Search Results (66)

Objective: This proof-of-concept study aimed to evaluate and compare the clinical performance of two AI language models (ChatGPT-3.5 and OpenAI o3) in answering clinical pharmacy multiple-choice questions (MCQs), benchmarked against responses from specialist clinical pharmacists in Jordan, including academic preceptors and hospital-based clinicians. Methods: A total of 60 clinical pharmacy MCQs were developed based on current guidelines across four therapeutic areas: cardiovascular, endocrine, infectious, and respiratory diseases. Each item was reviewed by academic and clinical experts and then pilot-tested with five pharmacists to determine clarity and difficulty. Two ChatGPT models—GPT-3.5 and OpenAI o3—were tested using a standardized prompt for each MCQ, entered in separate sessions to avoid memory retention. Their answers were classified as true/false positives or negatives and retested after two weeks to assess reproducibility. Simultaneously, 25 licensed pharmacists (primarily from one academic institution and several hospitals in Amman) completed the same MCQs using validated references (excluding AI tools). Accuracy, sensitivity, specificity, and Cohen’s Kappa were used to compare AI and human performance, with statistical analysis conducted using appropriate tests at a significance level of p ≤ 0.05. Results: OpenAI o3 achieved the highest accuracy (83.3%), sensitivity (90.0%), and specificity (70.0%), outperforming GPT-3.5 (70.0%, 77.5%, 55.0%) and pharmacists (69.7%, 77.0%, 55.0%). AI performance declined significantly with increasing question difficulty. OpenAI o3 showed the highest accuracy in the cardiovascular domain (93.3%), while GPT-3.5 performed best in infectious diseases (80.0%). Reproducibility was higher for GPT-3.5 (81.6%, κ = 0.556) than OpenAI o3 (76.7%, κ = 0.364). Over two test rounds, GPT-3.5’s accuracy remained stable, whereas OpenAI o3’s accuracy decreased from 83.3% to 70.0%, indicating some variability. Conclusions: OpenAI o3 shows strong promise as a clinical decision-support tool in pharmacy, especially for low- to moderate-difficulty questions. However, inconsistencies in reproducibility and limitations in complex cases highlight the importance of cautious, supervised integration alongside human expertise. Full article

Background: Nursing students often experience heightened levels of stress during clinical training due to the dual demands of academic and clinical responsibilities. These stressors, compounded by environmental and organizational factors, can adversely affect students’ well-being, academic performance, and the quality of patient care they deliver. Aim: This study aimed to identify the key stressors influencing nursing students’ perceptions of single-shift quality (SSQ) during clinical training and to examine how well students can predict the quality of their shift based on pre-shift expectations. Methodology: A cross-sectional survey design was implemented, collecting pre- and post-shift data from 325 nursing students undergoing clinical training in Alabama. The survey measured 13 domains related to workload, environmental conditions, organizational interactions, coping strategies, and overall satisfaction. Paired t tests and linear regressions were used to assess changes in perception and identify key predictors of SSQ. Results: This study found significant discrepancies between students’ pre- and post-shift evaluations across multiple domains, including internal environment, organizational interaction with clinical faculty/preceptors, and coping strategies (p < 0.001). Students also accurately predicted stable factors such as patient characteristics and external environment. Pre-shift expectations did not significantly predict post-shift experiences. Post-shift perceptions revealed that stress-coping strategies and collegiality were the strongest predictors of shift quality. Conclusion: Students enter clinical shifts with optimistic expectations that often do not align with actual experiences, particularly regarding support and stress management. The SSQ framework offers a valuable tool for identifying gaps in clinical training and guiding interventions that foster resilience and better alignment between expectations and real-world practice. Full article

Over the past decade, telehealth provision of care has become increasingly common. This shift away from in-person clinics may impact the experience of medical learners and the preceptors who train them. This study aimed to measure and compare obstetrics and gynecology resident physicians’ perceived quality of educational feedback during telemedicine compared to in-person clinical encounters. This prospective observational study recruited residents enrolled in a family planning clinical rotation at an academic residency program. After every in-person and telemedicine clinic session from January 2021 to February 2022, participating residents were sent a link to a 3 min survey via text message. Ordinal regression modeling was used to compare Likert responses between the telehealth and in-person clinical settings. All nine residents enrolled in the clinical rotation chose to participate in this study and responded to 114 of 132 survey prompts (86%). Participants positively rated the feedback they received during all clinic sessions. When comparing the two clinic experiences, there was no statistically significant difference in perceived quality of feedback or satisfaction with feedback. Residents’ perception of educational feedback during telemedicine clinic is at least similar for most measures and superior for contraception counseling when compared to an in-person clinic. Full article

