Reforming clinical psychological science training: The importance of collaborative decision-making with trainees.

To effectively address the staggering burden of mental illness, clinical psychological science will need to face some uncomfortable truths about current training practices. In a commentary authored by 23 current or recent trainees, Palitsky and colleagues highlight a number of urgent challenges facing today's clinical interns. They provide a thoughtful framework for reform, with specific recommendations and guiding questions for a broad spectrum of stakeholders. Key suggestions are applicable to the entire sequence of clinical training. While there is cause for cautious optimism, overcoming these systemic barriers will require a coordinated, all-hands approach and a more collaborative approach to policy-making.

A survey of the perceptions and practices of faculty in clinical neuropsychology doctoral training programs: is heterogeneity the norm?

Objective: Doctoral education is a cornerstone in the training of clinical neuropsychologists. However, we know little about perceptions, practices, and needs of the faculty who oversee doctoral training in clinical neuropsychology (CN). Method: Seventy-one faculty from 45 doctoral programs providing CN training completed at least part of a survey assessing characteristics of their programs, current training practices and views, and challenges to CN doctoral training. Results: Over half of CN faculty reported having zero or only one CN colleague. CN faculty reported that the goals of CN doctoral training are research training, clinical training, and acquisition of knowledge and skills reflected in the Houston Conference Guidelines (HCG). CN faculty reported that doctoral trainees obtain more clinical hours than faculty would like and endorsed alternative clinical metrics, including competency-based ratings. CN faculty are divided about the benefits of a required two-year postdoctoral CN fellowship. Conclusions: The HCG states that specialization in CN begins at the doctoral level. CN faculty in doctoral programs are fully immersed in the early development and education of future CN researchers and practitioners. Tensions between clinical and research training in CN at the doctoral level-and student overemphasis on accruing clinical hours-might place CN at risk for failing to make research innovations necessary for our field to evolve and thrive. More CN doctoral faculty are needed to serve as mentors to students, especially for students from backgrounds that have been historically excluded and marginalized. A greater voice from CN doctoral faculty in CN governance is needed.

An insight into the clinical learning environment of dental institutes: a study in the twin cities of Pakistan.

OBJECTIVE: To assess the perceptions of dental students regarding their clinical learning environment in an urban setting. METHODS: This descriptive, cross-sectional survey was conducted from March 2020 to May 2021 after approval from the ethics review committee of Islamic International Dental College, Islamabad, Pakistan. It comprised of clinical year students, house officers and postgraduate trainees from 6 dental teaching hospitals of Rawalpindi and Islamabad. Data was collected using a pre-validated instrument assessing the dental clinical learning environment. Data was analysed using SPSS 24. RESULTS: Of the 1030 students approached, 561(54.4%) responded. Of them, 448(80%) were girls, 234(41.7%) were 3rd year students, 110(19.6%) were 4th year students, 120(21.4%) were house officers and 97(17.3%) were postgraduate trainees. Female students had a better patient attitude and were more confident in their abilities to keep up with their peers (p<0.05). The students were content with the performance of their clinical teachers, with a mean score of 70.99+/-16.0, while the lowest score of 54.67+/-22.9 was for clinical infrastructure and materials. Students of Islamabad pointed out the lack of clinical materials and maintenance of equipment but noted better research opportunities compared to their Rawalpindi counterparts (p<0.05). CONCLUSIONS: The clinical learning environment for Islamabad and Rawalpindi cities individually was good. Overall, students were satisfied with their clinical teachers, learning and training experience. Dental materials, infrastructure and maintenance factors scored the lowest.

A cord of four strands: Perspective of pre-medical and medical students on combined teaching modalities in undergraduate biochemistry.

