How P(H)C is your curriculum?

In South Africa and internationally, the alignment of health professions education programme with primary healthcare (PHC) policies is seen to promote the training of fit-for-purpose graduates who can adequately respond to the demands of patient and community needs. This article seeks to describe the development of a tool to assess the degree of PHC in an undergraduate medical curriculum. In defining what is meant by PHC, four dimensions of PHC were identified for the purpose of designing the tool, namely values underpinning PHC, principles of PHC, a generalist focus of the programme, and the level of care that the programme is delivered at. The tool also sought to assess how the content in these dimensions is covered in the curriculum and to which depth students are required to engage. The perspectives that were considered were: what content was being covered, what pedagogy was used, in which context it was being taught and how it was being assessed. For each of these aspects, the dimensions are assessed using an amended Miller's pyramid to assess the expectations of outcomes for the curriculum. The tool is presented and the article reflects on the use of the tool in a process of assessing a medical curriculum.

Click and learn: a longitudinal interprofessional case-based sepsis education curriculum.

BACKGROUND: Sepsis is a global healthcare challenge and a leading cause of morbidity and mortality. In the USA, the Centers for Medicare & Medicaid Services has integrated the Severe Sepsis and Septic Shock Management Bundle (SEP-1) into their Core Quality Measures, which has been linked to lower mortality rates. However, SEP-1's multiple bundle elements present compliance challenges without comprehensive education and a collaborative approach involving nurses and providers (attending physicians, resident physicians, nurse practitioners and physician assistants). METHODS: We developed a virtual longitudinal, case-based curriculum using Kern's six-step approach to curriculum development and evaluated its effectiveness using the Kirkpatrick model. The curriculum was distributed hospital-wide over a 32-month period. RESULTS: A total of 3616 responses were received for the Sepsis Case-Based Curriculum modules, with 47% from nurses and 53% from providers. Responses were distributed similarly among medical and surgical specialties, as well as intensive care units. Nurses' responses were 56% correct, and providers' responses were 51% correct. Most respondents expressed a likelihood of applying the learning to their practice and reported increased knowledge of sepsis. Themes from participant feedback indicated that they found the activity informative and applicable to real-world cases. Additionally, the hospital's SEP-1 bundle compliance improved from 71% (Q1 2021) to 80% (Q3 2023) during the study period. CONCLUSION: Meeting SEP-1 bundle elements requires a team-based approach involving providers and nurses. Given the busy hospital environment and diverse care providers, a longitudinal, engaging and concise educational curriculum related to real-life scenarios can enhance sepsis and SEP-1 education.

Promoting resilience among medical students using the Wadi framework: a clinical teacher's perspective.

Resilience is essential for medical students to navigate the challenges of their education and future careers. Defined as the ability to adapt well in the face of adversity, resilience can be learned and is critical for maintaining mental health. Medical educators play a pivotal role in fostering resilience by integrating it into both formal and informal curricula, including the hidden curriculum, which can significantly influence students' coping strategies. Research highlights the importance of resilience training in reducing depression and anxiety among students, underscoring its necessity as a core component of medical education. This essay presents the Systematic Assessment for Resilience (SAR) framework, which provides a comprehensive approach to promoting resilience through four key constructs: self-control, management, engagement, and growth. Practical strategies for each construct are discussed, including assessment mapping, time management, and the use of formative assessments to enhance students' preparedness and self-control. Engagement is fostered through collaborative assessments, open book exams, and regular formative feedback, while growth is encouraged via self-reflection and faculty development. Implementing the SAR framework has shown positive outcomes, with students reporting reduced anxiety and improved performance. However, further exploration and institutional support are needed to fully integrate these strategies into medical education. The SAR framework offers a feasible and effective method for cultivating resilience, contributing to students' mental well-being and equipping them to face future challenges in their medical careers. Continued refinement and broader institutional adoption will be crucial to sustaining the impact of resilience training in medical education.

The pattern of reporting and presenting validity evidence of extended matching questions (EMQs) in health professions education: a systematic review.

