The way we teach physical diagnosis needs to be revitalized. Medical students now see patients in their first year, and the traditional head-to-toe physical exam (HTTE) can be overwhelming with its over 100 manoeuvres an...The way we teach physical diagnosis needs to be revitalized. Medical students now see patients in their first year, and the traditional head-to-toe physical exam (HTTE) can be overwhelming with its over 100 manoeuvres and does not give learners physical exam readiness for early clinical work. We have developed and implemented Core + Clusters (C + C). C + C begins with a streamlined Core Exam, with approximately 40 manoeuvres, that prepares learners for early clinical experiences. Diagnostic Clusters, the second component of C + C, are sets of history-taking questions and physical examination manoeuvres critical to discriminating among diagnoses in common clinical presentations. They build on prior education models by combining hypothesis-driven history-taking with hypothesis-driven physical examination to better resemble clinical practice. The C + C model is feasible, requires resources similar to those used in the HTTE curriculum and is flexible enough to adapt to the curricula of diverse institutions. In this paper we offer a C + C toolkit which describes the C + C components, gives examples of curricular implementation and shares lessons we have learned from over 10 years of experience with C + C.
BACKGROUND: Trans (trans) is an umbrella term referring to diverse gender identities including transgender and nonbinary. Trans people have faced discrimination in healthcare settings as demonstrated in research reportin...BACKGROUND: Trans (trans) is an umbrella term referring to diverse gender identities including transgender and nonbinary. Trans people have faced discrimination in healthcare settings as demonstrated in research reporting the experiences of trans patients. There is limited UK-based literature on this topic, particularly from healthcare professional (HCP) perspectives. This review draws together existing evidence on themes in the attitudes and knowledge of HCPs towards trans patients. METHODS: In this evidence review, a systematic search was conducted of multiple key databases using key concepts: (1) transgender, (2) attitudes and (3) healthcare professionals. Reflexive thematic analysis was used to analyse the qualitative data and narrative synthesis for the quantitative data. MMAT checklists were used to critically appraise the data. FINDINGS: After thematic analysis of 14 articles, five themes were developed: (1) discriminatory attitudes towards trans patients, (2) knowledge gaps and training needs, (3) uncertainty around caring for trans patients, (4) impact of HCP knowledge and attitudes on trans patients, (5) trans inclusive attitudes of HCPs. CONCLUSION: The main themes were interlinked: Discriminatory attitudes (Theme 1) were connected to knowledge gaps (Theme 2), which were linked with uncertainty (Theme 3), ultimately all negatively impacting trans patients (Theme 4). Recommendations such as embedding trans healthcare education in HCP curriculums and implementing trans-inclusive policy were made. Recommendations from these findings aim to contribute to a more trans-inclusive healthcare culture where trans patients feel welcome instead of stigmatised and can build trusting HCP-patient relationships with positive consequences for patient care.
BACKGROUND: Research engagement during medical school enhances students' critical thinking, research skills, and competitiveness for future careers. The University College Dublin (UCD) Student Summer Research Awards (SSR...BACKGROUND: Research engagement during medical school enhances students' critical thinking, research skills, and competitiveness for future careers. The University College Dublin (UCD) Student Summer Research Awards (SSRA) programme provides undergraduate medical students with an opportunity to undertake supervised research projects. This study aimed to evaluate the feasibility and acceptability of the SSRA General Practice programme among medical students engaged in primary care research. METHODS: A mixed-methods study was conducted, including a secondary analysis of programme participation data (2016-2024) and a self-administered survey distributed to former SSRA participants. Quantitative data were analysed using IBM SPSS Version 27, whereas qualitative responses were examined through thematic analysis. RESULTS: Of 82 applicants, 45 students (54.8%) were selected for the SSRA General Practice programme, with 44 (97.7%) successfully completing it. Research dissemination was high, with 40 (90.9%) participants presenting at SSRA Poster Night and having their abstracts published. Additionally, 16 (36.4%) published in scientific journals, and 29 (65.9%) presented at national and international conferences. Among 18 survey respondents, the majority reported increased research skills (77.8%), satisfaction with supervision (77.8%), enhanced motivation for research (50.0%) and general practice careers (55.6%). CONCLUSION: The GP SSRA programme has demonstrated positive outcomes by increasing student engagement in research and reported greater interest in primary care research and general practice. Future efforts should focus on increasing funding, supervisor involvement and integrating structured research training into the medical curriculum.