Butein (3,4,2′,4′-tetrahydroxycalone) is a chalcone derivative and plant polyphenol extracted from Rhus verniciflua Stokes. Butein has an open C-ring structure and a variety of biological activities. Molecular mechanisms by which butein could affect cell viability, ROS levels, mitochondrial function, apoptosis, and necrosis in prostate cancer cells were investigated using 2D monolayer and 3D sphere culture systems. Cytotoxicity and cell cycle monitoring showed that butein treatment decreased cell viability and increased peaks of sub-G₀/G₁ and G₂/M phases analyzed by flow cytometry. These changes were observed with a concurrent induction of DNA damage, apoptosis, and necrosis. Although 3D spheres treated with butein showed decreased cell viability, they were slightly more resistant than cells in 2D cultures. This phenomenon was accompanied by an increase in mediators of apoptosis and necrosis. Monitoring changes of apoptosis-related proteins via Western blot showed that butein decreased caspase-3, PARP, and Bcl-2, but increased Bax. Meanwhile, butein increased levels of p-receptor interacting serine/threonine–protein kinase 3 (p-RIP3) and p-mixed lineage kinase domain-like kinase (p-MLKL) known to be mediators of necrosis. Overall, our data suggest that butein can induce apoptosis and necrosis of prostate cancer cells by regulating pro- and anti-apoptotic proteins via ROS. Thus, butein might be a potential agent for treating prostate cancer. Full article

The objective was to evaluate the growth in pharmacy student performance in entrustable professional activity (EPA) assessments across the experiential curriculum based on preceptor assessments on an entrustment–supervision (ES) scale. This retrospective cohort study used assessments based on the 2016 American Association of Colleges of Pharmacy Core EPAs and an expanded ES scale during introductory and advanced pharmacy practice experiences (IPPEs/APPEs) in the third and fourth professional years from fall 2020 to fall 2023. The primary outcome was the change in ES level, assessed by preceptors over time. The secondary outcomes were growth rates across types of experiences, training environments, and experience order. A conditional growth curve model and ordinal mixed effects model were used to demonstrate discrete entrustment decisions. A total of 509 students received 12,426 assessments by 557 preceptors. Raw ES levels and unconditional growth curves for EPA show increases in entrustability from years P3 to P4. Comparing care settings, there was lower entrustment in inpatient than outpatient settings and at academic medical centers than other settings. There were no significant differences in ES levels regardless of which IPPE was taken first. However, when the first APPE was an inpatient medicine experience, ES levels across APPEs for EPA 3 were higher when compared to ambulatory care as the first APPE, and they were higher for EPA 5 when compared to community pharmacy as the first APPE. Paired with ES scales, EPAs can be integrated into pharmacy experiential curricula to demonstrate longitudinal growth in student entrustment. Full article

Pharmacy preceptors often feel unprepared to support and manage underperforming student pharmacists in experiential education settings. Further, there is little guidance on how preceptors can best support struggling student pharmacists with mental health concerns or those requiring disability accommodations. Further, recent literature has demonstrated elevated rates of preceptor burnout when working with difficult students. Resources to address challenging experiential student pharmacist situations were gathered through a literature review and from several offices of experiential education. This toolkit aims to provide strategies and resources to support preceptors working with struggling student pharmacists, particularly those facing mental health challenges and/or those requiring accommodations. Full article