The Extended matching Questions (EMQs), or R-type questions, are format of selected-response. The validity evidence for this format is crucial, but there have been reports of misunderstandings about validity. It is unclear what kinds of evidence should be presented and how to present them to support their educational impact. This review explores the pattern and quality of reporting the sources of validity evidence of EMQs in health professions education, encompassing content, response process, internal structure, relationship to other variables, and consequences. A systematic search in the electronic databases including MEDLINE via PubMed, Scopus, Web of Science, CINAHL, and ERIC was conducted to extract studies that utilize EMQs. The framework for a unitary concept of validity was applied to extract data. A total of 218 titles were initially selected, the final number of titles was 19. The most reported pieces of evidence were the reliability coefficient, followed by the relationship to another variable. Additionally, the adopted definition of validity is mostly the old tripartite concept. This study found that reporting and presenting validity evidence appeared to be deficient. The available evidence can hardly provide a strong validity argument that supports the educational impact of EMQs. This review calls for more work on developing a tool to measure the reporting and presenting validity evidence.

Sex Educators' Strategies for Building Student Trust.

Although clinicians have been the focus of research on trust in health care, much of the health guidance Americans receive occurs outside clinical settings. School-based health education is one such setting. Given the importance of interpersonal dynamics to clinicians' work, trust likely features heavily in achieving health educators' outcomes. This study asks: How do health educators approach building trust with students? In interviews with 39 sexual health educators in Ohio and Illinois, I find that educators report several strategies that they use in their attempt to build student trust: They use personal anecdotes and informality to distinguish themselves from teachers; adjust their approach based on their race, gender, or age if they perceive these identities impede trust; and emphasize lessons are factual when facing pushback. My findings reveal key differences in how clinicians and nonclinical professionals approach trust and more broadly, how organizational factors impact health professionals' approach to trust.

Building resilience among undergraduate health professions students: identifying influencing factors.

BACKGROUND: Resilience contributes to mental well-being, hence expediting recovery from stressful events. Health professions students, in particular, often experience heightened levels of stress and anxiety due to academic demands and other stressors. This study aimed to explore the factors contributing to resilience and identify support systems that universities can implement to help undergraduate health professions students build resilience and manage their mental well-being. METHODS: A total of 28 students from the fields of Medicine, Dentistry, Pharmacy, and Dietetics and Nutrition participated in semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The interviews were stopped when data saturation was achieved. The data were analysed using thematic analysis. RESULTS: Thematic analysis of the interviews identified five key themes contributing to resilience: life experience, socioeconomic factors, personal attributes, support resources, and role modelling. Universities play a crucial role in fostering resilience among health professions students through soft skills training, workplace-oriented training, mentoring, and extracurricular activities. These opportunities enable students to develop and strengthen resilience in both formal and informal settings. Such initiatives not only equip students to manage future career challenges but also support their overall personal and professional development. CONCLUSIONS: This study provided a comprehensive understanding of the contributing factors to health professions students' resilience. The availability of support resources together with a nurturing environment provided by university are crucial. By fostering resilience, students are better prepared to navigate the challenges of the demanding professions and develop the emotional fortitude necessary for long-term success in healthcare.

Regulation of health professions education and the growth of schools in Somalia.

BACKGROUND: Health professions education, encompassing training programs for medicine and surgery, nursing, midwifery, medical laboratory sciences,, and public health, along with their regulations, are pivotal to achieving universal health coverage and Sustainable Development Goals, contributing significantly to health outcomes and public trust in the healthcare workforce. However, low- and middle-income countries, especially in sub-Saharan Africa, face challenges, such as inadequate resources, outdated curricula, and weak governance. Somalia in particular grapples with a fragmented health system and a critical shortage of skilled health professionals, exacerbated by decades of civil war and political instability. METHODS: This study employed a mixed-method approach that incorporated both qualitative and quantitative data collection and analysis. A comprehensive literature review was conducted along with semi-structured interviews with 44 key informants, including representatives from professional health schools and officials from the Ministry of Health. Additionally, five focus group discussions were held with young professionals and an online survey was administered to students enrolled in professional health courses. The data analysis employed descriptive for quantitative data, and thematic analysis for qualitative data, guided by the human resources for health (HRH) maturity model framework. RESULTS: This study identified 112 health professions schools across Somalia, with a significant concentration in urban areas, particularly in Benadir. The health workforce analysis revealed a pronounced urban-rural disparity and a density of health professionals below the WHO's recommended threshold. The focus group discussions and surveys highlighted the employment challenges faced by young physicians and students' perceptions of their training and future employment opportunities. CONCLUSION: The proliferation of health professions schools without adequate quality control, the critical shortage and maldistribution of skilled health professionals, and the absence of a comprehensive regulatory framework are significant challenges facing Somalia's healthcare system. The establishment of the National Health Professionals' Council (NHPC) Act in 2020 marks a step towards addressing these issues. This study emphasizes the need for accreditation of health professions schools, capacity building of HRH teams, and collaboration among stakeholders to improve healthcare workforce development and regulation. Addressing urban-rural disparities and combating professional misconduct are also crucial for achieving universal health coverage and improving health outcomes in Somalia.