BACKGROUND: Undergraduate medical students often feel unprepared to manage unstable patients, especially in emergency and intensive care settings. Inadequate exposure to real clinical learning tasks without hands-on expe...BACKGROUND: Undergraduate medical students often feel unprepared to manage unstable patients, especially in emergency and intensive care settings. Inadequate exposure to real clinical learning tasks without hands-on experience may contribute to these feelings of unpreparedness. Traditional lectures might not sufficiently support the development of medical skills in this area. This article describes the design and satisfaction-based evaluation of a 1-h innovative workshop for teaching undergraduate medical students how to manage unstable neurologic patients. APPROACH: In March 2025, the Swiss Medical Students' Convention organised by the Swiss Medical Students' Association took place in Lausanne, Switzerland, with the goal of improving students' readiness to manage unstable patients in an acute care environment. The workshop included students from diverse Swiss universities and training backgrounds, which called for a flexible and inclusive approach. It employed experiential learning strategies and gamification principles to engage students in three structured stations, focusing on neurologic assessment, identifying red flags in comatose patients and preventing secondary cerebral damage. EVALUATION: After the workshop, students completed a questionnaire with closed and open-ended questions. Quantitative and qualitative data were analysed using descriptive statistics. Data indicated a high level of satisfaction among participants regarding the structure, content and interactivity of the workshop. Medical students appreciated the peer-based, mixed-level learning approach, which promoted collaboration and critical thinking. IMPLICATIONS: This initiative demonstrates how short, hands-on, student-centred workshops can enhance medical students' engagement for critical care management. Future research should include preassessment and postassessment to measure its impact on clinical reasoning and knowledge growth.
BACKGROUND: In the United States, approximately 90% of the population believes in God or a higher power. Spirituality is integral to decision-making for some patients, and when spiritual needs are met, healthcare costs m...BACKGROUND: In the United States, approximately 90% of the population believes in God or a higher power. Spirituality is integral to decision-making for some patients, and when spiritual needs are met, healthcare costs may be reduced. At the University of Michigan Medical School, we observed a paucity of education in spiritual care. We developed an elective to engage medical students in reflecting on spirituality in the care of critically ill patients and their own experiences and evaluated the impact of this educational model. APPROACH: Senior medical students shadowed chaplains and participated in reflection sessions with chaplain-led peer groups. A retrospective pre-post survey was collected from students to assess the impact of the elective. EVALUATION: Seventy-eight students participated in the elective between 2017 and 2020. After the elective, students reported increases in how much they value finding personal meaning in patient care (88%- 100%) and responding to patients' spiritual concerns (53%-94%). Review of narrative feedback revealed that the elective fostered a more inclusive understanding of spirituality, heightened recognition of spiritual care as an essential yet often overlooked aspect of care, increased awareness and empowerment to use available resources, and meaningful personal and professional growth within a safe, reflective space. IMPLICATIONS: The elective shifted student perception on the importance of the role of spirituality in medicine. Educational initiatives such as this help address a need within undergraduate medical education and can serve as a platform for integrating spirituality and interprofessional education and collaboration into medical training.