Background: Experiential learning is a vital component of health-professional education. It provides students with the opportunity to apply their knowledge in real-life settings before becoming licensed practitioners. Preceptors (i.e., practice educators) play a crucial role in developing students’ professional skills and competencies, as well as shaping their attitude during their clinical training. Ensuring preceptors’ quality and preparedness is a key aspect in students’ experiential learning due to the important impact of the provided training on the quality of the students’ learning experience. There is a knowledge gap about the desired attributes of pharmacy preceptors in the Gulf region, specifically Qatar, highlighting the need to explore preceptors’ views on this topic. Purpose: The aim of this scoping review is to identify the available tools in the literature to explore the desirable attributes of pharmacy preceptors as clinical educators. The objectives are to explore the reported desirable attributes of clinical preceptors in the published literature and select and utilize an appropriate tool to identify the desirable attributes of pharmacy preceptors in Qatar. Methods: The scoping review was designed to identify the relevant original research articles, which were published in English language, utilizing CINAHL, ERIC, ProQuest, and PubMed databases. Key concepts were preceptorship, attributes, pharmacy, and tools. Quantitative and mixed-methods study designs were included. The included articles were summarized according to their design, setting, population, and outcomes. The validity of the used instruments in these studies was reported. Results: A total of six articles qualified for inclusion into the full screening and were used to inform the results of this review. Skills like being a role model, assessment, and feedback expertise were of the highly important attributes to different populations (i.e., students, graduates, and preceptors). The review revealed the need for more validated tools in pharmacy research to increase the knowledge about the desired qualities of preceptors. Finally, a list of the most reported attributes in the literature was created after grouping all the reported attributes into five categories: (1) knowledge, teaching, and presentation skills; (2) professionalism and development skills; (3) communication skills; (4) supportive mentoring; and (5) enthusiasm and interest. Conclusions: the top three identified attributes were related to communication, assessment and feedback, and professionalism. The results of this review demonstrated a lack of well-designed and validated tools in pharmacy research that can be used to explore the desirable attributes of pharmacy preceptors. This necessitates further research to develop and validate a new appropriate tool to ultimately understand the perceptions of pharmacy preceptors on this topic. Including more databases in the research could have enriched the findings. Full article

Used to mark devotion to the main propagators of Jainism, namely the Jina (arhat), the Liberated Souls (siddha), the Teachers (ācārya), the spiritual Guides (guru), the Preceptors (upādhyāya), and the monks (muṇi), the formula of homage to the five supreme entities (pañcanamaskāra) underwent a significant development in the medieval period where it became a mantra protecting against all evils and violence and symbolising Jainism in its entirety and its respect for life in all its forms amidst the various Indian religions. In the present paper, I intend to investigate how the formula was used in largely unknown romance poems composed in the Prakrit language by Jaina scholar monks in medieval North India between the 8th and 12th centuries. Particular attention will be paid to how the writer monks used the formula of homage in the narrative to avoid the use of violence. The analysis will also focus on the development of the formula in the hymns of praise of the romance poems and study its significance in the context of the spread of Jainism at the turn of the first millennium, a period that led to the advent of King Kumārapāla, who has remained famous in history not only for the imposing monuments he left behind, but also for his conversion to Jainism and his governance according to principles of non-violence. Full article

Introduction: The concept of clinical readiness for practice among nursing students is yet to be analyzed, and there is a lack of empirical evidence on its usage among academics and clinicians. Methods: This concept analysis is anchored on a systematic literature review that adhered to the PRISMA guidelines and incorporated the eight iterative steps of Walker and Avant’s concept analysis method. This concept analysis method involved: (1) choosing a concept; (2) determining the objectives of the analysis; (3) identifying usages of the concept; (4) determining the defining attributes; (5) identifying a model case; (6) identifying other cases, including borderline, contrary, and related cases; (7) identifying antecedents and consequences; and (8) defining empirical references. The integrative thematic data synthesis method was adopted. Results: The concept of nursing students’ clinical readiness for practice is said to have four interrelated attributes. These attributes included (1) professional skills, (2) communication skills, (3) self-management skills, and (4) self-confidence. The two antecedents for nursing students’ clinical readiness to practice are (1) personal factors, including demographic characteristics, prior healthcare experience, income, and emotional intelligence; and (2) educational factors, including the clinical learning environment, clinical internship program, learning resource, and learning strategy. The consequence of clinical readiness for the practice of nursing students includes obtaining practice skills that can lead to more personal and job-related satisfactory outcomes. Conclusions: clinical readiness for practice in nursing encompasses the acquisition and integration of professional knowledge, skills, effective communication abilities, and self-management capabilities and the application of these competencies with confidence toward the provision of high-quality care to patients. Clinical Relevance: Understanding the components of clinical readiness is crucial for nursing educators, preceptors, and healthcare institutions to ensure that nursing students are adequately prepared for the challenges they will face in clinical practice. By recognizing the importance of professional knowledge, skills, communication, and self-management in clinical readiness, educators and training institutions can tailor their curricula, programs, and support systems to better prepare nursing students for the demands of real-world healthcare settings. This focus on clinical readiness ultimately delivers safe, effective, and compassionate patient care. Full article

