Framework. Focusing on Component 3 of the MSC framework, Cultural Variations in the Consultation Constellation, we found that in the past 25 years, school psychology has answered the call as it relates to considerations of diversity in scholarly works, cultural context within consultation, issues related to the application of consultation practices within schools, and implications for future empirical research. However, scholarship is still lacking a clear, consistent method for measuring the saliency of cultural identities in the consultation triad (i.e. consultant, consultee, and client) and how this saliency affects consultation practice, especially as this influence relates to intersectionality. We present our systematic literature review findings and provide an updated call to action for school-based consultation researchers to focus on how incorporating intersecting identities can enhance the use of the MSC framework.

Educating nurses for a climate-impacted world: A systematic review of curricular and professional training approaches