Synergy between formal and informal education

The informal components of education can shape a person's capacity to contribute. Such informal components might include cultural backgrounds, work experiences, and extracurricular pursuits. To appreciate the synergy between formal and informal education it can be helpful to explore a particular case of someone who actually combined the two to make the whole more than the sum of its parts.

Obstetric violence is a misnomer

The term "obstetric violence" has been used in the legislative language of several countries to protect mothers from abuse during pregnancy. Subsequently, it has been expanded to include a spectrum of obstetric procedures, such as induction of labor, episiotomy, and cesarean delivery, and has surfaced in the peer-reviewed literature. The term "obstetric violence" can be seen as quite strong and emotionally charged, which may lead to misunderstandings or misconceptions. It might be interpreted as implying a deliberate act of violence by healthcare providers when mistreatment can sometimes result from systemic issues, lack of training, or misunderstandings rather than intentional violence. "Obstetric mistreatment" is a more comprehensive term that can encompass a broader range of behaviors and actions. "Violence" generally refers to the intentional use of physical force to cause harm, injury, or damage to another person (eg, physical assault, domestic violence, street fights, or acts of terrorism), whereas "mistreatment" is a more general term and refers to the abuse, harm, or control exerted over another person (such as nonconsensual medical procedures, verbal abuse, disrespect, discrimination and stigmatization, or neglect, to name a few examples). There may be cases where unprofessional personnel may commit mistreatment and violence against pregnant patients, but as obstetrics is dedicated to the health and well-being of pregnant and fetal patients, mistreatment of obstetric patients should never be an intended component of professional obstetric care. It is necessary to move beyond the term "obstetric violence" in discourse and acknowledge and address the structural dimensions of abusive reproductive practices. Similarly, we do not use the term "psychiatric violence" for appropriately used professional procedures in psychiatry, such as electroshock therapy, or use the term "neurosurgical violence" when drilling a burr hole. There is an ongoing need to raise awareness about the potential mistreatment of obstetric patients within the context of abuse against women in general. Using the term "mistreatment in healthcare" instead of the more limited term "obstetric violence" is more appropriate and applies to all specialties when there is unprofessional abuse and mistreatment, such as biased care, neglect, emotional abuse (verbal), or physical abuse, including performing procedures that are unnecessary, unindicated, or without informed patient consent. Healthcare providers must promote unbiased, respectful, and patient-centered professional care; provide an ethical framework for all healthcare personnel; and work toward systemic change to prevent any mistreatment or abuse in our specialty.

Professionalism in the context of providing elective services: reflecting on bias

We examine the provision of elective pronunciation services, such as intelligibility enhancement, to non-native speakers by speech language pathologists (SLPs). Practices associated with the 'modification' of non-native accent raise significant professionalism questions about bias for SLPs and healthcare professionals. These questions arise partly due to the socio-cultural context in which SLPs practice and their clients live, and the relational nature of communication. We argue that due to the ambiguity inherent in accent modification practices, SLPs must weigh a variety of considerations before determining the circumstances in which such services are professionally acceptable. Our argument is rooted in consideration of the complex nature of professionalism related to communication. After surveying potentially relevant models from other healthcare professions and finding them wanting, we support our position in light of current literature on topics such as accounts of functionality. We conclude by generalizing our anti-bias recommendations to interprofessional healthcare professionalism.