INTRODUCTION: Sustaining clerkship preceptors is increasingly challenging, leading to interest in preceptor retention and incentive strategies. Guided by self-determination theory (SDT), this study examined preceptor ret...INTRODUCTION: Sustaining clerkship preceptors is increasingly challenging, leading to interest in preceptor retention and incentive strategies. Guided by self-determination theory (SDT), this study examined preceptor retention and factors associated with retention after a large-scale curriculum reform including transition to an all-longitudinal integrated clerkship (LIC) curriculum. METHODS: A survey was administered to 1164 LIC preceptors at a single institution. Questions focused on intention to precept the next year, reasons for continuing or leaving and incentives to motivate teaching. Descriptive and comparative statistics were performed. RESULTS: An 83% response rate was achieved (n = 965), with a preceptor retention rate of 84.5% (816/968). The most common reasons cited for leaving precepting roles were as follows: needing a break (n = 46, 30.1%), leaving clinical practice (n = 31, 20.1%) and decreased clinical time (n = 29, 19.3%). Specialty, participation in faculty development and perceived ease/difficulty of assessment forms were not associated with retention; only being a first-year preceptor was shown to have significant negative association (p = 0.006). Most preceptors leaving teaching cited personal reasons (n = 74, 46.7%). For those planning to return to precepting, the most common reason cited was the longitudinal relationship with students (n = 536, 66%). CONCLUSIONS: Faculty decisions to continue or discontinue precepting were driven primarily by personal or structural factors rather than dissatisfaction with the curriculum. Consistent with SDT, the longitudinal relationship with students was the strongest motivator to precept, suggesting the LIC model itself may support faculty recruitment and retention. First-year faculty are at greatest risk for attrition and represent a key target for intervention and support aimed at retention.
BACKGROUND: Simulation-based training enhances medical education by improving learners' experience and proficiency. High-fidelity simulation (HFS) increases skill acquisition and retention when compared to standard train...BACKGROUND: Simulation-based training enhances medical education by improving learners' experience and proficiency. High-fidelity simulation (HFS) increases skill acquisition and retention when compared to standard training techniques. Debriefing is a key part of simulation education and peer-led debriefing (PLD) may also be appropriate. This study aims to determine whether PLD is as effective as instructor-led debriefing (ILD) in improving learner outcomes in HFS. METHODS: This SRMA followed the PRISMA and Cochrane guidelines and was registered on PROSPERO (CRD420251082121). PubMed, Cochrane and Embase were databases searched from inception to June 2025. Two independent reviewers screened studies, extracted data and assessed risk of bias using RoB 2. Outcomes were pooled using random-effects models; heterogeneity was assessed using I using RevMan 5.4. FINDINGS: Six studies (five quasi-experimental and one RCT) containing 476 participants (peer-led: 245; instructor-led: 231) were included. No statistically significant differences were found between PLD and ILD. The overall certainty of the evidence was low to moderate. For Debriefing Assessment for Simulation in Healthcare (DASH), MD = -1.06 (95% CI: -3.81, 1.69; p = 0.45; I = 87%). Organised debriefing: MD 0.19 (95% CI: -0.64, 1.02; p = 0.65; I = 91%). Other outcomes (e.g., helping achieve good practice, identifying performance gaps and establishing engaging learning environment) also showed nonsignificant differences. IMPLICATIONS: No statistically significant differences were observed between PLD and ILD across the included studies. Limited and heterogeneous evidence base means the findings should be interpreted cautiously. Robust, well-designed RCTs are needed to confirm these findings, address heterogeneity and explore long-term effects.
BACKGROUND: Colour vision deficiency (CVD) or colour blindness can affect healthcare professionals in tasks that require colour perception. Despite its occurrence, there is limited awareness within healthcare education t...BACKGROUND: Colour vision deficiency (CVD) or colour blindness can affect healthcare professionals in tasks that require colour perception. Despite its occurrence, there is limited awareness within healthcare education to support students and practitioners with CVD. This narrative literature review examines the impact of CVD on educational experiences and clinical performance, summarises recommended teaching interventions and identifies gaps in training and institutional support. METHODS: A methodical search was conducted using seven databases (CINAHL, EMBASE, ERIC, Google Scholar, MEDLINE, PsycINFO and PubMed) using keywords related to CVD and healthcare education. Articles published between August 2013 and January 2026 were included if they addressed CVD in healthcare professionals or students and discussed educational practices or clinical implications. Thematic analysis was used to categorise findings and develop insights. FINDINGS: The review identified gaps in screening, awareness and support for individuals with CVD in healthcare education and clinical practice. Few programs screen for CVD or offer accommodations for those with CVD. The literature supports the use of universal design principles, alternative instructional strategies and assistive technology. Effective interventions include grayscale imaging, high-contrast visuals, adaptive technologies and purposeful instructional design. CONCLUSIONS: There is a need to implement changes in both healthcare education and clinical practice to support individuals with CVD. Routine screening, universal design principles, adaptive tools and standardised guidelines are essential. Future research needs to evaluate the effectiveness of current interventions, identify best practices in education and inform evidence-based policies to promote a supportive educational environment.
