BACKGROUND: Simulation-based education is widely used in nursing and medical education, but its use in physical therapy education remains inconsistent. The International Nursing Association for Clinical Simulation and Le...BACKGROUND: Simulation-based education is widely used in nursing and medical education, but its use in physical therapy education remains inconsistent. The International Nursing Association for Clinical Simulation and Learning developed standardised benchmarks to measure good simulation and provide evidence-based guidelines for implementation. These Healthcare Simulation Standards of Best Practice (HSSOBP), particularly the prebrief, are often underutilised. Prebriefing promotes a psychologically safe learning environment and sets clear expectations, which are linked to improved student learning and confidence. This project aimed to develop, implement and evaluate a standardised prebrief aligned with HSSOBP across three Doctor of Physical Therapy programs. APPROACH: Faculty from three academic institutions collaborated to design a standardised prebrief adapted for their simulation-based learning experiences (SBLEs). Students completed the Simulation Effectiveness Tool-Modified after participating in SBLEs to assess impact. EVALUATION: A total of 165 students participated across five SBLEs. Of those, 98% agreed prebrief improved their confidence and supported learning. Open-ended feedback reinforced that it contributed to a positive and productive simulation experience. The standardised prebrief framework is adaptable across institutions and health professions, offering a practical, scalable approach to improve readiness, confidence and learning while promoting consistency and safer patient care. IMPLICATIONS: Standardised prebriefing is a practical approach to improving simulation-based education. It promotes consistency while allowing flexibility to fit local needs. Core elements are relevant across health professions. This model offers a replicable framework for educators aiming to strengthen simulation outcomes. Future research should explore its long-term impact on learning and clinical performance.
INTRODUCTION: Simulation-based learning experiences (SBLEs) are increasingly used to enhance clinical competencies, with communication skills being a key focus. However, there remains a gap in identifying and validating...INTRODUCTION: Simulation-based learning experiences (SBLEs) are increasingly used to enhance clinical competencies, with communication skills being a key focus. However, there remains a gap in identifying and validating assessment tools specifically suited for evaluating communication with SBLEs in physical therapist education. This systematic review aims to identify existing validated communication skills assessment tools suitable for use in physical therapist education, addressing this critical need. METHODS: A systematic review was conducted to identify validated communication assessment tools applicable to physical therapist training. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and utilised the Modified Medical Education Research Study Quality Instrument (MMERSQI) to assess instrument methodological quality. Studies included in the review were selected based on relevance and quality, with attention to tool characteristics and psychometric properties. RESULTS: The review identified a range of communication assessment tools, categorised into general, niche and framework-based communication tools, highlighting their applicability across different healthcare contexts. CONCLUSION: Existing communication assessment tools offer a promising foundation for evaluating learner performance in SBLEs. Rather than developing new instruments, educators should consider adapting and implementing validated tools, particularly those with demonstrated reliability, for use in physical therapy education. Future research should focus on integrating and validating these tools into diverse simulation contexts to enhance instruction effectiveness and learner outcomes.
BACKGROUND: People experiencing homelessness face significant health inequities, yet their voices remain largely absent from medical education. Partnering with community-based advocates enables the integration of lived e...BACKGROUND: People experiencing homelessness face significant health inequities, yet their voices remain largely absent from medical education. Partnering with community-based advocates enables the integration of lived experience and advocacy expertise into curriculum design and delivery. This study aimed to develop and evaluate a medical education module on homeless health that embeds community-based advocacy and lived-experience expertise to advance cultural safety. APPROACH: A homelessness health module was collaboratively developed by clinical teachers, researchers, educators and community advocates with lived and professional experience of homelessness. Guided by Kern's Six Steps of Curriculum Development, a targeted needs assessment was conducted through a focus group with community advocates. Insights informed six learning objectives and the design of interactive teaching sessions. The module was delivered to second-year graduate-entry medical students and evaluated using open-ended questionnaires exploring students' understanding of cultural safety and advocacy in homeless health. EVALUATION: Fifty-three students (33%) submitted open-ended questionnaires. Deductive content analysis confirmed alignment with themes identified during the needs assessment, with most students recognising life experiences (69%), demographic hardship (65%) and healthcare access barriers (69%) as central to homelessness. Inductive thematic analysis revealed additional themes related to survival priorities and medication adherence barriers. IMPLICATIONS: Embedding community voices and patient perspectives shaped curriculum content, delivery and evaluation. Students developed compassion, reflexivity and a deeper awareness of inequities. This accessible, scalable model demonstrates how cultural safety can be embedded in inclusion health education.