Patient Perspectives Regarding Healthcare Professional Attire

Introduction Physician attire has been shown to influence patients' impression of their healthcare provider. Scrubs and formal office attire are interchangeably worn by physicians. This study aimed to determine differences in scrubs and formal office attire on patient perceptions of professionalism, friendliness, aptitude, and empathy. Methods A single-center questionnaire study was conducted and a total of 150 patients were included. Patients were recruited from the inpatient and outpatient settings. Patients completed a questionnaire in which they rated 22 photographs. The photographs comprised a series of randomly arranged vignettes, with each participating physician appearing twice - once in formal office attire, once in scrubs. The physicians served as their own controls. Patients were asked to rate the depicted physicians based on the following four criteria - professionalism, friendliness, aptitude, and empathy. Each criterion was rated on an 11-point scale (0-10). Comprehensive demographic information, including age, gender, and race, was collected. Results A total of 150 responses were collected (50 inpatient and 50 orthopaedic surgery outpatient, 50 general medicine outpatient). Scrubs were rated significantly higher than formal office attire in all domains: professionalism [mean 7.52 (SD 1.95) vs. 6.69 (SD 2.38), p< 0.001], friendliness [mean 7.54 (SD 1.86) vs. 6.87 (SD 2.23), p< 0.001], aptitude [mean 7.44 (SD 1.99) vs. 6.72 (SD 2.36), p < 0.001] and empathy [mean 7.36 (SD 2.01) vs. 6.71 (SD 2.36), p < 0.001]. The perceived age of the physician did not affect any of the domain scores. Female physicians scored poorer in professionalism [mean 6.95 (SD 2.30) vs. 7.20 (SD 2.16), p < 0.05] compared to male physicians, but this difference resolved when analyzing only physicians wearing Scrubs.  Conclusion Patients view physicians in scrubs as having higher professionalism, friendliness, aptitude, and empathy as compared to physicians in formal office attire. Physicians should don standardized colored scrubs with a prominent name tag to improve patient perceptions.

"Definitely a Dark Time:" professional and ethical issues in post-acute care physical therapy during the COVID-19 pandemic

BACKGROUND

Disproportionate effects of the SARS-CoV-2 (COVID-19) pandemic on older adults in post-acute care settings created many professional and ethical challenges for patients and healthcare providers.

OBJECTIVE

The purpose of this study was to examine the professional and ethical issues of physical therapists (PTs) and physical therapist assistants (PTAs) in providing facility-based post-acute care in residential settings (skilled nursing facilities, inpatient rehabilitation facilities, and long-term acute care hospitals) during the COVID-19 pandemic.

METHODS

A qualitative descriptive research design was used to explore professional and ethical issues during the COVID-19 pandemic. PTs and PTAs described their experiences during semi-structured interviews conducted virtually. Interview data was analyzed with reflexive thematic analysis.

RESULTS

Thematic analysis produced 4 themes: facility-wide battle against infection and death, doing the best you can to provide care amidst COVID-19 constraints, promoting ethical good and doing the right thing, and a dark intense time.

CONCLUSIONS

Professional and ethical constraints on providing care faced by PTs and PTAs during the COVID-19 pandemic can inform current and future clinical practice. Although some of the challenges faced by PTs and PTAs were unique to COVID-19, many problems represent preexisting systemic and organizational issues that were exacerbated by the pandemic.

Negative faculty role modelling - is it a reflection of deteriorating societal values?

BACKGROUND

Negative faculty role modelling is an area of growing concern especially due to its implications on medical professionalism. The study aims to explore the impacts of negative role modelling on professionalism of medical students in the context of Pakistan.

METHODS

This qualitative study is part of a larger study exploring impacts of role modelling on professionalism of students. It is based on Constructivist Grounded Theory involving six semi-structured interviews with clinical faculty and three focus group discussions with 22 students. Initial, focused, selective coding and thematic analysis was used to find the core category.

RESULTS

Three overarching categories were developed: traits observed with negative role models; impact of negative role modelling; factors promoting negative role modelling. Subcategories of impacts included negative impact on professionalism, emotional impact, and its paradoxical positive impact. Negative role modelling, a manifestation of declining professionalism, was attributed to deteriorating societal values; further compounded by the lack of required mechanisms by institutions and the regulatory authority at their respective levels.

CONCLUSIONS

In the absence of a strong moral platform at societal level, the burden of responsibility rests with the faculty and more importantly with institutions and regulatory bodies to discourage negative role modelling and educate students to recognize, reflect on and avoid negative behaviours and adopt strong professional values.