Despite being a traditional coursework for pre-medical and medical students around the globe, biochemistry education suffers from a lack of positive appreciation due to the nature of the subject combined with deficiency of teaching modalities. A first semester biochemistry course was designed to include four different teaching modalities: lectures, recitations, case studies, and student presentations. A multi-item, anonymous, and voluntary questionnaire was distributed to students who had just completed the course and to those who had taken it the previous year. The questionnaire asked students to evaluate the course and how the different modalities affected their learning. These questionnaires took place in a two-year period between 2020 and 2021. Eighty-six (46%) of 186 total students responded. The vast majority of respondents agreed with the use of multimodal teaching techniques with respect to its impact on overall preparedness for future coursework, understanding, and enjoyability. Lectures and recitations were found to be the most useful in information retention and learning, although the same were found to be less enjoyable than other modalities. Although case studies and presentations were found to be enjoyable, most students ranked them low in terms of information retention and were the most voted to be removed from the course. There was general agreement between premedical and medical students' perception on the usefulness of the multimodal teaching techniques with respect to medical biochemistry modules and standardized exams. The agreement between cohorts suggests the premedical students accurately evaluated the usefulness of the course for the following year and validates the usefulness of the premedical student surveys. Use of multiple modalities in biochemistry education can be of substantial benefit in engaging and preparing students for further education.

Motivations for and outcomes of graduate education amongst dental hygienists: A pan-Canadian study.

OBJECTIVES: Motivations and career outcomes of dental hygienists with baccalaureate degrees have been recently reported; however, few studies have explored Canadian dental hygienists pursuing graduate education. There is limited evidence to inform career outcomes and motivating factors for advanced education, limiting knowledge of how professional outcomes have evolved alongside advancements in graduate program offerings. This study focused on understanding motivating factors to pursue graduate education and the professional outcomes of dental hygienists with graduate degrees. METHODS: This nested online anonymous survey was conducted between November and December 2021 with dental hygienists who graduated from one of four Canadian baccalaureate-level dental hygiene degree programs and had further indicated that they were pursuing or had obtained additional graduate-level education (n = 60). Participants were asked to report on any advanced graduate-level education. Open-ended questions on graduate degree education were analysed through thematic analysis. RESULTS: Motivations for pursuing graduate degrees were influenced by personal and professional preferences. Master's degree recipients cited expanded career opportunities, alternate interests, convenience, and dissatisfaction with/desire to leave clinical practice as major motivators. Doctoral degree holding dental hygienists identified expanded/alternate career opportunities as major motivation but also cited program convenience as an influencer. The availability of distance and flexible programming is a novel finding that positively influences the pursuit of advanced education. CONCLUSION: Dental hygienists are pursuing graduate education to expand their scope of knowledge and create new career opportunities. Graduate degree programs that accommodate work-life balance through flexible and online offerings are very attractive to dental hygienists.

Perfil e percurso profissional de egressos dos cursos de mestrado e doutorado da Fundação Oswaldo Cruz (2013-2020) / Profile and career path of graduates from the Oswaldo Cruz Foundation master's and doctoral courses (2013-2020) / Perfil y trayectoria profesional de egresados de los cursos de maestría y doctorado de la Fundación Oswaldo Cruz (2013-2020)

Resumo: O objetivo do estudo é analisar o perfil de egressos e identificar fatores associados ao desempenho positivo relativo à trajetória de formação e de inserção profissional entre aqueles que concluíram cursos presenciais de mestrado e doutorado acadêmico da Fundação Oswaldo Cruz (Brasil). Participaram do estudo 2.462 egressos (1.402 de mestrado e 1.060 de doutorado) que responderam um questionário digital, contendo questões sobre perfil do egresso e inserção profissional antes do ingresso no curso e após a conclusão. Foi criada uma medida sobre "desempenho positivo pós-curso". Os resultados revelam que egressos de mestrado com impacto positivo do curso tendem a ser homens; ter especialização antes de ingressar no curso; ter emprego remunerado após o término do curso nas áreas de pesquisa, educação, assistência e gestão; e ser servidor público. No doutorado o seguinte perfil é evidenciado: egressos com emprego remunerado após o término do curso nas áreas de pesquisa ou educação; contratados por Regime Jurídico Único ou contrato temporário de pessoa jurídica; e com publicação científica ou patente. A avaliação/acompanhamento de egressos deve se instaurar como uma importante política pública educacional, incorporada no processo de autoavaliação institucional, o que possibilita rever rumos e prioridades na agenda educacional e pedagógica da instituição.

