BackgroundVirtual patients (VPs) are a sub-type of healthcare simulation that have been underutilised in health education. Their use is increasing, but applications are varied, as are designs, definitions and evaluations. Previous reviews have been broad, spanning multiple professions not accounting for design differences.ObjectivesThe objective was to undertake a systematic narrative review to establish and evaluate VP use in pharmacy. This included VPs that were used to develop or contribute to communication or counselling skills in pharmacy undergraduates, pre-registration pharmacists and qualified pharmacists.Study selectionEight studies were identified using EBSCO and were quality assessed. The eligibility criteria did not discriminate between study design or outcomes but focused on the design and purpose of the VP. All the included studies used different VP applications and outcomes.FindingsFour themes were identified from the studies: knowledge and skills, confidence, engagement with learning, and satisfaction. Results favoured the VPs but not all studies demonstrated this statistically due to the methods. VP potential and usability are advantageous, but technological problems can limit use. VPs can help transition knowledge to practice.ConclusionsVPs are an additional valuable resource to develop communication and counselling skills for pharmacy students; use in other pharmacy populations could not be established. Individual applications require evaluation to demonstrate value due to different designs and technologies; quality standards may help to contribute to standardised development and implementation in varied professions. Many studies are small scale without robust findings; consequently, further quality research is required. This should focus on implementation and user perspectives.

Pharmacist–patient counselling can benefit patients and optimise care, but appropriate training is required. A virtual patient (VP) tool to teach pharmacists non-vitamin K oral anticoagulant counselling was developed; the VP may be used for continuing professional development. The objective was to develop and show proof of concept of the VP. A cyclic development approach was adopted whereby the client, developers and a steering group informed VP design, content and aesthetic. This included formal and informal evaluation; ethical approval was not required. The VP received varied feedback. Positive feedback concerned the technology and the high-standard of animations. Negative elements concerned international VP use and differences in practice, also technological comments, regarding VP delivery and usability on various electronic devices. The VP was reported to be ‘valuable’ and realistic with high-quality animations. The steering group commented on VP’s clinical appropriateness, cultural relevance and usability. Areas highlighted for improvement were rectified during development, including the incorporation of printable feedback. European considerations concerned differences in culture and practice. The development process successfully developed the VP and the proof of the concept was demonstrated. This will inform future VP development; a large-scale VP evaluation is underway.

BackgroundThe COVID-19 pandemic resulted in a loss of clinical clerkship opportunities for medical students. To address this problem while maintaining patient safety, this pilot study explored the feasibility of using a wearable headset to live stream teaching ward rounds to remotely based medical students.MethodsThree live streamed teaching ward rounds were delivered to three groups of medical students (n=53) using the Microsoft HoloLens 2 device and Microsoft Teams software, and results pooled for analysis. Feedback was gathered from students and instructors using the evaluation of technology-enhanced learning materials (ETELM). Patient feedback was gathered using the Communication Assessment Tool to explore any impact on interpersonal communication.ResultsThe response rate for the ETELM-learner perceptions was 58% (31/53), 100% for the ETELM-instructor perceptions. Students strongly agreed that the overall quality of the teaching session and instructors was excellent. However, 32% experienced issues with audio or video quality and one remote student reported cyber sickness. The statement ‘educational activities encouraged engagement with session materials/content’ returned the most varied response. Instructors reported technological problems with delivery while using the HoloLens 2 device and environmental noise in the ward was a disruptive factor. Preparation and skilled facilitation were key to delivering a high-quality teaching session. Patients reacted generally favourably to the technology and no negative effects on interpersonal communication were identified.ConclusionThe experience of live streamed ward rounds was well received by patients, medical students and teaching faculty. However, there remain limitations to the routine use of HoloLens 2 technology in our setting including steep learning curves, hardware costs and environmental factors such as noise and WiFi connectivity. Live streamed ward rounds have potential postpandemic implications for the judicious use of resources, and the possibility for few educationally minded clinicians to teach at scale in a patient-friendly manner.

The HCR-20 is the most widely used structured professional judgement instrument for assessing risk of violence. Recent developments in secure settings have addressed service user involvement in risk assessment to empower service users, and encourage them to take responsibility for their pathway through hospital. This audit aimed to examine the quality of, and service-user involvement in, the HCR-20 assessments completed on two wards (a low secure and a psychiatric rehabilitation ward) within Somerset Partnership NHS Foundation Trust. Data from the current RiO (electronic patient record system) Risk Screen and Risk Information sections and the most up-to date HCR-20 report (if there was one) was reviewed across a number of domains. The in-house HCR-20 training programme appeared to be effective, with most assessors following the appropriate data collection process. The quality of the risk assessments was mixed with the historical section being more consistently completed than the clinical and risk sections. The results of the audit facilitated the development of standards for the completion of HCR-20 risk assessments on the two wards reviewed. Limitations of the audit in terms of generalisation are noted. Nonetheless, this audit serves to give an early impression on the extent of collaboration with service users on risk assessments.

The training missions offered by FTW have successfully provided education to both UK and Vietnamese surgeons in Craniofacial surgical techniques and patient care. No negative responses were identified in both questionnaires. The feedback provides evidence of FTW's effective training program, while allowing insight into where further improvements can be made.

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BackgroundInterventions for anger represent the largest body of research on the adaptation of cognitive behavioural therapy (CBT) for people with intellectual disabilities. The extent to which the effectiveness of these interventions reflects the behavioural or cognitive components of CBT is uncertain. This arises in part because there are few measures of anger-related cognitions. MethodThe Profile of Anger-related Cognitions (PAC) is built around interpersonal scenarios that the participant identifies as personally anger-provoking, and was designed as an extension of the Profile of Anger Coping Skills (PACS). A conversational presentational style is used to approach ratings of anger experienced in those situations and of four relevant cognitive dimensions: attribution of hostile intent, unfairness, victimhood, and helplessness. The PAC, and other measures, including the PACS, was administered to (i) people with ID identified as having problems with anger control (n=12) and (ii) university students (n=23); its psychometric properties were investigated and content analyses were conducted of participants' verbal responses. In a third study, clinicians (n=6) were surveyed for their impression of using the PAC in the assessment of clients referred for help with anger problems. ResultsThe PAC had good consistency and test-retest reliability, and the total score on the four cognitive dimensions correlated significantly with anger ratings but not with impersonal measures of anger disposition. The predominant cognitions reported were perceptions of unfairness and helplessness. People with ID and university students were in most respects very similar in both the psychometric analyses and the content analyses of their verbal responses. The PAC had high acceptability both to people with ID and to clinicians. ConclusionsThe PAC may be a useful instrument for both clinical and research purposes. Personal relevance and the conversational mode of administration are particular strengths.