Community college student perceptions of digital anatomy models as a curricular resource.

Digital model platforms and applications are common in anatomy education and continue to grow in number, which suggests that educators and students find use for these tools despite the lack of widely accepted best practices. Consequently, it is a challenge for educators to mindfully integrate digital models into curriculum. This short-term, longitudinal study investigated the effects of integrating a monoscopic digital model as a teaching tool during lectures on reproductive and endocrine anatomy as an intervention in a community college human anatomy and physiology course. Student use and perceptions of digital models were analyzed for correlation with the nature of the course content and the intervention (n = 92). Academic content significantly affected self-reported student use (p < 0.001) as well as student perceived usefulness of the model (p = 0.02). These findings support the conjecture that digital anatomy models may be better for achieving certain specific learning goals opposed to all learning goals. Integration of digital models as an instructional method did not consistently influence student behavior but it made a difference in participant ability to recognize this technology outside of the lecture. Overall, participants had a positive perception of digital models, although they were not perceived as more important than all other curricular resources. Inclusion of monoscopic digital models for teaching anatomy should be considered by educators since teaching with digital models can demonstrate strengths and weaknesses for students within the context the of learning objectives, assisting students to make more informed decisions about effective learning tools.

An evaluation of practice supervisor training for final-year healthcare students.

Practice supervisors are fundamental in the development and upskilling of the future workforce in health care. This article outlines a new initiative for one higher education institution, which integrated practice supervisor training into the curriculum for third-year students across several healthcare programmes. The training consisted of two pre-recorded sessions, which were delivered by the students' personal tutors. A final face-to-face session was then facilitated, where students were supported to consolidate their learning and build on their knowledge. Evaluation data were collected via an anonymous questionnaire. In total, 352 questionnaires were returned. Data were managed and analysed using descriptive statistics within Excel. The qualitative comments received were collated and analysed using simple thematic framework analysis. Most attendees found the content and the delivery of the programme and their opportunity for discussions to be good, very good or excellent, showing overall that content was positively evaluated by 98.4% of attendees, delivery at 97.4% and opportunity for discussion at 97.9%. The evaluation data results show that practice supervisor preparation can be effectively delivered when located in the final year for undergraduate healthcare students. The importance of the content being interactive and allowing for plenty of opportunities for group discussions has been highlighted by the feedback.

Prevalence of Dunning-Kruger effect in first semester medical students: a correlational study of self-assessment and actual academic performance.

INTRODUCTION: The ability to self-assess is a crucial skill in identifying one's own strengths and weaknesses and in coordinating self-directed learning. The Dunning-Kruger effect occurs when limited knowledge causes individuals to overestimate their competence and underestimate others', leading to poor self-assessment and unrecognized incompetence. To serve as a foundation for developing strategies to improve self-assessment, the self-assessment abilities of first-semester students were assessed. METHODS: In the final weeks of the summer 2021, winter 2021/22, and summer 2022 semesters, the academic performance (oral anatomy exam) of first semester students was assessed (0-15 points). Before the exam results were announced, students were asked to self-assess their performance. RESULTS: Exam scores (M = 10.64, SD = 2.95) and self-assessed scores (M = 10.38, SD = 2.54) were comparable. The absolute difference between them, as a measure of self-assessment ability ranged from - 9 to + 9 points (M = -0.26, SD = 2.59). Among participants (N = 426), 18.5% assessed themselves accurately, 35.5% overestimated, and 46.0% underestimated their performance. The correlation between actual score and self-assessment was ρ = -0.590 (p < 0.001), reflecting the Dunning-Kruger effect. When separated by gender, correlation for females was ρ = -0.591 (p < 0.001), and for males ρ = -0.580 (p < 0.001). CONCLUSIONS: Realistic self-assessment is a challenge for first-semester students. The data indicate that females tend to overestimate their performance while males underestimate theirs. A pronounced Dunning-Kruger effect is evident in both genders, with significant negative correlations between self-assessment and actual performance. There are several reasons for the occurrence of the Dunning-Kruger effect. Considering that the COVID-19 pandemic influenced learning environments, collaborative learning was significantly restricted. The lack of opportunities for comparison could potentially lead to unrealistic self-assessment.