BACKGROUND: The clinical teaching fellow (CTF) role is often taken by resident doctors between training programmes to develop skills within medical education. This project explored CTF experiences of pastoral care provis...BACKGROUND: The clinical teaching fellow (CTF) role is often taken by resident doctors between training programmes to develop skills within medical education. This project explored CTF experiences of pastoral care provision at one medical school in the United Kingdom (UK), specifically focusing on their own role and responsibilities to inform practical support strategies for doctors as future medical educators. METHODS: This study adopted a qualitative, hermeneutic phenomenological approach. Five focus groups were conducted at different hospital sites where medical students undertake clinical placements, known individually as academies. The focus groups explored what pastoral support meant to CTFs and their experiences of providing pastoral support to medical students. Reflexive thematic analysis was undertaken collaboratively by the research team. FINDINGS: The views of CTFs at different academies were generally aligned and four themes were identified. These included: (1) holistic pastoral care; (2) organisational influences: a mismatch of expectations; (3) challenges of the role; and (4) support for CTFs. The term pastoral care remains ill-defined, but there was universal agreement amongst CTFs that it required a holistic approach to all student-related issues. The near-peer educational relationship between CTFs and medical students appears to be a fulfilling aspect of the role. Further clarity is required surrounding the expectations of the CTF role, which has led to indistinct boundaries surrounding the promotion of student well-being. CONCLUSION: Future considerations include acknowledgment of the cognitive load associated with supporting students, defining CTF responsibilities within the current escalation pathways and providing preparatory and sustained training.
PURPOSE: Neuroendovascular intervention (NEI) or interventional neuroradiology (INR) exposure is limited during neurosurgery, neurology and diagnostic radiology residencies as this is a fellowship-based area of competenc...PURPOSE: Neuroendovascular intervention (NEI) or interventional neuroradiology (INR) exposure is limited during neurosurgery, neurology and diagnostic radiology residencies as this is a fellowship-based area of competence. Although structured curricula exist, residents may graduate with limited knowledge and skills related to endovascular patient management and procedures. Our study explores trainee and faculty perspectives on neurointerventional learning opportunities during residency training. METHODS: A scoping review was conducted using the Preferred Reporting Items for Systematic-Reviews and Meta-Analyses extension for Scoping Reviews. OVID MEDLINE, OVID Embase and PUBMED databases were searched for original research published in the English language on neurosurgery, neurology and radiology residencies. Covidence was used to compile studies, screen studies and extract data that met criteria. RESULTS: Of 1025 articles, 30 studies met the inclusion criteria. The most common study designs were surveys (30%) and literature reviews (23%). We identified three key emerging concepts in residency: (1) existing gaps in INR exposure, (2) calls for earlier curricular integration and (3) the emergence of curricular initiatives to increase INR exposure to address these gaps. CONCLUSION: Trainees and program leaders report perceived limitations in INR exposure during residency training while acknowledging that procedural competence can be gained through post-residency fellowships. Current perspectives and educational approaches described in the literature highlight ongoing discussion regarding the role of residency in providing foundational exposure and career awareness in INR.