Abstract: This study aims to analyze the profile of graduates and identify factors associated with positive performance regarding training and professional insertion among those who have completed face-to-face master's and doctoral courses at the Oswaldo Cruz Foundation (Brazil). A total of 2,462 graduates participated in the study (1,402 master's and 1,060 doctoral graduates), who answered a digital questionnaire containing questions about individual characteristics and professional insertion before entering the course and after completion. A measure on "positive post-course performance" was created. The results show that Master's graduates with a positive impact from the course tend to be men; to have a specialization degree before entering the course; to have paid employment after finishing the course in the areas of research, education, assistance, and management; and to be civil servants. In the Doctorate, the following profile is evident: graduates with paid employment after finishing the course in the areas of research or education; hired under a single legal regime or temporary contract as a legal entity; and with a scientific publication or patent. Evaluating/monitoring graduates must be established as an important public educational policy, incorporated into the institutional self-evaluation process, which makes it possible to review directions and priorities in the institution's educational and pedagogical agenda.

Resumen: El objetivo del estudio es analizar el perfil de egresados e identificar factores asociados al desempeño positivo relacionado a la trayectoria de formación e inserción profesional entre aquellos que concluyeron cursos presenciales de maestría y doctorado académico de la Fundación Oswaldo Cruz (Brasil). Participaron del estudio 2.462 egresados (1.402 de maestría y 1.060 de doctorado) que contestaron el cuestionario de manera digital, con preguntas sobre el perfil del egresado y la inserción profesional antes del ingreso al curso y tras su conclusión. Se creó una medida sobre "desempeño positivo tras el curso". Los resultados muestran que los egresados de la maestría con un impacto positivo del curso tienden a ser hombres; tener especialización antes de ingresar al curso; tener trabajo remunerado tras concluir el curso en las áreas de investigación, educación, asistencia y gestión; y ser funcionario público. Se evidencia el siguiente perfil en el doctorado: egresados con trabajo remunerado tras el término del curso en las áreas de investigación o educación; contratados bajo un régimen jurídico único o un contrato temporal de persona jurídica; y con publicación científica o patente. La evaluación/seguimiento de egresados se debe establecer como una importante política pública educativa, incorporada en el proceso de autoevaluación institucional, lo que permite revisar direcciones y prioridades en la agenda educativa y pedagógica de la institución.

Graduate anatomy education: How are we training the future generations of anatomy educators?

The teaching of anatomy is relevant to many fields and anatomy teachers are in demand. Individuals with a graduate anatomy education are some of the most sought-after candidates to fill open teaching positions, but it is unclear as to what constitutes a graduate anatomy education. The purpose of this study was to investigate the components of a graduate anatomy education in the United States. A survey regarding the components of doctoral, master's, and graduate certificate programs was distributed to program directors and department chairs at 71 US institutions. Respondents indicated that there were 17 doctoral, 28 master's, and 9 graduate certificate programs. Students completed coursework in all the traditional anatomical subdisciplines in approximately half of doctoral (53%) and master's (57%) programs, though the number was lower in graduate certificate programs (22%). In comparison, within 12 programs (5 doctoral, 4 master's, and 3 graduate certificate) students were required to complete coursework in less than 2 anatomical subdisciplines. Required coursework outside the subdisciplines usually involved educational theories and practices (61% of programs), research methods (52% of programs), and/or physiology (37% of programs). Respondents indicated that most programs (81%) were designed to prepare their students to teach. It appears that graduate anatomy training likely involves gross anatomy coursework, coursework in another anatomical subdiscipline, and coursework in educational theories and practices. Given the likely decline in the number of doctoral-level anatomy programs from 21 to 19, serious consideration should be given to hiring teaching candidates with master's or graduate certificate training in anatomy.

Prevalencia y correlatos de ideación suicida pasiva y activa en ingresantes de posgrado / Prevalence and correlates of passive and active suicidal ideation among students entering graduate courses / Prevalência e correlatos de ideação suicida passiva e ativa em ingressantes da pós-graduação

Objetivo: identificar la prevalencia y los factores asociados a la ideación suicida pasiva y activa a lo largo de la vida en estudiantes ingresantes de posgrado. Método: estudio analítico y de diseño transversal, con una muestra compuesta por 321 estudiantes ingresantes de posgrado. Se realizó análisis estadístico descriptivo e inferencial múltiple. Resultados: los análisis multivariados indican que la ideación suicida pasiva y activa tuvieron una prevalencia mayor y similar en los estudiantes de orientación sexual minoritaria, del sexo femenino, que realizaban actividad física diaria ≤ 30 minutos/día y sufrieron victimización por violencia psicológica en los últimos 12 meses. Los factores abuso de alcohol, las exigencias del posgrado stricto sensu no afectaron las relaciones familiares y baja autoestima se asociaron solo con la ideación suicida pasiva. A su vez, el consumo de marihuana en los últimos 30 días, no tener una buena relación interpersonal con sus pares académicos, ejercer la actividad profesional junto con las exigencias del posgrado se asociaron únicamente con ideación suicida activa. Conclusión: se identificó una alta prevalencia de ideación suicida pasiva y activa a lo largo de la vida en los estudiantes ingresantes de posgrado y se comprobó que hubo similitudes y diferencias entre algunos de los factores asociados a ambos resultados.

