Background The National Medical Commission (NMC) of India has redesigned the graduate medical education program to equip Indian medical graduates with essential information, skills, attitudes, values, and responsiveness as physicians in their initial interactions with the community. Central to this initiative is the Attitude, Ethics, and Communication (AETCOM) module, designed as a guide for educators and institutions to implement a comprehensive, long-term program. This aims to ensure that students develop competency as clinicians, leaders, team players, communicators, lifelong learners, and professionals. Objectives The aim of this study is to evaluate students\' perceptions of the AETCOM modules during their first year. Methodology This cross-sectional study was conducted at BLDE (Deemed to be University), Vijayapura, India, utilizing self-administered, semi-structured questionnaires for data collection. The study included second- and third-year medical students, with all respondents who submitted their responses being included in the study. The total sample size comprised 123 students. Results Ninety-eight percent of the students agreed that the NMC had taken excellent initiative with the AETCOM module and found its duration sufficient. They suggested that the teaching-learning techniques should include more interactive sessions. Conclusions Feedback from the AETCOM module is crucial for enhancing its effectiveness, and it should be gathered from all medical colleges to propose necessary improvements.

UNASSIGNED: Feedback is a fundamental aspect of aphasia treatments. However, learning from feedback is a cognitively demanding process. At the most basic level, individuals must detect feedback and extract outcome-related information (i.e., feedback processing). Neuroanatomical and neuropsychological differences associated with post-stroke aphasia may influence feedback processing and potentially how people with aphasia (PWA) respond to feedback-based treatments. To better understand how post-stroke aphasia affects feedback-based learning, the current study leverages event-related potentials (ERPs) to (1) characterize the relationship between feedback processing and learning, (2) identify cognitive skills that are associated with feedback processing, and (3) identify behavioural correlates of feedback-based learning in PWA.
UNASSIGNED: Seventeen PWA completed a feedback-based novel word learning task. Feedback processing was measured using the feedback-related negativity (FRN), an ERP hypothesized to reflect the detection and evaluation of outcomes communicated via feedback. Individuals also completed neuropsychological assessments of language (phonological processing, verbal short-term memory) and executive functioning.
UNASSIGNED: PWA elicited an FRN that was sensitive to feedback valence. The magnitude of the FRN was not associated with novel word learning but was strongly correlated with performance on another feedback-based task, the Berg Card Sort. Cognitive variables (information updating, selective attention) but not language variables were associated with novel word learning.
UNASSIGNED: For PWA, feedback processing may be associated with learning in some but not all feedback-based contexts. These findings may inform future research in determining which variables moderate the relationship between feedback processing and learning with the long-term goal of identifying how feedback can be modified to support successful learning during aphasia rehabilitation.

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BACKGROUND: Assessment of undergraduate students using assessment instruments in the clinical setting is known to be complex. The aim of this study was therefore to examine whether two different assessment instruments, containing learning objectives (LO`s) with similar content, results in similar assessments by the clinical supervisors and to explore clinical supervisors\' experiences of assessment regarding the two different assessment instruments.
METHODS: A mixed-methods approach was used. Four simulated care encounter scenarios were evaluated by 50 supervisors using two different assessment instruments. 28 follow-up interviews were conducted. Descriptive statistics and logistic binary regression were used for quantitative data analysis, along with qualitative thematic analysis of interview data.
RESULTS: While significant differences were observed within the assessment instruments, the differences were consistent between the two instruments, indicating that the quality of the assessment instruments were considered equivalent. Supervisors noted that the relationship between the students and supervisors could introduce subjectivity in the assessments and that working in groups of supervisors could be advantageous. In terms of formative assessments, the Likert scale was considered a useful tool for evaluating learning objectives. However, supervisors had different views on grading scales and the need for clear definitions. The supervisors concluded that a complicated assessment instrument led to limited very-day usage and did not facilitate formative feedback. Furthermore, supervisors discussed how their experiences influenced the use of the assessment instruments, which resulted in different descriptions of the experience. These differences led to a discussion of the need of supervisor teams to enhance the validity of assessments.
CONCLUSIONS: The findings showed that there were no significant differences in pass/fail gradings using the two different assessment instruments. The quantitative data suggests that supervisors struggled with subjectivity, phrasing, and definitions of the LO´s and the scales used in both instruments. This resulted in arbitrary assessments that were time-consuming and resulted in limited usage in the day-to-day assessment. To mitigate the subjectivity, supervisors suggested working in teams and conducting multiple assessments over time to increase assessment validity.