Integrating community service-learning into a dental hygiene curriculum: a document analysis

Background

Community service-learning (CSL) aims to promote civic engagement among students and deepen their understanding of social issues, connecting students to communities where they may practise as future health care providers. This study's aims were two-fold: first, to determine whether incorporating a non-dental community service-learning experience into a fourth-year behavioural science course can develop abilities related to the dental hygiene baccalaureate competencies; second, to examine the overall student learning experience.

Methods

Seven community agencies presented projects to the dental hygiene class, and students individually selected their top 3 choices. Projects were diverse, ranging from literacy tutoring to creating a program plan or hosting a public virtual event with an interprofessional health panel discussing nutrition. Dental hygiene students participated in a 20-hour placement with one community project and completed individual reflection journals that focused on their experience. Using a document analysis approach, the authors examined the reflection journals through an iterative process to identify themes.

Results

Ten student reflections were analysed and three themes emerged: 1) increased social awareness; 2) application of dental hygiene core competencies; and 3) the challenges of the learning experience. Students consistently discussed how the project allowed them to apply 5 dental hygiene core competencies and how their learning experience aligned with their future professional role as a dental hygienist. Students articulated increased understanding of their individual privilege and awareness of social issues in their community.

Conclusions

Participation in non-dental CSL increased dental hygiene students' social awareness of local communities. Students demonstrated an ability to apply their learning to their developing competencies as future dental hygienists.

Exploring Medical Students' Perceptions of Peer-to-Peer Interactions Related to Applying to a Surgical Residency

OBJECTIVE

The objectives were to (1) identify themes related to competitive peer-to-peer interactions elicited from the lived experiences of undergraduate medical students, and (2) understand how these experiences influenced medical students' choices related to surgical residency programs.

DESIGN

A qualitative descriptive methodology, with purposive and maximal variation sampling (e.g., selection based on medical school location; gender), was adopted for this study.

SETTING

Temerty Faculty of Medicine, University of Toronto.

PARTICIPANTS

Participants were 15 undergraduate medical students from 4 medical schools in Ontario, Canada, who agreed to an individual semi-structured interview by Zoom or telephone.

RESULTS

Peer-to-peer interactions influence students' perception of self and identity formation related to surgical specialty decision-making and interest. These interactions were shown to hold greater value, specifically for information gathering. Identity formation, related to pursuing a surgical residency, was influenced by the attitudes and perceptions of competition with peers throughout medical school. Cultures of competition were seen to dictate peer-to-peer interactions and their associated value, with their perception and experience differing between medical schools.

CONCLUSIONS

Peer-to-peer interactions and a culture of competition have inherent roles in the residency decision-making process. We observed that student background and pre-formed relationships influenced how students perceived and responded to competition. Addressing the culture of competitiveness associated with peer-to-peer interactions along with considering student background and pre-existing relationships may provide insight into how medical educators can tailor learning experiences that limit the detrimental effects of hidden curriculum influences.

Professionalism in pre-licensure nursing education: Core values, didactic coursework and clinical training

AIM

To discuss professionalism for pre-licensure nursing students and identify recommendations for inclusion in core values, didactic coursework and clinical training.

BACKGROUND

Professionalism is part of the nursing identity that encompasses integrity and honesty. This concept has been difficult to translate into formal education in nursing programs and clinical practice.

DESIGN

A discursive paper.

DATA SOURCES

A search of national literature without date restrictions in PubMed, CINAHL, Google Scholar and frameworks for nursing education. We explored principles of professionalism in nursing education and practice.

DISCUSSION

Evidence-based literature supports the integration of core values of altruism, autonomy, human dignity, integrity, honesty and social justice into didactic curricula, and clinical training. Principles of professionalism can be incorporated intentionally in nursing education to maintain patient safety and trust.

