Inclusion of patient age and sex in single best answer (SBA) questions is standard practice, whereas ethnicity is typically included only when considered clinically relevant. This selective use may inadvertently cue students or introduce bias. This study examined whether including patient ethnicity in SBA questions influences student performance, response time and item psychometric properties. A prospective randomised controlled study was conducted using two versions of a final-year formative assessment. In each version, approximately half of the questions included the patient's ethnicity, while the corresponding questions in the alternate version omitted this information. Students were randomly assigned to one of the two exam versions. Two hundred and sixty-seven final-year medical students participated in the study. The mean score for questions without ethnicity was 80.3% and for questions with ethnicity was 79.8% (mean difference = -0.5 pp, p = 0.12). On average, students spent 1.6 seconds longer to answer questions with ethnicity compared to questions without ethnicity (p < 0.01). In SBA questions with and without ethnicity, there was no significant difference in mean facility (79.8% vs. 80.3%, p = 0.17) or mean item-total score point-biserial correlation (0.20 vs. 0.21, p = 0.63). These indicate that including patient ethnicity did not significantly impact overall student performance or mean item-level psychometric properties. However, it was associated with longer response times, suggesting a small but significant increase in cognitive load. Educators involved in assessment design should carefully consider this added cognitive burden when deciding whether to include patient ethnicity in future assessments.

In health professions education, cultivating commitment to collaborative practice is essential. However, collective dedication as a desired outcome in interprofessional education (IPE) often remains overlooked. Psychological factors contributing to team members' collective dedication are poorly understood within health professions collaborative learning environments. This study examined relationships among team psychological factors (interdependence, relatedness, efficacy, and potency) and their influence on collective dedication in an IPE context.

This column addresses the knotty problems and dilemmas many scholars grapple with when studying health professions education. In this article, the authors examine whether a journal is the most suitable format for disseminating research. We explore other venues that researchers have used to reach specific audiences, and we describe how to present rigorous scholarship in those venues.

In this editorial the editor considers the role of stewardship and curation in the work of academic journals.

While it's commonplace in medical education to train learners using simulated patient encounters, task trainers, or by practicing skills on healthy volunteers, little is known about how well learning and skills transfer to patient care. The purpose of this research is to quantify Point-of-Care Ultrasound (POCUS) skill transfer to patient care through performance assessment. A quantitative analysis of aggregated data consisting of image quality of student-performed POCUS examinations from one midwestern Physician Assistant program was performed. Probabilities for scores of 1-2, 3, 4, and 5 were estimated using a multivariable cumulative logit model. Forty-six PA students were included in the study. A total of 6,218 POCUS examinations were included; 4,506 on non-patients, and 1,712 on patients. When evaluating skill transfer from non-patients to patients, the probability of obtaining a high-quality examination decreases significantly, with a more substantial decrease in performance on more complex skills. The probability of a high-quality examination on the twenty-fifth examination was the highest when learning transfer happened earlier. While training medical providers using non-patient experiences is common, educators must understand the significant loss of quality upon skills transfer to patient care. More complex or higher risk skills likely require close monitoring at the point of skill transfer, to support the learner and ensure patient safety. Based on the findings of this research, earlier skill transfer is associated with worse immediate performance but better long-term re-learning outcomes. Increased deliberate practice prior to skill transfer is associated with better first-time performance on actual patients.

Undergraduate interprofessional education aims to prepare health professions students for a future work field characterised by wicked problems demanding interprofessional collaboration (IPC). Interprofessional identity (IPI) has been suggested as key to IPC, but how to foster its formation remains underdeveloped. Therefore, we aimed to identify (1) the main characteristics of IPI and (2) guidelines for educational design fostering interprofessional identity formation (IPIF). Per critical review methodology, we analysed educational sciences, health professions education and management sciences literature. The results of two iterative, non-exhaustive literature searches were analysed through reflexive thematic analysis. The first search focused on conceptualisations of IPI to identify its main characteristics and theories explaining IPIF, the second on the mechanisms of these theories fostering IPIF to derive guidelines for educational design. Analysis of the first search yielded five themes characterising IPI: (1) sense of belonging to an interprofessional team; (2) commitment to working interprofessionally; (3) values, attitudes, beliefs, and ethics related to IPC; (4) knowledge and understanding of roles, responsibilities, and expertise; and (5) IPC skills. We identified five prevalent theories explaining IPIF. Analysis of the second search resulted in guidelines for educational design fostering IPIF targeting the student, interprofessional team, faculty, and curriculum. Fostering IPI alongside IPC competencies is crucial for preparing students for IPC. This critical review highlighted key characteristics of IPI and proposes ED-IPIF, a theory-based framework for fostering IPIF through integrated educational design. Future research should address existing gaps and empirically test the ED-IPIF through longitudinal studies and robust tools for measuring IPI.