UNASSIGNED: Residents must prepare for effective communication with patients after medical errors. The video-based communication assessment (VCA) is software that plays video of a patient scenario, asks the physician to record what they would say, engages crowdsourced laypeople to rate audio recordings of physician responses, and presents feedback to physicians.
UNASSIGNED: To evaluate the effectiveness of VCA feedback in resident error disclosure skill training.
UNASSIGNED: This single-blinded, randomized clinical trial was conducted from July 2022 to May 2023 at 7 US internal medicine and family medicine residencies (10 total sites). Participants were second-year residents attending required teaching conferences. Data analysis was performed from July to December 2023.
UNASSIGNED: Residents completed 2 VCA cases at time 1 and were randomized to the intervention, an individual feedback report provided in the VCA application after 2 weeks, or to control, in which feedback was not provided until after time 2. Residents completed 2 additional VCA cases after 4 weeks (time 2).
UNASSIGNED: Panels of crowdsourced laypeople rated recordings of residents disclosing simulated medical errors to create scores on a 5-point scale. Reports included learning points derived from layperson comments. Mean time 2 ratings were compared to test the hypothesis that residents who had access to feedback on their time 1 performance would score higher at time 2 than those without feedback access. Residents were surveyed about demographic characteristics, disclosure experience, and feedback use. The intervention\'s effect was examined using analysis of covariance.
UNASSIGNED: A total of 146 residents (87 [60.0%] aged 25-29 years; 60 female [41.0%]) completed the time 1 VCA, and 103 (70.5%) completed the time 2 VCA (53 randomized to intervention and 50 randomized to control); of those, 28 (54.9%) reported reviewing their feedback. Analysis of covariance found a significant main effect of feedback between intervention and control groups at time 2 (mean [SD] score, 3.26 [0.45] vs 3.14 [0.39]; difference, 0.12; 95% CI, 0.08-0.48; P = .01). In post hoc comparisons restricted to residents without prior disclosure experience, intervention residents scored higher than those in the control group at time 2 (mean [SD] score, 3.33 [0.43] vs 3.09 [0.44]; difference, 0.24; 95% CI, 0.01-0.48; P = .007). Worse performance at time 1 was associated with increased likelihood of dropping out before time 2 (odds ratio, 2.89; 95% CI, 1.06-7.84; P = .04).
UNASSIGNED: In this randomized clinical trial, self-directed review of crowdsourced feedback was associated with higher ratings of internal medicine and family medicine residents\' error disclosure skill, particularly for those without real-life error disclosure experience, suggesting that such feedback may be an effective way for residency programs to address their requirement to prepare trainees for communicating with patients after medical harm.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT06234085.