CONCLUSION

The principles of professionalism, related to core values of the nursing profession, are abundantly described in the literature. However, these principles represent core values that have not been formally conceptualized. With the changing landscape of healthcare, there is a need for deliberate, measurable integration of professionalism into pre-licensure education.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public involvement in the design or drafting of this discursive paper.

The Importance of Learning with Patients: Post-Pandemic Takeaways on Learning Professionalism in Clinical Settings

Background

Public demands for high-quality healthcare require medical schools to ensure that physicians attain various competencies, including professionalism and humanism. This can be accomplished through various interactions and socialisations within the healthcare community. These meaningful learning experiences become more critical as students face unpredictable learning opportunities in clinical settings. However, professional development focuses on lapses, remediation and knowledge retention rather than its practice. To nurture professional and humanistic physicians, this study explores how medical students perceive learning professionalism in clinical settings.

Methods

This is a qualitative phenomenology study involving medical students in clinical rotations at the Faculty of Medicine Universitas Indonesia. Respondents were chosen through a purposive sampling method that considered their gender and clinical years. Data were collected through focus group discussions (FGDs) and thematic analysis was used.

Results

Three FGDs were conducted with 31 clinical students. Learning professionalism in clinical settings presents challenges, including the hidden curriculum (HC), limited exposure to patients and the clinical learning environment because of the social restrictions caused by the COVID-19 pandemic. The tailored strategy to learn professionalism in the clinical learning environment was more teacher-driven, including role modelling, debriefing, providing feedback and teaching context-specific knowledge on professionalism, followed by patient interactions.

Conclusion

The significance of students' interactions with the clinical learning environment, especially with patients and clinical teachers as role models, is the key to learning professionalism in clinical settings. This finding is an important takeaway in curriculum design for professionalism.

Which 'end' do you have in mind? Clinical supervisors' perceptions of professional Identity Formation outcomes in GP residency

PURPOSE

Professional Identity Formation (PIF) is crucial for high-quality patient care and physician well-being. Few empirical studies examined PIF in residency from the perspective of supervisors. In GP residency, residents are supervised with an 'end in mind' that remains unexplored. To encourage supervisors to reflect on their teaching behaviours, this study investigated GP clinical supervisors' perceptions of PIF outcomes in GP residency.

METHODS

Applying qualitative description, focus group interviews were conducted between spring and autumn 2019. Using a semi-structured interview guide, supervisors' perceptions of PIF outcomes were explored. In an iterative coding process applying constant comparison, a thematic analysis was performed of focus group transcripts.

RESULTS

We conducted eight focus groups with 55 supervisors at four training institutes across the Netherlands. Half of the supervisors were female. GP supervisors tend to address the 'poor GP' when prompted to address the 'good GP'. PIF outcomes in GP residency should revolve around taking ownership in patient care, self-care and the persistence of GP as a profession.

CONCLUSION

PIF can be challenged by a lack of positive language. Supervisors' strong beliefs regarding ideals of the profession potentially compromise PIF when they do not resonate with residents' beliefs, resulting in poor educational alliance.

The Australian Health Informatics Competency Framework: Conceptual Design, Framework Development, and Certification Delivery

The Australian Health Informatics Competency Framework (AHICF) guides the healthcare workforce in identifying the required competencies to perform as a health informatician, and more definitively defines the foundational body of knowledge on which the discipline is based. The aim of this paper is to describe the conceptual foundations in developing the AHICF v1.0, detail the methods used to revise and publish AHICF v2.0, and explore the certification and workforce outcomes achieved. This paper contributes to the competency framework and certification discourse, and knowledge of the increasing importance and recognition of health informaticians through certification. Further, implications for workforce training and education, career advancement and recruitment strategies, are also discussed.