BACKGROUND: Surgical placement for medical students can be challenging due to the unfamiliar operative room environment and confronting vision of open surgery. Virtual reality (VR) could provide an engaging way to prepar...BACKGROUND: Surgical placement for medical students can be challenging due to the unfamiliar operative room environment and confronting vision of open surgery. Virtual reality (VR) could provide an engaging way to prepare students for surgical learning. We sought to evaluate the impact of VR on student engagement and confidence in surgical placement, and to assess the use of VR technology in this context. APPROACH: Orthopaedic surgeons, involved in the medical students' education, developed workshops adapted from similar sessions with surgical trainees. Workshops occurred prior to surgical placement. Students performed orthopaedic surgical procedures using VR under a surgeon's supervision. EVALUATION: Thirty-six students participated in a workshop, 34 (94%) completed a pre-workshop survey, 27 (75%) a post-workshop feedback, 19 (52%) provided post-placement feedback and 22 (61%) participated in a subsequent focus group. Quantitative and qualitative data were analysed. Following the VR workshop, students were more confident in integrating into the surgical environment and actively interacting and engaging with the surgical team. Students found the VR technology fun to use, enjoyed doing virtual 'hands on' surgery and were desensitised to the visual impact of real surgery. Challenges were a lack of tactile feedback, the procedures not being relevant to junior doctor level and the cost of the software. Having the opportunity to meet and engage with surgeons in a non-threatening environment was an important benefit. IMPLICATIONS: VR is an engaging way to introduce students to surgery prior to clinical placement and give them more confidence when experiencing the operative room environment for the first time.
BACKGROUND: Feedback is a pivotal instrument for learning and performance enhancement in medical and surgical training. Its established importance for resident development, aiming for highly qualified patient care, faces...BACKGROUND: Feedback is a pivotal instrument for learning and performance enhancement in medical and surgical training. Its established importance for resident development, aiming for highly qualified patient care, faces delivery and utilisation challenges, shifting focus to active learner reception. A critical gap exists in understanding surgical residents' perceptions of this essential process. OBJECTIVE: This study aims to systematically identify and map available data regarding surgical residents' feedback perceptions during training, thoroughly analysing findings and delineating existing knowledge gaps. METHODS: Following the Arksey and O'Malley and JBI methodology, a comprehensive search across Medline, Directory of Open Access Journals (DOAJ), Directory of Open Access Scholarly Resources (ROAD), Academic Search Premier (ASP), BioMed Central Open Access (BMC) and Wiley-Blackwell (Wiley) included studies on surgical residents' feedback perceptions (attitudes, experiences, values, beliefs, satisfaction and reported impact). Data charting involved both quantitative and qualitative analyses. RESULTS: Twelve articles (2017-2024), predominantly United States-based, were included. Residents consistently valued feedback for development and confidence, preferring immediate, verbal and face-to-face delivery, ideally during or directly following a procedure. Common concerns included low frequency, lack of specificity or explicit labelling and delayed provision leading to perceived irrelevance. Influential factors encompassed timing, the learning environment, source credibility (senior residents often preferred) and preceptor personal traits. Critically, the direct impact on learning progress and skill development was often underexamined. CONCLUSION: The current evidence based on surgical residents' feedback perceptions is limited by methodological heterogeneity, reliance on retrospective designs and insufficient direct measurement of its actual impact. Resident-preceptor perception discrepancies persist, alongside inadequate detail on feedback characteristics. Thus, standardised, comprehensive and impact-focused research is critically needed to enhance surgical training feedback practices, ultimately contributing to improved patient care. TRIAL REGISTRATION: Not applicable.