Background: The global shift from open esophagectomy (OE) to minimally invasive esophagectomy (MIE) for treating esophageal cancer is well-established. Recent data indicate that transitioning from hybrid minimally invasive esophagectomy (hMIE) to total minimally invasive esophagectomy (tMIE) can be challenging due to concerns about higher leakage rates and lower lymph node counts, especially at the beginning of the learning curve. This study aimed to demonstrate that a safe transition from OE to tMIE for cancer is possible using process management methodology. Methods: A step-change approach was adopted in process management planning, with hMIE serving as an intermediate step between OE and tMIE. This single-center, case–control study included 150 patients who underwent the Ivor Lewis procedure with curative intent for esophageal cancer. Among these patients, 50 underwent OE, 50 hMIE (laparoscopic procedure followed by conventional right thoracotomy), and 50 tMIE (laparoscopic and thoracoscopic approach). A preceptored training scheme was implemented during execution, and treatment results were monitored and controlled to ensure a safe transition. Results: During the transition, the tMIE group was not worse than the hMIE and OE groups regarding operation duration (p = 0.135), overall postoperative complications (p = 0.020), anastomotic leakage rates (p = 0.773), 30-day mortality (p = 1.0), and oncological outcomes (based on R status (p = 0.628) and 2-year survival (p = 0.967)). Additionally, the tMIE group showed superior results in terms of major postoperative pulmonary complications (p = 0.004) and ICU stay duration (p < 0.001). Conclusions: Utilizing managerial methodology and practice in surgery, as a bridge between interdisciplinary and transdisciplinary approaches, demonstrated that transitioning from OE to tMIE, with hMIE as an intermediate step, is safe and feasible without compromising outcomes. Full article

Nursing students’ integration of theoretical knowledge and practical abilities is facilitated by their practice of nursing skills in a clinical environment. A key role of preceptors is to assess the learning goals that nursing students must meet while participating in clinical practice. Consequently, the purpose of this study was to explore the current evidence in relation to competency assessment and assessment approaches, and the willingness of preceptors for assessing nursing students’ competency in a clinical setting. The scoping review used the five-stage methodological framework that was developed by Arksey and O’Malley, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Relevant studies were searched by applying a comprehensive literature search strategy up to April 2024 across the following databases: CINAHL, OVID MEDLINE, EMBASE, and PUBMED. A total of 11,297 studies published between 2000 and April 2024 were revealed, and 38 were eligible for inclusion, which the research team categorised into three main themes: definitions of competence, tools for assessing competence and preceptors’ and mentors’ viewpoints in relation to the assessment of nursing students’ competence. This review established that there are a multitude of quantitative instruments available to assess clinical competence; however, a lack of consistency among assessment instruments and approaches between countries and higher education institutions is prevalent. Existing research evidence suggests that the preceptors carried out the assessment process clinically and they found difficulties in documenting assessment. The assessing of nursing students’ competency and the complexity of assessment is a concern for educators and mentors worldwide. The main concern centers around issues such as the interpretation of competence and complex measurement tools. Full article