Assessment of Research Ethics Knowledge of Pediatricians

Objectives. To assess knowledge of ethics knowledge among child healthcare professionals. Methods. We translated the Test of Residents' Ethics Knowledge for Pediatrics (TREK-P) in Azeri and administered it to: (i) third-year medical students (n = 21), (ii) pediatrics residents (n = 24), (iii) practicing pediatricians (n = 21), and (iv) fellows (n = 9) who participated in a Fogarty International Center/National Institute of Health (Fogarty/NIH) R25 research ethics education program. The difference in the TREK-P score between the groups and the correlation between the TREK-P score and other factors were evaluated. Results. The fellows scored significantly higher than the other groups (P = .006). There was no significant difference between the other 3 groups. Within a joined group of pediatricians and fellows, previous training on ethics was the only factor that correlated with the higher TREK-P scores (P < .05). Conclusions. The higher scores in fellows support the effectiveness of postgraduate Fogarty/NIH training programs in research ethics.

Health and social care professional standards need to be updated to advance leadership and action for environmental sustainability and planetary health

BACKGROUND

Human health is inextricably linked to planetary health. The desire to nurture and protect both concurrently requires the mitigation of healthcare-associated environmental harms and global initiatives that support sustainable lifestyles. Health leadership is important to bring adequate attention and action to address planetary health challenges. Health professionals are central to this endeavour, but the will and energy of a few will not be adequate to address this urgent challenge.

STUDY

We present an appraisal of the current UK health professional standards, frameworks and curricula to identify content related to planetary health and environmental sustainability.

RESULTS

No current UK health professional standard provides statements and competencies to guide practising and trainee health professionals to focus on and advance the sustainability agenda within their clinical practice and across wider healthcare systems.

CONCLUSION

Update of health professional standards is needed to ensure that health professionals in every specialty are supported and encouraged to lead the implementation of environmentally sustainable practices within the health sector and advocate for planetary health.

How to Exercise Integrity in Medical Billing: Don't Distort Prices, Don't Free-Ride on Other Physicians

This paper proposes that billing gamesmanship occurs when physicians free-ride on the billing practices of other physicians. Gamesmanship is non-universalizable and does not exercise a competitive advantage; consequently, it distorts prices and allocates resources inefficiently. This explains why gamesmanship is wrong. This explanation differs from the recent proposal of Heath (2020. Ethical issues in physician billing under fee-for-service plans. J. Med. Philos. 45(1):86-104) that gamesmanship is wrong because of specific features of health care and of health insurance. These features are aggravating factors but do not explain gamesmanship's primary wrong-making feature, which is to cause diffuse harm not traceable to any particular patient or insurer. This conclusion has important consequences for how medical schools and professional organizations encourage integrity in billing. To avoid free-riding, physicians should ask themselves, "could all physicians bill this way?" and if not, "does the patient benefit from the distinctive service I am providing under this code?" If both answers are "no," physicians should refrain from the billing practice in question.

Can professional nursing value claims be refused? Might nursing values be accepted provisionally and tentatively?

Value-act relationships are less secure than is commonly supposed and this insecurity is leveraged to address two questions. First, can nurses refuse professional value claims (e.g., claims regarding care and compassion)? Second, even when value claims are accepted, might values be held provisionally and tentatively? These questions may seem absurd. Nurses deliver care and nursing is, we are told, a profession the members of which hold and share values. However, focusing attention on the problematic nature of professional value claims qua claims permits a more conciliatory and realistic stance to be taken towards nurses holding alternative values and value interpretations. This could prove beneficial.

[Considering Medical Professionalism from the Standpoint of Pharmacy Education]