Objective: to identify the prevalence and factors associated with passive and active suicidal ideation throughout life among students entering graduate courses. Method: an analytical and cross-sectional study with a sample comprised of 321 students entering graduate courses. Multiple descriptive and inferential statistical analyses were performed. Results: the multivariate analyses indicated that passive and active suicidal ideation were similarly more prevalent among female students belonging to minority sexual orientations who engaged in daily physical activity ≤ 30 minutes/day and were victims of psychological violence in the past 12 months. Alcohol abuse, family relationships not impaired due to the demands imposed by stricto sensu graduate studies and low self-esteem were only associated with passive suicidal ideation. In turn, recent marijuana use in the last 30 days, poor interpersonal relationships with academic peers, and engagement in professional activities concomitantly with the demands imposed by graduate studies were only associated with active suicidal ideation. Conclusion: high prevalence of lifetime passive and active suicidal ideation was identified among graduate students, and similarities and differences were verified between some associated factors for both outcomes.

Objetivo: identificar a prevalência e fatores associados à ideação suicida passiva e ativa ao longo da vida em estudantes ingressantes na pós-graduação. Método: estudo analítico e de delineamento transversal, amostra composta por 321 estudantes ingressantes da pós-graduação. Realizou-se análise estatística descritiva e inferencial múltipla. Resultados: análises multivariadas apontaram que ideação suicida passiva e ativa foram similarmente mais prevalentes entre estudantes de orientações sexuais minoritárias, do sexo feminino, que realizavam atividade física diária ≤ 30 minutos/dia e sofreram vitimização por violência psicológica nos últimos 12 meses. O abuso de álcool, o não prejuízo no relacionamento familiar por demandas da pós-graduação stricto sensu e a baixa autoestima foram associadas unicamente com ideação suicida passiva. Por sua vez, o consumo de maconha ocorrido nos últimos 30 dias, a falta de um relacionamento interpessoal satisfatório com seus pares acadêmicos e a prática da atividade profissional em concomitância com as demandas da pósgraduação foram associadas apenas com ideação suicida ativa. Conclusão: identificou-se alta prevalência de ideação suicida passiva e ativa ao longo da vida entre estudantes ingressantes na pós-graduação e verificou-se a ocorrência de similitudes e diferenças entre alguns fatores associados para ambos os desfechos.

The collaborative development of graduate education and high economic quality and its dynamic evolution forecast.

To promote the coordinated development of high quality postgraduate education and economy is the realization of all-round construction of the socialist modernization of China power.Based on the panel data of 30 provinces in China from 2009 to 2021, this paper constructs the index of graduate education and high-quality economic development respectively, and analyzes it by coupling coordination model, kernel density estimation and spatial Markov chain model.The results show that: first, the postgraduate education and the high economic quality of most provinces in China are matched, but there is a significant difference between the eastern and western regions in their collaborative development; Second, the level of synergistic development between graduate education and high economic quality is low, and the central and northeastern regions are seriously divided, but the differences in synergistic effects between different regions are narrowing.Third, according to the results of trend prediction, there is the coexistence of "beggar-thy-neighbor" and "good-neighborliness", and it is difficult to achieve leapfrog coordinated development.Therefore, it is proposed to pay attention to the high-quality economic development to provide a rich material basis for graduate education, the change of graduate education structure should adapt to the needs of high-quality economic development, and implement different reform measures in different regions to promote the comprehensive construction of a modern socialist country.

Done with a degree? Immigration-specific disparities among holders of bachelor's degrees in the transition to graduate studies in Germany.