(1) Objectives: A divergence in self- and preceptor-evaluations of clinical skills has been noted during Advanced Pharmacy Practice Experiences (APPEs). The goal of this study was to determine the domains of overestimation of clinical skills by students during their APPE rotations. (2) Methods: Preceptor-assigned grades for APPE rotations from 2017–2022 were analyzed to identify instances of letter grade B or lower. The self- and preceptor-evaluations of APPE rotation were compared to determine the domains of divergence in evaluation between students and preceptors. (3) Results: Between 2017 and 2022, 305 student APPE rotations were graded as B or lower (~14%) by the preceptors. A statistically significant difference was noted between self- and preceptor-assigned letter grades across all practice settings including ambulatory patient care, community pharmacy, general medicine patient care, hospital/health system pharmacy, and special population patient care APPE rotations. In addition, examining the self- and preceptor evaluation rubric for these rotations revealed a statistically significant overestimation of clinical skills by students in all 9 domains of APPE evaluation. Finally, the divergence in the rating of clinical skills between student- and preceptor evaluation was found to be highest in the domains of planning and follow-up of patient care, disease knowledge, and communication with patients. (4) Conclusions: Students who fail to exhibit exemplary practice readiness during APPEs tend to overestimate their clinical skills in all domains of APPE evaluation. The results from our study support the need for additional avenues to assist in the identification of deficits in student learning before APPEs to increase their self-awareness (metacognition). Full article

(1) Background: This scoping review aims to explore the literature on feedback for pharmacy students during experiential learning, with a focus on identifying the modes of delivery of feedback and the perceived impact of feedback on student learning outcomes. (2) Methods: The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR) guidelines. PubMed, Web of Science, Embase, EBSCO, ERIC, and ProQuest Central were searched electronically from their inception until the end of February 2023 using a combination of keywords and MeSH terms related to feedback, pharmacy education, and student learning outcomes. Data were synthesized narratively. (3) Results: This review included 13 studies published between 2008 and 2022. Almost half of the included studies were conducted in the USA (n = 6, 46%) and reported the perspective of undergraduate pharmacy students (n = 6, 46%). Verbal feedback was the most common mode of feedback delivery (n = 6, 46%). The enablers of effective feedback included timely feedback (n = 6, 46%), feedback provided in a goal-oriented and objective manner (n = 5, 40%), and student-specific feedback (n = 4, 30%). On the other hand, the most common impediments to feedback efficacy were providing extremely positive feedback and lack of constructive criticism. (4) Conclusions: Our findings highlight the importance of feedback model implementation in pharmacy education and preceptor training programs to ensure effective and quality feedback to pharmacy students. Full article

Students are required to complete supervised practice hours prior to becoming Registered Dietitians and Physician Assistants. Research suggests that environmental and social factors affect dietetic interns’ diets during their internship, although these factors have not been studied among physician assistant interns. This cross-sectional study utilized an online survey to compare dietetic interns’ (n = 81) and physician assistant interns’ (n = 79) fruit and vegetable intake, food security, barriers to healthy eating, and empowerment for making healthy dietary choices during an internship. Differences were assessed via independent t-tests and chi-square distributions. The significance was set at p < 0.05. Dietetic interns had a higher vegetable intake (p = 0.002) while physician assistant interns had higher rates of food insecurity (p = 0.040). Dietetic interns reported a greater impact on their dietary choices due to mental fatigue (p = 0.006), while physician assistant interns’ dietary choices were more heavily impacted by peer influence, interactions with patients, and interactions with preceptors (p < 0.05). There was not a group difference in overall empowerment (p = 0.157), although both groups rated empowerment for asking for help with food and nutrition challenges the lowest of the empowerment sub-items. Addressing interns’ unique needs may support students’ educational success and wellbeing once they are professionals, promote a diverse workforce, and ensure optimal care for patients. Full article

Morphing structures are a relatively new aircraft technology currently being investigated for a variety of applications, from civil to military. Despite the lack of literature maturity and its complexity, morphing wings offer significant aerodynamic benefits over a wide range of flight conditions, enabling reduced aircraft fuel consumption and airframe noise, longer range and higher efficiency. The aim of this study is to investigate the impact of morphing horizontal tail design on aircraft performance and flight mechanics. This study is conducted on a 1:5 scale model of a Preceptor N-3 Pup at its trim condition, of which the longitudinal dynamics is implemented in MATLAB release 2022. Starting from the original horizontal tail airfoil NACA 0012 with the elevator deflected at the trim value, this is modified by using the X-Foil tool to obtain a smooth morphing airfoil trailing edge shape with the same $C_{L_{\alpha }}$. By comparing both configurations and their influence on the whole aircraft, the resulting improvements are evaluated in terms of stability in the short-period mode, reduction in the parasitic drag coefficient $C_{D_0}$, and increased endurance at various altitudes. Full article