Team-based learning in health professions education: an umbrella review.

BACKGROUND: Team-Based Learning (TBL) has garnered considerable attention in education research. To consolidate the existing evidence, we conducted an umbrella review with four objectives: (a) to identify TBL review characteristics, (b) to synthesize findings from previous reviews regarding TBL effectiveness and outcomes, (c) to determine which student groups benefit most, and (d) to identify the most and least researched elements. METHODS: The Joanna Briggs Institute (JBI) methodology was followed: [1] Search strategy and literature search [2] Screening and Study Selection [3] Assessment of methodological quality [4] Data collection, and [5] Data summary. We utilized Endnote, Excel, and MAXQDA for efficient project management and analyzing data. RESULTS: Analyzing twenty-three reviews spanning from 2013 to 2024, we found a peak in TBL research in 2022 including more than 312 unique primary studies involving more than 63,987 participants. Notably, the United States and China accounted for over 61% of the total primary articles focused on students from medicine, nursing, pharmacy, and dentistry. Evidence supports the superiority of TBL in enhancing cognitive outcomes. However, findings related to retention are mixed. Insufficient evidence exists to draw robust conclusions when comparing TBL with other active learning methods. TBL demonstrates favorable outcomes in terms of clinical performance and engagement. Non-technical skills show mixed results. Notably, TBL positively impacts self-study, learning ability, decision-making, and emotional intelligence. Faculty experiences reveal an initial increase in workload, but generally hold positive attitude. Faculty development remain limited in duration and scope. Freshmen, academically weaker students, undergraduates, Chinese female students, and nursing students appear to benefit most from TBL. Team formation and size are the most frequently studied elements. CONCLUSION: TBL holds promise for improving learning outcomes, but ongoing investigation is essential to maximize its impact in diverse educational contexts. This umbrella review underscores the need for further research in specific areas i.e. effective pre-class learning methods and faculty workload.

Interactive hygiene training using free open source software.

OBJECTIVES: Regular hygiene trainings are an important way to refresh and improve knowledge about hygiene measures and the prevention of healthcare-associated infections. We aimed to develop an e-learning course to allow healthcare workers (HCWs) to learn these contents through a self-paced online format. METHODS: We developed an interactive hygiene training for HCWs of a tertiary care hospital using different content types of the HTML-5 package (H5P) plugin embedded into a Moodle-based learning management system. We evaluated the course using a short online questionnaire. RESULTS: We present various suitable topics for online hygiene trainings as well as their implementation in an e-learning course. Examples include content on hand hygiene indications and techniques, information on multidrug-resistant organisms and other current topics in infection control. HCWs reported high overall satisfaction, perceived increase in knowledge, practical relevance as well as good usability and comprehensibility. DISCUSSION: Currently available commercial and non-commercial hygiene trainings present a number of specific advantages but also drawbacks. The presented approach combines the advantages of both approaches. The majority of the presented content can be readily adapted to suit various hospitals and care facilities or serve as inspiration for creating similar courses while remaining cost-effective. CONCLUSION: H5P course presentations are a low-threshold, cost-effective way to implement digital hygiene trainings in a wide variety of clinical settings.

Leading Across Health Professions: Reflections on Opportunities and Challenges.