Worldwide interest in teaching medical professionalism has increased drastically over the past two decades and is recognized as an important core competency. It is also essential in pharmacy education. However, there is no single definition of medical professionalism owing to its multifaceted nature, leading to difficulty in understanding it. The foundational concept of professionalism are the social contract and accountability, which describe the relationship between the profession and the society which it serves. Profession must understand expectations from the society, which is trustworthy, assures competence, and devoted to the public good for the contract based on their mutual trust. In "teaching," three basic educational actions ("setting expectations," "providing experiences," and "evaluating outcomes") are required. There are two learning goals of professionalism education: the minimum goal of not doing unprofessional acts and the aspirational goal of pursuing a higher level of interiorized professionalism which leads to the professional identity formation. The true professionals are "reflective practitioners," who have the ability to manage ambiguous problems using their interiorized professionalism in complicated situations. Therefore, reflection is one of the central concepts of professionalism education. The Professionalism Mini-Evaluation Exercise (P-MEX), an observational tool to evaluate medical professionalism, has some favorable aspects; the Japanese version is available and is a guide to specific actions for professionalism through its items, although some cautions must be exercised when using it. Considering that teaching professionalism includes not only formal but informal and hidden curricula, all of the staff in the educational environments should consider professionalism education by understanding professionalism.

Using Reflective Practice to Enhance Student Professionalism

Reflective practice, critically reflecting on one's actions or attitudes to engage in the process of continuous adaptation and learning, has proven to be an effective strategy for improved patient care. Additionally, literature supports applying reflective practice for professional growth in medical providers. When contemplating professionalism training in physician assistant (PA) education, it is important to consider how to obtain buy-in from students. One way to do this is to link professionalism to the students' future career as a PA. The School of Physician Assistant Studies at Pacific University (the Program) created an Online Orientation Reflective Practice Assignment that was implemented during online orientation. Students were prompted to use reflective practice to create detailed "plans for success." The goal of this assignment was to reduce common professionalism missteps students often experienced. Data regarding the number of professionalism encounters per cohort, broken down into occurrences by curricular phase (didactic vs clinical), was tracked and collated using Microsoft® Excel®. The data was analyzed to determine trends. Implementation of the Online Reflective Practice Assignment for all PA students at the beginning of their education has increased student awareness of the Program's, and the profession's, expectations regarding professionalism and accountability. Thus far, the resulting number of professionalism missteps have not decreased year-over-year. We hypothesize that this is due to the difficulty meeting increased administrative expectations and burdens put on students during the pandemic. Students' use of reflective practice to review what went wrong and to create plans to avoid missteps in the future allows them to focus on productive next steps in building their professional identity. Implementation of the Online Orientation Reflective Practice Assignment has better prepared students for the expectations of the PA profession and provided them with a solid foundation to build their professional identity throughout their education and into their careers.

A Qualitative Study on the Development of Professionalism Among Japanese Dental Students

BACKGROUND

Professionalism is believed to vary depending on factors such as era and culture. Therefore, clarifying the meaning of professionalism in each country, region, and workplace is essential. However, how professionalism is cultivated among dental students in Japanese schools has yet to be fully elucidated. Therefore, this study examined whether professionalism among Japanese dental students changes by year. This research will contribute to effective professional education.

PARTICIPANTS AND METHODS

The participants included six fourth-year dental students and nine fifth-year dental students. Semi-structured interviews were conducted from November 2018 to January 2019, and verbatim transcripts were created from the recorded data. Based on these verbatim transcripts, thematic analysis was utilized to examine and identify professionalism components for each academic year.

RESULTS

Three themes based on 14 constituent concepts were obtained for fourth-year students. Three themes based on 20 constituent concepts were obtained for fifth-year students. Fourth-year students primarily focused on technical aspects. In contrast, fifth-year students placed greater emphasis on attitude and communication skills.

CONCLUSION

From fourth-year students, who primarily focus on classroom learning and practical training, to fifth-year students who gain clinical experience, the constituent elements of professionalism became more complex. However, this study did not examine other aspects of healthcare professionalism, such as interprofessional collaboration. A comprehensive education program tailored to the clinical setting is necessary for cultivating professionalism.