Written examinations are commonly used to assess learning. Different resources made available during testing (closed-note, open-note, and cheat-sheet) may influence student learning. The effect of resource availability on long-term knowledge application is unknown. Understanding the effects of exam resource availability on long-term knowledge application is needed, as application is essential in applied fields such as Occupational Therapy. To explore differences in short-term knowledge retention (course one overall score, midterm exam, and final exam) and long-term knowledge application (course two summative assessment) among occupational therapy students who had different types of exam resource availability during course one (closed-note, open-note, cheat-sheet). Data were extracted from four consecutive cohorts (n = 73) as they completed two sequential occupational therapy courses. Exam resource availability was the independent variable (k = 3), with course one midterm and final exams and overall course grade, and course two summative assessment grade as dependent variables. Kruskal-Wallis tests compared differences across conditions. Concerning short-term retention, no significant differences were observed between groups for course one midterm exam grade or overall course one grade. Course one final exam grades were significantly higher in the cheat sheet condition compared to closed note (3.9%, p = .009). Concerning long-term application as measured by the course two summative assessment grade, the closed note condition scored significantly higher than open note (6.25%, p = .01). No other comparisons were significantly different. In this sample we observed a small difference in short-term knowledge retention in favor of a cheat sheet condition and moderate difference in long-term application in favor of a closed note condition. While results suggest possible differences in performance across exam conditions, findings should be interpreted cautiously due to the small, convenience-based sample. This exploratory analysis offers preliminary insights and identifies directions for future research on the pedagogical impact of exam design.

Innovative qualitative approaches are essential for exploring how health professions education (HPE) can address complex, value-laden constructs such as social accountability. Visual elicitation techniques, including rich picture interviews (RPIs), offer distinctive opportunities to surface layered, affective, and contextually embedded understandings. This methodological study examines participant perspectives on the use of RPIs within a broader qualitative interpretive description on social accountability. 46 participants, including learners, community representatives, faculty, and institutional leaders, created rich pictures (20-30 min) followed by semi-structured interviews (60 min) conducted virtually in English or French. Importantly, a dedicated segment of each interview explicitly elicited participants' reflections on the RPI process itself, including its accessibility, relevance, and perceived value. Data were analyzed using Braun and Clarke's reflexive thematic analysis. Three overarching themes captured participants' experiences: (a) from hesitation to reflective engagement, (b) visual thinking as a catalyst for dialogue and adaptability, and (c) affordances and boundaries of RPIs. Many began with apprehension, often tied to artistic skill or ambiguity of the task, yet valued RPIs for structuring reflection, deepening emotional engagement, and anchoring abstract concepts in personalized, tangible representations. Participants noted the method's adaptability across cultural, linguistic, and professional contexts, while also identifying barriers such as discomfort with drawing or the abstract nature of social accountability. By documenting these experiences across diverse partner groups, this study offers practical guidance for employing RPIs in HPE and related fields. RPIs can serve not only as data collection tools but as reflective, generative spaces that bridge abstract ideals with concrete experiences.

Effective patient education improves health outcomes, yet physical therapists and student physical therapists (SPTs) often report low self-efficacy and inadequate preparation for delivering education in clinical settings. While experiential learning enhances communication and confidence, most training occurs in classroom or simulated environments. Limited research has examined how SPTs develop patient education skills during real clinical interactions. This qualitative case study explored how SPTs describe their experiential learning cycle when providing patient education during an inpatient integrated clinical education (ICE) experience. Kolb's experiential learning theory guided the study design and data analysis within a constructivist research paradigm. Data sources included direct observation of inpatient care, semi-structured interviews, and qualitative surveys with nine second-year DPT students from a U.S.-based program. A deductive thematic analysis was conducted using the stages of Kolb's learning cycle as an organizing framework. Four themes were identified. First, students engaged in diverse patient education experiences shaped by clinical context and patient complexity. Second, opportunities for reflection were variable and often lacked structure. Third, students developed new ideas about effective education strategies, including communication adaptations, use of educational materials, and family involvement. Fourth, their ability to apply these ideas fluctuated based on environmental conditions and educator support. This study provides insight into how SPTs progress through experiential learning in real-time clinical settings. Findings underscore the importance of embedding structured reflection and purposeful practice into ICE curricula to better support student development. Improved curricular design may enhance student preparedness and promote effective, patient-centered communication in physical therapy practice.

Feedback is an emotional business; evoking optimism, fear or disappointment, which in turn can lead to engagement, further feedback seeking or avoidance. Emotions therefore are not just background noise but are fundamental to the experience. Through conceptualising emotions as embodied, social and complex, we seek to better understand how feelings work within feedback in clinical education, beyond an individual 'managing' their emotions. In this post-qualitative study, we ask: How does the interplay between feelings and feedback unfold in specialty medical training? To this end, we conducted a focussed ethnography of feedback in intensive care medicine and surgical training in Australian tertiary-care hospitals. Thinking with theory, we traced how trainees' feelings move within and between feedback encounters through observation-based field notes and interview transcripts. We provide thick description of how feedback is saturated with feeling, integrating our findings with discussion. Supervisors expressed their judgements about trainee performance as feelings, through feelings and about feelings. And trainees responded with feelings of their own. Formal feedback particularly intensified feelings, which 'stuck with' trainees, leading to action, including avoidance. Feelings served to strengthen relationships and reinforce social hierarchies both within and beyond the supervisor-trainee dyad. We infer that the judgements made in and around feedback - such as appraisal of source credibility, assessment of performance quality, and deciding future actions - are themselves fundamentally entangled with feelings. A first step to remedy the desire to 'manage' emotions through 'putting them away' is to acknowledge their presence in clinical learning environments.