Pharmacy leaders are well equipped to serve as academic leaders overseeing additional health profession programs and/or faculty. Organizing multiple health professions programs under one umbrella offers a number of opportunities, such as efficiencies in financial and human resources, expanded and more diverse leadership talent which offers advantages in succession planning, organizational effectiveness in its operations, expanded opportunities for interprofessional education and collaborations in research and scholarship, greater visibility as a partner for establishing pipeline agreements and clinical partners affiliations, and personal professional development and growth for those in senior leadership positions. However, pharmacy academic leaders with oversight over multiple health professions programs and faculty also face challenges in understanding the professional identities and culture of their faculty, complexities of equity of workload across numerous departments, mistrust from departments other than pharmacy, and their own increased workload and possible burnout. The American Association of Colleges of Pharmacy has recently established a new Multi-Professional Health Care Administrative Leaders Connect Community, which should be further promoted to increase membership. Programming to allow additional networking, sharing of best practices, mentorship and professional development of leaders who oversee, or aspire to oversee, multiple health professions programs can be beneficial. Further research can describe different models of organizing multiple health professions programs and identify best practices for successful organizational and operational structures.

Tree: Reducing the use of restrictive practices on psychiatric wards through virtual reality immersive technology training.

BACKGROUND: Restrictive practices (RPs) are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency. Seclusion is an equal part of RPs intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity. Using interventions by way of virtual reality (VR) could assist with reducing the need for RPs as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments. This could also aid staff to and change current RPs. AIM: To assess the feasibility and effectiveness of using a VR platform to provide reduction in RP training. METHODS: A randomised controlled feasibility study, accompanied by evaluations at 1 month and 6 months, was conducted within inpatient psychiatric wards at Southern Health National Health Service Foundation Trust, United Kingdom. Virti VR scenarios were used on VR headsets to provide training on reducing RPs in 3 inpatient psychiatric wards. Outcome measures included general self-efficacy scale, generalised anxiety disorder assessment 7 (GAD-7), Burnout Assessment Tool 12, the Everyday Discrimination Scale, and the Compassionate Engagement and Action Scale. RESULTS: Findings revealed statistically significant differences between the VR and treatment as usual groups, in the Everyday Discrimination Scale items Q8 and Q9: P = 0.023 and P = 0.040 respectively, indicating higher levels of perceived discrimination in the VR group. There were no significant differences between groups in terms of general self-efficacy, generalised anxiety disorder assessment 9, and Burnout Assessment Tool 12 scores. A significant difference was observed within the VR group for compassionate engagement from others (P = 0.005) over time. Most respondents recorded System Usability Scale scores above 70, with an average score of 71.79. There was a significant reduction in rates of RPs in the VR group vs treatment as usual group with a fluctuating variability observed in the VR group likely due to external factors not captured in the study. CONCLUSION: Ongoing advancement of VR technology enables the possibility of creating scenarios and simulations tailored to healthcare environments that empower staff by providing more comprehensive and effective training for handling situations.

What about us?: a call to include oral health professions within interprofessional education for collaborative practice.

Interprofessional collaboration (IPC) among the health professions is recognised as a vital component of efficient health systems and comprehensive healthcare teams. Interprofessional education for collaborative practice (IPECP) is foundational for health professional students to gain an understanding of professional roles, responsibilities, and the value of other professions to patient care. Oral health professionals are highly skilled and knowledgeable experts who recognise the oral-systemic health link. However, they have been largely excluded from, and underutilised within primary healthcare settings and interprofessional teams. Given that oral health is a key indicator of overall health and wellbeing, there is a need mobilise oral health professionals within primary healthcare practice. Yet, advancements for IPECP in oral health education face significant barriers which impede the integration of the oral health professions within interprofessional teams. Collaborative approaches across health programmes to devise intentional, authentic, and transformative strategies for IPECP are needed to bridge gaps in patient care and to dismantle problematic perceptions of 'oral health' as distinct from overall health and wellbeing in contemporary healthcare practice.

Radiography community involvement in the professional socialisation of diagnostic radiography students.