The article is based on the ASME Gold Medal Address the author gave in Edinburgh in July 2025, and it explores the transformative nature of technology use and the lessons learned regarding what we become when we do use t...The article is based on the ASME Gold Medal Address the author gave in Edinburgh in July 2025, and it explores the transformative nature of technology use and the lessons learned regarding what we become when we do use these tools and systems. Educational technologies are still sometimes used in ways that augment classroom and bedside learning, but they are rarely the focus of the conversation about technology in medical education. There is more investment in administrative, tracking and reporting technologies than in educational technologies. Indeed, on the surface, medical education today looks very similar to the way it looked decades ago, but what is happening underneath is quite different. Ambient technology means massive ambient surveillance but not by medical schools. Technology also supports backchannels between learners at different institutions and differentiated learning teams, which again do not seem to be issues that schools are attending to. This is all exacerbated by the rapid adoption of Generative Artificial Intelligence (GenAI) technologies. Given that the capabilities of a learner using technology are not the same as those of a learner not using technology and that education is all about altering capability states, why do medical educators not attend to tracking capability states (both actual and perceived)? When technology helps us to do certain things, it is always at a price. Medical educators need to better understand how technologies change beliefs, values, perceptions, customs and cultures that are central to training tomorrow's doctors.
BACKGROUND: Ultrasound-guided peripheral intravenous cannulation (US-PIVC) is a critical skill for resident doctors, yet standardised ultrasound training remains inconsistent in undergraduate medical curricula. This gap...BACKGROUND: Ultrasound-guided peripheral intravenous cannulation (US-PIVC) is a critical skill for resident doctors, yet standardised ultrasound training remains inconsistent in undergraduate medical curricula. This gap may compromise patient care and safety. APPROACH: A structured, competency-based US-PIVC simulation training was integrated into the final-year medical curriculum. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, we conducted a convergent parallel mixed-method study. Quantitative data were collected through a validated rating scale in an end-of-session assessment, whereas qualitative insights were gathered via focus group discussions. EVALUATION: Ninety-eight students participated in the simulation training, with students (n = 25) and staff (n = 4) contributing to focus group discussions. The objective competency assessment demonstrated a 98% pass rate, with 84% achieving full procedural proficiency. Thematic analysis revealed that structured US-PIVC training significantly enhanced students' confidence and preparedness for their foundation doctor role. Participants reported a perceived reduction in dependence on senior staff and improvements in both patient safety and procedural efficacy. To ensure skill retention, key recommendations included providing ongoing practice opportunities, implementing logbook signoffs, appointing designated US skills leads, fostering collaborative partnerships and maintaining US equipment. IMPLICATIONS: Our study highlights the need for structured, standardised US-PIVC training to reduce variability in clinical education. The programme improved confidence, proficiency and clinical efficiency while decreasing reliance on senior staff. Embedding mandatory training, logbook signoffs and simulation realism will enhance patient safety, procedural competency and preparedness for foundation roles.
Time is the invisible currency of academic medicine: highly valued, poorly distributed and often unmanaged at the institutional level. For clinical teachers, who balance patient care, teaching, research and administrativ...Time is the invisible currency of academic medicine: highly valued, poorly distributed and often unmanaged at the institutional level. For clinical teachers, who balance patient care, teaching, research and administrative responsibilities, time management is both a professional competency and a safeguard against burnout. This Toolbox presents evidence-guided, practical strategies for optimizing time in the clinical teaching environment, drawn from organizational behaviour, behavioural economics and implementation science. Six tools form the core of this framework. The first tool, Values Alignment, encourages educators to define core values and ensure that time investments reflect both personal priorities and institutional missions. The Focus Block tool emphasizes reserving peak cognitive hours for complex tasks, such as curriculum design, manuscript preparation and learner feedback, by using calendar blocking to safeguard this time. Task Batching and Reframing addresses the 'overhead tax' of administrative work, advocating for containment strategies, batching and reframing. The Time-to-Thrive Matrix helps distinguish urgent but low-value tasks from high-value, meaningful work. The Boundaries and Options tool focuses on avoiding overcommitment by evaluating opportunities against bandwidth, values and strategic goals. Finally, the Workload Equity Audit emphasizes recognizing and redistributing invisible labour, ensuring protected time and fair workload allocation as both a matter of equity and faculty retention. Lessons learned emphasize aligning values with work, protecting focus, addressing administrative burden, prioritizing intentional boundary-setting and ensuring equity-strategies relevant to both clinical teachers and their institutions. A supplemental Time Well Spent Toolkit supports practical application in daily practice.