BACKGROUND: Formative feedback is integral to the educational process. We recognised the need to improve our formative feedback due to variable quality, timeliness and depth. Our objective was to improve the quantity and...BACKGROUND: Formative feedback is integral to the educational process. We recognised the need to improve our formative feedback due to variable quality, timeliness and depth. Our objective was to improve the quantity and quality of formative feedback given to medical students during clinical rotations using the Define-Measure-Analyse-Improve-Control (DMAIC) problem-solving method. APPROACH: Based on initial assessment of 50% of students receiving completed formative feedback forms within 72 h after request, we created a task force with representatives from each rotation that met biweekly for 1 year. High-quality feedback was that achieving a Quality of Assessment for Learning score ≥ 4. We identified stakeholders and conducted focus groups to determine barriers; solutions were implemented asynchronously with task force input and iteration as necessary. Formal data were collected upon task force implementation and periodically for a year. Three key deficiencies emerged: faculty education regarding formative feedback, time for completion and proximity of receiving forms to the encounter. Three methods for improvement were implemented at representative discretion: QR codes to access forms, shortened forms with modified verbiage and increased small-group faculty education. EVALUATION: Although formally collected baseline data indicated a 73.4% completion rate for formative feedback forms (higher than anticipated), which remained unchanged over the course of a year, the interventions significantly increased the frequency of high-quality feedback (37.5%-59.4%, p = 0.01), with improvement in all rotations. IMPLICATIONS: Implementation of a task force combined with increased education and potentially simplifying form completion and wording improved formative feedback quality while maintaining quantity.
BACKGROUND: Children and young people with intellectual and developmental disabilities (IDD) often face significant challenges in emergency departments (ED), where a high-acuity environment can exacerbate distress, leadi...BACKGROUND: Children and young people with intellectual and developmental disabilities (IDD) often face significant challenges in emergency departments (ED), where a high-acuity environment can exacerbate distress, leading to behaviours of concern (BOC). Identifying and managing BOC requires specialised skills, yet many healthcare professionals report a lack of confidence and structured training. Traditional educational models may lack real-world applicability by failing to incorporate the lived experiences of patients and families. APPROACH: The Motivated for Change programme was codeveloped with caregivers to enhance healthcare professionals' ability to identify, mitigate, and de-escalate BOC in children with IDD using simulation-based education (SBE). The programme integrated prelearning modules, interactive lectures, and novel immersive simulations. SBE was codesigned with parents, clinicians and educators to reflect real-world ED challenges and guided child and family-centred approaches. Participants engaged in simulation exercises to practice communication strategies and implement reasonable adjustments in a structured, supportive learning environment. EVALUATION: Eighty-two ED healthcare professionals participated in 11 simulation sessions. Postsession surveys revealed SBE was effective in consolidating skills in communication and engagement (100%), identifying BOC (99%), preventing escalation (99%) and de-escalation strategies (96%). Ninety-seven percent felt more confident applying reasonable adjustments in clinical practice. Reflexive thematic analysis identified key learnings, including parent partnership, effective communication, early recognition and intervention and environmental modifications.
INTRODUCTION: Speech pathologists work with populations vulnerable to mental illness. Investigating the mental health literacy of speech pathology students in their final year of study is an important first step in ident...INTRODUCTION: Speech pathologists work with populations vulnerable to mental illness. Investigating the mental health literacy of speech pathology students in their final year of study is an important first step in identifying their preparedness for this area of professional practice. This study sought to investigate the mental health literacy of speech pathology students in their final year of undergraduate study by comparing their mental health literacy to that of first year students and considering relevant associates. METHOD: A cross-sectional between-groups study was conducted with speech pathology students in their first and final year of undergraduate study at an Australian university. Participants completed a 56-item online survey. RESULTS: Participants were 46 final year speech pathology students and 32 first year students. Final year students had higher mental health literacy scores than first years. Across the whole sample, previous engagement in treatment for mental health symptoms was the only predictor variable to account for a statistically significant portion of the variance in mental health literacy scores of students. CONCLUSIONS: Preliminary findings suggest that mental health literacy develops over the course of the degree and that final-year students appear prepared, from a knowledge perspective, for their role in supporting individuals with mental health needs. The main source of this knowledge appears to be personal experience of treatment. A review of mental health curriculum content might be appropriate to ensure those without personal treatment experience can develop knowledge, and for those with personal experience, this is comprehensive and evidence based.