INTRODUCTION: Professional socialisation entails acquisition and internalisation of knowledge, skills, and values necessary to become members of a chosen profession. In the healthcare professions, the process is initiated during undergraduate academic and clinical learning, with clinical learning considered as more significant. This suggests that clinical radiographers play a key role in socialising students into the radiography profession. Based on communities of practice, a theory of social learning, professional socialisation of diagnostic radiography students would involve different members of the radiography community. Limited knowledge exists on the professional socialisation of diagnostic radiography students. AIM: This study aimed to explore how diagnostic radiography students are socialised in the clinical environment with a focus on the role of communities of practice. METHODS: Qualitative, exploratory, and descriptive research was conducted. Data was collected through unstructured interviews and focus groups. Interview recordings were verbatim transcribed, and framework analysis was used to analyse data. FINDINGS: Data analysis resulted in the identification of a key theme, radiography community involvement, with four subthemes: shared responsibility for learning and teaching, critical reflection and lifelong learning, interpersonal skills, and empathy and consideration for students. CONCLUSION: Effective professional socialisation of diagnostic radiography students is essential to develop radiography knowledge, skills, and values. The findings presented in this paper highlight the importance of the radiography community involvement in the professional socialisation of students because the various members of this community have valuable knowledge to share and a role to play. IMPLICATIONS FOR PRACTICE: The findings can guide development of initiatives to support radiography community members in their role as facilitators of student professional socialisation, which in turn will enable effective professional socialisation for the students.

"Lives and times": The case for qualitative longitudinal research in anatomical sciences education.

Qualitative longitudinal research (QLR) focuses on changes in perceptions, interpretations, or practices through time. Despite longstanding traditions in social science, QLR has only recently appeared in anatomical sciences education (ASE). While some existing methodology papers guide researchers, they take a narrow view of QLR and lack specificity for ASE. This discursive article aims to (1) describe what QLR is and its benefits, its philosophies, methodologies and methods, considerations, and quality indicators, and (2) critically discuss examples of QLR in ASE. Underpinned by relativist ontology and subjectivist epistemology, time can be understood as fluid/subjective or fixed/objective. QLR is a flexible, creative, and exploratory methodology, often associated with other methodologies. Sampling is typically purposive, with repeated and recursive data collection methods, and complex three-strand analyses (themes, cases, and time), enabling cross-sectional and longitudinal analyses. QLR involves ethical, relationship, analytical, dissemination, and funding considerations. Key quality indicators relate to qualitative research as well as temporal aspects. Most of the nine ASE papers reviewed explored changes in anatomy learners, but few labeled their methodology as QLR. Just under half described their sampling as purposive, most employed pre-planned and standardized repeated interviews, analyzed their data cross-sectionally, and utilized qualitative data analysis software. Most cited the confirmability and transferability of their studies, but few cited credibility and dependability elements. Study timeframes and tempos were generally clear, but details of longitudinal retention/attrition were often lacking, and longitudinal data analysis was not often conducted. We therefore provide recommendations for the conduct of QLR in ASE.

The significance of a dialectical approach to enrich health professions education.

The Lancet Global Independent Commission has called for a systems-based approach to health professions education. They emphasised the acquisition of collaborative skills, critical reasoning and ethical conduct to prepare students for interprofessional collaborative practice (IPCP). Interprofessional education (IPE) has been put forward as a promising strategy. However, despite the global efforts to incorporate IPE in health professions education curricula, the evidence for a positive impact on IPCP is still inconclusive. This may be related to the misalignment between competency-driven IPE programs that focus on end-stage professional competence and the non-linear development of students' competence that is necessary for the dynamical nature of IPCP. Therefore, we argue that health professions education, and IPE in particular, needs to incorporate these dynamical processes including social and organization sensitivity. We present a conceptual framework that integrates the Cultural-Historical Theory, the principles of dialectical thinking and the concept of metastable attunement. While dialectical thinking is the ability to perceive the complexity of a dynamic reality that is in a state of constant transition, metastable attunement refers to the consequent adjustment to it. The subsequent instructional design employs a dialectical approach to teaching and learning, based on mediating activities and dialectical inquiry. To reach the full potential of this approach, the mediating activities should ensure a continuum of learning across the curriculum. In addition, faculty development needs to focus on the principles of dialectical inquiry as a pedagogy to optimally guide students. Further research into the extent to which healthcare professionals and students think dialectically may inform improvements to the proposed instructional design, the structure of the learning continuum and the essential requirements for faculty development.