In many Western societies, immigrants make more ambitious educational choices than their native counterparts of equal academic achievement and social origin. These ambitious decisions have been mainly observed at early and middle educational stages, whereas research on choices within higher education is scarce. Against this background, we investigate whether immigrants make more ambitious decisions than natives do also after having graduated from bachelor's programs in Germany. We theoretically derive that variations in immigration-specific differences in educational choices can be expected based on social origin and country of origin, as well as between the application for and the actual enrollment in graduate studies. Using survey data on educational trajectories of bachelor's degree holders, we observe our expectations to be confirmed for the investigated sample. First, immigration-specific differences in educational choices vary by social origin and are increased for graduates from low social origins. This finding supports that immigrants strive for status maximization, an idea that we understand as a theoretical specification of the motive for status gain. Second, they vary by country of origin, which suggests cultural factors to be subordinate. Third, immigration-specific differences in applications are more pronounced than differences in actual transitions, indicating that immigrants have fewer chances of transforming their aspirations into actual transitions. We conclude by discussing these three aspects more broadly.

Superación profesional de los docentes de enfermería para el desarrollo de su cultura pedagógica / Professional growth for the development of a pedagogical culture in the teaching nursing staff i: en

Los cambios en la educación médica demandan profesionales eficientes en su magisterio. En tal sentido, la docencia en la carrera de Enfermería debe ser ejercida con una amplia cultura pedagógica, lo cual se logra a partir de la superación académica que prepara al individuo para ser flexible al lidiar con las constantes variaciones sociales, institucionales y curriculares. Los referentes epistemológicos sobre este tema revelan una limitada sistematización de dicha superación en el docente de enfermería respecto a su formación profesoral. El presente artículo esboza brevemente las etapas del desarrollo de dicha superación, así como las insuficiencias que se presentaron en cada una de ellas. Por último, se describen algunos elementos de la superación profesional y de la cultura pedagógica, los que argumentan la trascendencia de ambas en el proceso formativo de los docentes de Enfermería.

Changes in medical education demand efficient professionals in their teaching. In this sense, education in the nursing career must be exercised with a broad pedagogical culture, which is achieved through academic growth that prepares the individual to be flexible in dealing with constant social, institutional and curricular variations. The epistemological referents on this subject reveal a limited systematization of such improvement in nursing teachers with respect to the development of their teacher training. This article briefly outlines the stages of the development of the growth, as well as the inadequacies that were presented in each one of them. Finally, some elements of professional development and pedagogical culture are described, which argue the transcendence of both in the formative process of nursing teachers.

Celebrating over 20 years: Outcomes from the first doctor of nursing practice program.

The first Doctor of Nursing Practice (DNP) program was opened at the University of Kentucky College of Nursing (UKCON) in 2001. As the CON celebrates 20 plus years of DNP education, leaders decided to do an assessment of the accomplishments and outcomes from the work of graduates. The purpose of this study was to delineate the achievements, outcomes and perception of the impact of graduates from the UKCON DNP program and assess the correlations of specific "perception of impact" variables. DNP graduates from 2005 to 2021 (n = 348) received an email about the study and a link to the survey. Ninety graduates who resided in 14 states responded. Over 84 % of participants indicated that their DNP degree helped them stand out as a leader. Participants reported that having a DNP education increased their knowledge and expertise in multiple areas, including how to lead, to influence, and to improve outcomes within their organizations. Narrative feedback related to top achievements since graduation included career advancement/promotion (n = 22), improving patient care quality/implementation of evidence-based initiatives (n = 21), and becoming a better leader (n = 19). This study illustrated the broad return on investment and the quantification of value that a DNP education brings, both to practice and academia.

Geropsychology training at the doctoral level: a program evaluation case example.

While the older adult population continues to grow, psychologists specializing in geropsychology remain a small fraction of the workforce. Facing this reality, it is essential for training programs to better monitor whether their students receive adequate training to serve older adults. The current study describes a brief, logistically feasible, and cost-effective program evaluation conducted within one APA-accredited clinical psychology doctoral program. The evaluation consisted of an online survey of doctoral students (n = 99) that explored their field training experiences with older adults, coursework related to aging, and their overall interest in working with older adults. Students reported significantly less coursework and significantly less field work focused on serving older adults when compared to other age groups. However, students reported a high level of interest in learning about aging, with a total of 73.74% of participants (n = 73) reporting at least some current interest. A number of institutional actions resulted from this evaluation, which demonstrate how a brief evaluation can yield data that is practically useful. This case example provides a useful model for others to follow, and may support other institutions' efforts to evaluate, monitor, and make potential improvements to aging-related training in their own programs.

