Transforming Post-Professional Clinical Skill Education with Digitally Integrated Instructional Design: An Industry-Relevant University-Setting Project Series

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript presents a well-structured approach to the development and implementation of online post-professional clinical education. The integration of various methods, along with their detailed description, provides the manuscript with a solid foundation and introduces innovative ideas for clinical education.

This work is of significant interest as it offers new ways on the implementation of online education through diverse methodologies. I consider the manuscript to be strong, particularly due to the detailed explanation of the educational strategies employed.

However, there are some areas that I find weak:

1. The number of respondents to the survey is limited to only four students, which is insufficient to draw conclusions.
2. The article mentions that “students agreed online tutorial discussions improved preparation for clinical practice”; however, there is no supporting data, such as numerical scores evaluation or direct quotations, to support this result.
3. It would be of high value to include a before-and-after analysis of students' perceptions, providing both quantitative and qualitative results.

While the manuscript serves as an instructive guide on delivering/ implementing new educational methods, it lacks clear evidence of changes in student outcomes. It appears more as a protocol that has been applied without providing a comprehensive evaluation of its effectiveness.

I would recommend including, even for the four students, a detailed report of both quantitative and qualitative results, rather than presenting conclusions without any visible scoring system or supporting data.

Author Response

Please see the attachment

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

This manuscript explores online approaches to teaching and assessing industry-relevant advanced clinical skills which is a timely and significant issue in clinical education. Transitioning traditionally face-to-face clinical skills training into a digital format is challenging but necessary in today’s evolving educational landscape. One of the strengths of this study is that it critically evaluates digital approaches for assessing advanced clinical competencies.

Please see below for detailed comments and suggestions: 

1. Use of Acronyms in the Abstract: Consider spelling out “4C-ID” in the abstract for clarity, especially for readers not familiar with this terminology. The full term “four-Component Instructional Design” is introduced later on page 2.   

2. Introduction Structure: The introduction is well-conceived and covers important conceptual ground. To improve readability and organization, I suggest numbering the subsections as follows:

• 1.1 Advancing Clinical Skills in Post-Professional Medical Education
• 1.2 Employing Instructional Design with Digitally Integrated Pedagogy to Advance Industry Skills
• 1.3 Aims and Intentions of This Project Series

3. Clarify “Complex Learning and Assessment”: The term “complex learning and assessment approaches” on page 3 is central but somewhat abstract. I recommend briefly clarifying what this encompasses—such as simulation-based learning, clinical assessments, or competency-based frameworks—within the introduction.

4. Figure Labeling in Section 2.1.2: To enhance clarity in Section 2.1.2, I suggest labeling sections of Figure 1 (e.g., a. “Attend the scheduled webinar,” b. “Clinical examination,” etc.). These labels can then be referenced consistently in the narrative of Sections 2.1.2 and 2.1.3, improving article readability. 

5. Visual Representation of Survey Results: The survey findings related to students’ experiences in advancing clinical skills, mentioned in Section 3.3, would benefit from a visual representation. Including a bar graph that illustrates the percentage of students who agreed with each survey category would enhance clarity and offer a more intuitive understanding of students reported improvements.

6. Supplementary Materials: Survey questions: I highly recommend including the Qualtrics survey questions as supplementary material and distinguishing how two voluntary surveys were different in section 2.3. Your reference 35 goes to the NSS survey, if survey questions are publicly available, perhaps you could add that as reference. This would be a valuable resource for other educators or researchers interested in adapting your study. Given that your project contributes a practical model for video-based clinical encounter assessment, this addition would further enhance its applicability. 

Author Response

Please see the attachment

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript presents a well structure idea of developments and implementation for online post-professional clinical education. The integration of different methods and its description is also mentioned which gives this article a solid base on the content and also innovative ideas for the clinical education.

The article is of huge interest as it brings new ideas of implementing online education and diverse methods. I will consider this manuscript pretty strong with strong base of how they implemented the education.

The revised version of the article reflects and explains the corrections noted in my previous review. Therefore, I approve this version.