BACKGROUND: Teaching compassionate concussion care, particularly by engaging patients and caregivers as partners in education, is a complex and evolving field. Clinician-educators are now expected to move beyond traditio...BACKGROUND: Teaching compassionate concussion care, particularly by engaging patients and caregivers as partners in education, is a complex and evolving field. Clinician-educators are now expected to move beyond traditional methods and draw on diverse approaches to understand how people learn. Yet, many current teaching practices lack clear theoretical grounding, limiting their ability to prepare physicians to address patients' individual needs. Despite growing interest in compassion education, little is known about how paradigms shape postgraduate concussion-care training and assessment. This scoping review aimed to (1) explore the educational paradigms and learning theories underpinning postgraduate concussion-care education and (2) contrast the paradigms guiding assessment of and for learning. METHODS: Following Arksey and O'Malley's scoping review framework, we searched MEDLINE, Embase, ERIC, Cochrane, and CINAHL. Eligible articles described full-length postgraduate concussion-care educational interventions. Extracted data included intervention design, educational paradigm, learning theory and reported outcomes. FINDINGS: Of the 1574 articles screened, 9 met inclusion criteria. Identified paradigms included behaviourism, positivism, cognitivism and constructivism. Social-cultural learning theory (a form of Constructivism) appeared in six of nine studies. Most studies did not explicitly state their guiding paradigm or align assessment with compassionate outcomes. CONCLUSION: This review highlights the implicit paradigms shaping concussion-care education and their limitations for cultivating compassion. Constructivism offers the most promise for advancing compassionate practice by fostering collaboration, reflection, and learner agency. Given the interpersonal, cognitive and contextual demands of concussion care, adopting a constructivist orientation may better prepare physicians to meet patient and caregiver needs.
BACKGROUND: Avoidance of important cultural dialogues among behavioural health clinicians can lead to worse treatment outcomes. Additionally, the quality of training in cultural humility for doctoral psychology trainees...BACKGROUND: Avoidance of important cultural dialogues among behavioural health clinicians can lead to worse treatment outcomes. Additionally, the quality of training in cultural humility for doctoral psychology trainees is also inconsistent. This project examined the effectiveness of a cultural humility workshop for behavioural health consultant trainees in primary care on trainees' self-rated perceptions of cultural humility. APPROACH: In this project, we compared pre- and postscores on self-perceived cultural humility after participants (n = 12) attended an in-person cultural humility in primary care workshop. EVALUATION: We found no significant differences in perceived ability to seize cultural opportunities or perceived ability to address microaggressions after the training, but perceived cultural humility was approaching significance. Though nonsignificant, all differences were in the expected direction, providing conditional support for our hypotheses. IMPLICATIONS: These findings provide important implications for training current and future behavioral health consultant trainees on practical methods for engaging in antiracist clinical work in primary care settings.