Empathy unmasked: the compassion quotient of dental students.

BACKGROUND: Despite an empathic doctor patient relationship being of utmost importance to improve health care outcomes, this aspect is scarcely explored in dental students of Pakistan. This primary objective of the present study was to assess the reliability and validity of the Jefferson Scale of Empathy- Health Professions Student (JSE- HPS) version in a sample of Pakistani dental students. The study also compared the differences in empathy levels of dental students studying in different academic years. METHODS: This comparative cross-sectional study was conducted on a sample of 304 students from first to final year from selected 02 private and 02 public dental colleges of Karachi, Pakistan from December 2021- January 2022. The self-administered Jefferson Scale of Empathy- Health Professions Student (JSE-HPS) version was used for data collection. This questionnaire includes 20 items that can be answered on a 7-point Likert scale. After attendance sheets were obtained, random student names were marked, and questionnaire distributed by hand to these students. All forms were collected right after to maximize response rate. RESULTS: A total of 304 forms with complete data were returned, a response rate of 86.9%. Females (97.79 ± 15 94) were more empathetic than males (94.16 ± 12.13) (p = 0.001). Students of third-year were the most empathetic (p = 0.000). Internal consistency of questionnaire was acceptable (Cronbach's α- 0.77). Factor analysis revealed factor related to belief that patient's perspectives improve health outcome had 14 items with factor coefficient > 0.4 contributing to largest proportion of variance (23.15%). CONCLUSIONS: Our study shows JSE- HPS to have acceptable internal consistency. Structural validity of the scale evaluated by confirmatory factor analysis reported results that were in concordance to those suggested by developers of this scale. In our study population, like other studies, females were more empathic than males. Third-year dental students were more empathetic than students of other undergraduate years.

Snapshot of Examination Usage in Emergency Medicine Clerkships.

Objective Emergency Medicine (EM) clerkships often use a written exam to assess the knowledge gained over the course of an EM rotation in medical school. Clerkship Directors (CDs) may choose the National Board of Medical Examiners (NBME) EM Advanced Clinical Science Subject Exam (ACE), the Society for Academic Emergency Medicine (SAEM) M4 exam, which has two versions, the SAEM M3 exam, or departmental exams. There are currently no published guidelines or consensus regarding their utility. This survey-based study was designed to collect data regarding current practices of EM clerkship exam usage to analyze trends and variability in what exams are used and how.  Methods The authors designed a cross-sectional observational survey to collect data from EM CDs on exam utilization in clerkships. The survey population consisted of clerkship directors, assistant clerkship directors, or faculty familiar assessments in their EM clerkship. Initial dissemination was by electronic distribution to subscribers of the Clerkship Directors in Emergency Medicine (CDEM) list-serve on the SAEM website. Subsequently, contact information of CD's from institutions that had not responded was obtained by manual search of the Emergency Medicine Residents' Association (EMRA) Match website and individual correspondence was sent at regular intervals. Data obtained include clerkship characteristics, exam used, weight of the exam relative to the overall grade, and alternatives if the preferred exam was previously taken. Results Eighty-seven programs (42% response rate) completed the survey between August 2019 and February 2021. Of the 87 responses, 71 (82%) were completed by a CD. Forty-six (53%) institutions required an EM rotation. Students were tested in 34 (74%) required EM clerkships and 48 (69%) out of 70 EM electives. In required rotations that used an exam, 20 (59%) used the NBME EM ACE, while 28 of 46 (61%) of EM electives that reported an exam used the SAEM M4 Exam. Five (15%) of the required clerkships used a departmental exam. Of clerkships requiring an exam, 46 (57%) weighed the score at 11-30% of the final grade. Data for extramural rotations mirrored that of EM electives. One-third of respondents indicated they do not inquire about previously taken exams. Conclusion This survey demonstrates significant variability in the type of exam, the weighting of the score, and alternatives if the preferred exam was previously taken. The lack of a consistent approach in how these exams are used in determining students' final EM grades diminishes the reliability of the EM clerkship grade as a factor used by residency directors in choosing future residents. Further research on optimal usage of these exams is needed.