Usefulness of Mobile Devices in Learning Process for Residents of Pediatric Surgical Specialties.

INTRODUCTION: In the hospital setting, the use of mobile devices among surgical residents is increasing. To assess the usefulness of mobile devices for residents of pediatric surgical specialties. MATERIALS AND METHODS: The study used a mixed-method design. First, a self-developed online questionnaire with 23 items was used to obtain quantitative data, which was analyzed via simple discriminant analysis. Qualitative data were obtained using the focus group technique with the subsequent triangulation of quantitative and qualitative data. RESULTS: The residents used mobile devices for learning and communication. Using quantitative data, the study found that the major functions of mobile devices were communicating with other residents and taking clinical photos, and that for learning, were speaking with attendings, residents, collecting patient information, and searching for unfamiliar terms. Triangulation analysis confirmed that mobile devices aid in agile communication, the search for data on drugs or diseases, and consultation of medical applications. Qualitative data informed the limitations of devices and the inconsistencies between official regulations and their advantages in clinical practice. CONCLUSIONS: We demonstrate the usefulness of mobile devices among surgical residents in clinical care and recommend that hospitals should regulate policies to maximize the use of mobile devices.

Experiences of neurodivergent students in graduate STEM programs.

Introduction: Despite efforts to increase the participation of marginalized students in Science, Technology, Engineering, and Mathematics (STEM), neurodivergent students have remained underrepresented and underserved in STEM graduate programs. This qualitative study aims to increase understanding of the experiences of neurodivergent graduate students pursuing advanced degrees in STEM. In this analysis, we consider how common graduate school experiences interface with the invisibility of neurological diversity, thus contributing to a set of unique challenges experienced by neurodivergent students. Materials and methods: In this qualitative study, 10 focus group sessions were conducted to examine the experiences of 18 students who identify as neurodivergent in graduate STEM programs at a large, research-intensive (R1) university. We used thematic analysis of the transcripts from these focus groups to identify three overarching themes within the data. Results: The findings are presented through a novel model for understanding neurodivergent graduate STEM student experiences. The findings suggest that students who identify as neurodivergent feel pressure to conform to perceived neurotypical norms to avoid negative perceptions. They also may self-silence to maintain stability within the advisor-advisee relationship. The stigma associated with disability labels contributes a heavy cognitive and emotional load as students work to mask neurodiversity-related traits, navigate decisions about disclosure of their neurodivergence, and ultimately, experience significant mental health challenges and burnout. Despite these many challenges, the neurodivergent graduate students in this study perceived aspects of their neurodivergence as a strength. Discussion: The findings may have implications for current and future graduate students, for graduate advisors who may or may not be aware of their students' neurodivergence, and for program administrators who influence policies that impact the wellbeing and productivity of neurodivergent students.

A Survey of Clinical Immersion Experiences in Biomedical Engineering.

Immersion in clinical environments is generally believed to be a valuable experiential learning opportunity for students in biomedical engineering, both at the undergraduate and the graduate level. Immersion is believed to foster an understanding of medical culture, clinical operations, interprofessional collaboration, and oftentimes allows students to either identify unmet clinical needs. The National Institutes of Health supports efforts through grants to incorporate these clinical immersion programs into biomedical engineering curricula, and this has potentially facilitated an expansion of these programs across the United States. Unknown is how common clinical immersion experiences are in biomedical engineering programs, in general how these are organized and executed, and their goals. We conducted a survey of biomedical engineering programs to learn how many programs offer clinical immersion experiences, over what timeframe and in what formats, and what is known about their goals and learning outcomes. We present here the results of that survey which includes 52 clinical immersion courses and programs, 14 of which either are or were previously funded by the NIH. Each of these courses or programs engages, on average, about 27 students per year, but range in size from 2 to 160. The duration of the immersion experience likewise varies greatly from 3 to 400 h. The objectives of these programs are mostly to identify problems, develop engineering solutions to problems, or to learn clinical procedures. Despite the impressive breadth of experiences revealed by this survey, we still know relatively little about their impact on student learning, motivation, identity, or career path. Desired outcomes and assessment strategies must be better aligned with the structure of the clinical immersion experiences themselves if we are to determine if they are effective in meeting those outcomes, including those of professional preparation.