BACKGROUND: The usual output following health consultations from paediatric services is a clinical letter to the referring professional or primary care provider, with a copy sent to the patient\'s caregiver. There is little research on how patients and caregivers perceive the letter content. We aimed to: first understand child, young people and caregiver experiences of and preferences for receiving a health feedback letter about the child/young person\'s health measures within a healthy lifestyle programme; and second to provide a set of recommendations for designing letters to children, young people and their families within a healthy lifestyle programme.
METHODS: This qualitative study, informed by Kaupapa Māori principles, included focus groups of children aged 5-11 years and young people aged 12-18 years who were participants in a healthy lifestyle programme in Taranaki, Aotearoa New Zealand and of their respective caregivers (total n = 47). Discussions were audio-recorded, transcribed and analysed using thematic analysis.
RESULTS: Key themes were identified: letters sometimes acted as \'discourses of disempowerment\'-some participants experienced a lack of safety, depersonalisation with medical jargon and \'feeling like a number\'. Participants described the need for acknowledgement and affirmation in written communication-health feedback should include validation, choice regarding content, respectful tone and a strengths-based approach to health messages.
CONCLUSIONS: Letters to referrers, copied to families, can be perceived as disempowering, and participant and caregiver perspectives of content should be considered. This study challenges conventional practice in communicating health feedback with broader implications for written communication in healthcare. We propose separate letters aimed at the child/young person and their caregiver that offer choice in the information they receive. The administrative burden of multiple letters can be mitigated by advances in digital health.
UNASSIGNED: This study originated in response to feedback from service users that current health feedback was not meeting their needs or expectations. Patient perspectives, especially from children, are rarely considered in the generation of clinic letters from health professionals. Participants were child participants in the community-based clinical service and their caregivers, and care was taken to represent the demographic backgrounds of service users. Collection and interpretation of Māori data were led by researchers who were local community members to ensure prioritisation and preservation of participant voice. Where possible, results are illustrated in the text by direct quotes from participants, whose identities are protected with a pseudonym.

UNASSIGNED: The implementation of task sharing and shifting (TSTS) policy as a way of addressing the shortage of physicians and reducing the burden of hypertension in Africa birthed the idea of the African School of Hypertension (ASH). The ASH is saddled with the responsibility of training non-physician health workers across Africa continent in the management of uncomplicated hypertension.
UNASSIGNED: To get feedback from some faculty members and students who participated in the first ASH programme.
UNASSIGNED: This was a cross-sectional exploratory qualitative study conducted among eight students and eight faculty members. Feedback from the program was obtained by conducting in-depth interviews centred on description of course content; expectations and knowledge acquired from ASH; level of interaction between students and faculty members; challenges faced during the ASH; level of implementation of acquired training; and suggestions to improve subsequent ASH programs.
UNASSIGNED: The course content of the ASH was described as simple, appropriate and adequate while interaction between students and faculty members were highly cordial and engaging. New knowledge about hypertension management was acquired by the students with different levels of implementation post-graduation. Some identified challenges with the ASH program were poor internet connectivity during lectures, non-uniformity of TSTS policies and hypertension management guidelines across Africa, technical problems with hypertension management app and low participation from other African countries apart from Nigeria. Some recommendations to improve ASH program were development of a uniform hypertension management guideline for Africans, wider publicity of the ASH, interpretation of lectures into French and Portuguese languages and improvement of internet connectivity.
UNASSIGNED: The ASH programme has largely achieved its objectives with the very encouraging feedback received from both faculty members and the students. Steps should be taken to address the identified challenges and implement the suggested recommendations in subsequent ASH program to sustain this success.