Professionalism Program Evaluation and Its Impact on Undergraduate Medical Students

Objective The study aims to evaluate the effectiveness of a professionalism program by conducting focus group discussions (FGDs). The research focuses on understanding how the program influences the development of professionalism skills among medical students, as well as their perceptions and experiences regarding the program. The study's objectives revolve around identifying the strengths and weaknesses of the program from the perspective of the students. Methods This was a qualitative study done after obtaining approval from the Institutional Review Committee, Islamic International Medical College. Students of 4th year Bachelor of Medicine and Bachelor of Surgery (MBBS; 56 students) were selected for the study. A convenience sampling technique was used to select the participants for FGDs. Seven separate FGDs were conducted, with eight participants in each group. All the FGDs were audiotaped. Data were transcribed and translated. Data were analyzed using the thematic analysis on Atlas. Both obvious and hidden content were analyzed. Codes and themes were identified, which were then finalized with consensus. Codes were then categorized into sub-themes, and finally, themes were generated. Results Participants identified the problems associated with applying professionalism during FGDs. These challenges encompassed hefty workloads and a perceived disparity between theoretical knowledge and practical implementation. The students highlighted the importance of practical teaching methods, the cultivation of role models, the alignment of curriculum with real-world experiences, and the revision of assessment methods. This study analyzes the obstacles and potential advantages associated with professionalism education and presents significant perspectives on improving it for upcoming healthcare practitioners. Conclusion Professionalism is a crucial component, and each graduate of a medical school should be fully qualified as a professional after graduation. As we want our future doctors to be skilled at both professional qualities and diagnosis, it is crucial that medical institutions teach professionalism.

Improving optometry student interpersonal skills through online patient, clinician and student evaluation and feedback

CLINICAL RELEVANCE

Interpersonal skills are crucial for successful clinician-patient interactions. To prepare future optometrists for clinical practice, pedagogical evaluation is important to support the implementation of new strategies for teaching and evaluating interpersonal skills.

BACKGROUND

Optometry students largely develop their interpersonal skills through in-person patient interactions. Telehealth is increasing, yet strategies to develop the interpersonal skills of students for teleconsulting have not been explored. This study aimed to assess the feasibility, effectiveness and perceived usefulness of an online, multisource (patients, clinicians and students) evaluation and feedback program for developing interpersonal skills.

METHODS

Via an online teleconferencing platform, optometry students (n = 40) interacted with a volunteer patient, observed by a teaching clinician. Patients and clinicians evaluated the interpersonal skills of the student in two ways: (1) qualitative written feedback, and (2) quantitative rating (Doctors' Interpersonal Skills Questionnaire). All students received written patient and clinician feedback after the session, but not their quantitative ratings. A subset of students (n = 19) completed two sessions, self-ratings, and were provided with their written feedback and an audiovisual recording from their first interaction before completing the second session. All participants were invited to complete an anonymous survey at program completion.

RESULTS

Patient and clinician overall interpersonal skills ratings were positively correlated (Spearman's r = 0.35, p = 0.03) and showed moderate agreement (Lin's concordance coefficient = 0.34). Student self-ratings did not match patient ratings (r = 0.01, p = 0.98), whereas there was moderate agreement between clinician and student ratings (Lin's concordance coefficient = 0.30). Ratings improved at the second visit (p = 0.01). Patient ratings were higher than clinicians (p = 0.01) and students (p = 0.03). All participants agreed that the program was feasible, useful and effective at fostering good interpersonal skills.

CONCLUSION

Multisource feedback about interpersonal skills contributes to improvement in student performance. Patients and clinicians can evaluate and provide useful feedback to optometry students about their interpersonal skills using online methods.

The heart of anaesthesiology: revitalising humanism in the age of technology

Technological innovation has greatly aided modern medicine, and anaesthesiology in particular, but also contributes to dehumanising influences that promote physician burnout and dissatisfaction among patients. Here we advocate for a profound reaffirmation of humanistic principles-empathy, compassion, and communication-in perioperative medicine. We propose adaptable strategies to bolster humanism in practice, such as curricular offerings, simulation training, role modelling, and recognition. As perioperative technologies continue to evolve, the threat of depersonalisation in anaesthetic care looms, making commitments to humanism a crucial precondition for healing in the communities in which we work and live.