INTRODUCTION: Extreme health inequities are experienced by Inclusion Health groups (including people experiencing homelessness, problem substance use, Gypsy, Roma and Traveller communities, vulnerable migrants, sex worke...INTRODUCTION: Extreme health inequities are experienced by Inclusion Health groups (including people experiencing homelessness, problem substance use, Gypsy, Roma and Traveller communities, vulnerable migrants, sex workers, people in contact with the justice system and victims of modern slavery). There is evidence that undergraduate medical education is failing to prepare students to work effectively with these socially excluded groups. This research explores challenges and opportunities in teaching Inclusion Health to medical students. METHODS: Twenty-three educators involved in teaching Inclusion Health at medical schools in the United Kingdom and Ireland were recruited purposively through known contacts and snowball sampling. Semistructured interviews were conducted, and the interview transcripts were analysed using reflexive thematic analysis. An inductive approach was taken, and the analysis was underpinned by a critical realist ontology. RESULTS: Five distinct themes were identified from the data: 'My goodness me, it's difficult to get that stuff in'; creating space for Inclusion Health in undergraduate curricula 'It's the human-to-human connection'; the importance of meaningful contact with people with lived experience The impact of the hidden curriculum 'Assessment is the biggest hurdle' Inclusion Health as a core competency for clinical practice CONCLUSION: Inclusion Health groups, who face intersecting forms of exclusion such as poverty, violence and trauma are at risk of being further excluded by undergraduate medical curricula. This paper enhances understanding of the challenges that are limiting Inclusion Health education. Most importantly, the paper presents solutions for how Inclusion Health can be incorporated into undergraduate medical teaching and assessment.
INTRODUCTION: Transition to residency (TTR) courses, aimed at preparing graduating medical students for residency, are increasing in prevalence. Although specialty-specific just-in-time training is nationally recommended...INTRODUCTION: Transition to residency (TTR) courses, aimed at preparing graduating medical students for residency, are increasing in prevalence. Although specialty-specific just-in-time training is nationally recommended, many courses still deliver generalised, non-specialty-specific content. The learning benefits of a specialty-specific teaching approach remain unclear. METHODS: Guided by the communities of practice framework, we developed a 4-week TTR course with specialty-specific context for seven medical specialties: anaesthesiology, emergency medicine, family medicine, internal medicine, obstetrics and gynaecology, paediatrics and surgery. The course used identical topics contextualised to each specialty. Students self-selected cohorts aligned with their planned residency and learned from specialty-specific instructors. To explore students' educational experiences, we conducted five semi-structured focus groups with 33 of 183 graduating students selected via block randomisation. Interviews explored two domains: (1) overall learning experience and (2) influences of specialty-specific instruction, context and cohort structure. Transcripts were analysed using an inductive, thematic approach. RESULTS: Three themes were identified: Learning experience: enriched by specialty-specific content, contextual relevance and faculty expertise. Learning environment: shaped by psychological safety fostered through stable cohorts and a non-competitive post-match setting Connection: promoted by specialty alignment, shared experiences and relational learning within cohorts. CONCLUSIONS: Specialty-specific content, context and instructors enhanced learner engagement through authentic, meaningful experiences. The post-match timing and cohort structure fostered psychological safety. Specialty-aligned social environments supported interpersonal connection and emerging professional identity. Our findings suggest that increasing specialty-specific content and structuring learning in specialty-specific cohorts may enhance engagement, emotional safety and professional identity development.
BACKGROUND: Lecturers in higher education commonly use slide software like Microsoft PowerPoint. Mayer's cognitive theory of multimedia learning (CTML) describes 15 principles for helping people learn better with words a...BACKGROUND: Lecturers in higher education commonly use slide software like Microsoft PowerPoint. Mayer's cognitive theory of multimedia learning (CTML) describes 15 principles for helping people learn better with words and images and is supported by a large number of empirical studies. Medical school curricula are intensive so teaching should be as effective as possible. Though there is existing research into lectures, this does not specifically determine whether CTML principles are being adopted. This study investigated to what extent lecturers incorporated the principles of CTML into lecture slide design at a single UK medical school. METHODS: Lectures were observed both live and recorded. Based on CTML principles, this included the time students were exposed to text-heavy (> 10 words) versus text-light (≤ 10 words) slides; whether images were used; the use of outlines, highlighting and pointing; extraneous images; and the labelling and timing of images. Word counts for slide sets were also recorded. RESULTS: Students were exposed to text-heavy slides 84.4% of the time. Forty percent of lectures used outlines at the beginning. Slide sets contained a median of 1531 words and a mean of 38.3 words per slide. CONCLUSION: Slide design appeared to consistently violate CTML principles; therefore, lecturers should receive training in adhering to these principles. Future research should examine what barriers exist to adopting CTML principles and how such training for teachers on these principles could be delivered.