Processing of quantifiers such as \"many\" and \"few\" relies on number knowledge, linguistic abilities, and working memory. Negative quantifiers (e.g., \"few,\" \"less than half\") induce higher processing costs than their positive counterparts. Furthermore, the meaning of some quantifiers is flexible and thus adaptable. Importantly, in neurotypical individuals, changing the meaning of one quantifier also leads to a generalized change in meaning for its polar opposite (e.g., the change of the meaning of \"many\" leads to the change of that of \"few\"). Here, we extended this research to patients with fluent and non-fluent aphasia after stroke. In two experiments, participants heard sentences of the type \"Many/few of the circles are yellow/blue,\" each followed by a picture with different quantities of blue and yellow circles. The participants judged whether the sentence adequately described the picture. Each experiment consisted of three blocks: a baseline block to assess the participants\' criteria for both quantifiers, a training block to shift the criteria for \"many,\" and a test block, identical to the baseline to capture any changes in quantifier semantics. In Experiment 1, the change of the meaning of \"many\" was induced by using adaptation to small numbers (20-50%) of circles of the named color. In Experiment 2, explicit feedback was given in the training block after each response to rate proportions of 40% (or higher) as \"many,\" whereas 40% is normally rather rated as \"few.\" The objective was to determine whether people with fluent or non-fluent aphasia were able to process quantifiers appropriately and whether generalized semantic flexibility was present after brain damage. Sixteen out of 21 patients were able to perform the task. People with fluent aphasia showed the expected polarity effect in the reaction times and shifted their criteria for \"many\" with generalization to the untrained quantifier \"few.\" This effect, however, was only obtained after explicit feedback (Experiment 2) but not by mere adaptation (Experiment 1). In contrast, people with non-fluent aphasia did not change the quantifier semantics in either experiment. This study contributes to gaining new insights into quantifier processing and semantic flexibility in people with aphasia and general underlying processing mechanisms.

BACKGROUND: Developing L2 speaking proficiency can be challenging for learners, particularly when it comes to fostering self-regulation and maintaining engagement. Intelligent Personal Assistants (IPAs) offer a potential solution by providing accessible, interactive language learning opportunities.
METHODS: This mixed-methods study investigated the effectiveness of using Google Assistant within a learning-oriented feedback (LOA) framework to enhance L2 speaking proficiency, self-regulation, and learner engagement among 54 university-level EFL learners in China. Convenience sampling assigned participants to either an experimental group (n = 27) using Google Assistant with tailored activities or a control group (n = 27) using traditional methods. The Oral Proficiency Interview (OPI) assessed speaking performance. Self-reported questionnaires measured L2 motivation and the Scale of Strategic Self-Regulation for Speaking English as a Foreign Language (S2RS-EFL) evaluated speaking self-regulation. Additionally, semi-structured interviews with a subsample of the experimental group provided qualitative insights.
RESULTS: The Google Assistant group demonstrated a statistically significant improvement in speaking performance compared to the control group. While no significant difference in motivation was found, thematic analysis of interviews revealed perceived benefits of Google Assistant, including increased accessibility, interactivity, and immediate pronunciation feedback. These features likely contributed to a more engaging learning experience, potentially fostering self-regulation development in line with the core principles of LOA.
CONCLUSIONS: This study suggests Google Assistant as a promising supplementary tool for enhancing L2 speaking proficiency, learner autonomy, and potentially self-regulation within an LOA framework. Further research is needed to explore its impact on motivation and optimize engagement strategies.

Lateropulsion is a post-stroke phenomenon marked by an active push of the body across the midline towards the more affected side and/or a resistance of the weight shift towards the less affected side. Within the mechanisms of treatment, feedback systems have been shown to be effective. The aim of the present study was to create a body of knowledge by performing a literature review on the use of feedback mechanisms in the treatment of lateropulsion and to report two cases of lateropulsion patients who had undergone feedback-based treatment.
METHODS: The review was performed across five different databases (Embase, Medline/PubMed, Scopus, Web of Science, and PEDro) up to February 2024, and haptic feedback intervention was incorporated into the case series (with lateropulsion and ambulation capacity as the main variables).
RESULTS: In total, 211 records were identified and 6 studies were included after the review of the literature. The most used feedback modality was visual feedback. In the case series, positive results were observed from the intervention, particularly in the recovery of lateropulsion and balance, as well as in the improvement of gait for one patient. Patients demonstrated good adherence to the intervention protocol without adverse effects.
CONCLUSIONS: Visual feedback is the most commonly used feedback modality in lateropulsion patients but other mechanisms such as haptic feedback also are feasible and should be taken into account. Larger sample sizes, extended follow-up periods, and the isolation of feedback mechanisms must be established to clarify evidence.