The research focused on the concrete structures surrounding a hospital-wide diabetes nursing team system rather than on nurses’ general feelings about employer support or their objectively demonstrated diabetes knowledge. In the participating system, 87 unit-based diabetes liaison nurses—one in each of 77 clinical departments and 10 emergency or outpatient units—worked alongside eight central quality-control members. Liaison nurses remained in their primary departments while helping implement diabetes-related nursing procedures, disseminate training information, provide patient education, communicate with the central team and supervise relevant quality-control requirements. They received additional structured training organised by hospital nursing administration and the diabetes nursing team and were required to participate in diabetes-related training at least once per quarter.

The hospital group’s campuses at Jianhua, Fanxilu and Fangbei operated under unified nursing governance, shared clinical protocols and coordinated training and quality-control processes. Registered nurses providing direct patient care in endocrinology and non-endocrinology departments were eligible, including nurses working in internal medicine, surgery, intensive care, outpatient services and other clinical units. Trainee nurses, student nurses and administrative staff without direct patient-care responsibilities were excluded. Of the 337 participants, 41.2% worked in endocrinology and 58.8% in non-endocrinology departments. Nearly half were senior-level N3–N4 nurses, while 70.9% held supervisor nurse titles. Mean clinical experience was 13.0 ± 6.1 years, and 56 participants, or 16.6%, were diabetes liaison nurses.

Nurses generally rated the organisational system favourably. The mean total score was 79.1 ± 17.1 out of 100, with scores across five conceptually defined domains ranging from 15.5 to 16.0 out of 20. These covered system construction and standardisation, training and competency support, communication and collaboration, resources and incentives, and organisational culture and professional development. Self-assessed diabetes knowledge averaged 16.9 ± 4.6 out of 20, while willingness to engage in further systematic diabetes training averaged 4.2 ± 1.2 on a five-point scale. These results describe nurses’ perceptions rather than verified clinical competence. Although the survey included a supplementary 10-item objective knowledge questionnaire, the study did not formally test agreement between that measure and self-assessed knowledge.

Endocrinology and non-endocrinology nurses reported broadly similar perceptions. There were no significant differences between the groups in overall system satisfaction, any of the five organisational domains, self-assessed diabetes knowledge or willingness to learn, with all p values above 0.05. Because the study was cross-sectional, this similarity cannot show that the hospital-wide model caused equal perceptions or eliminated departmental differences. One possible explanation proposed by the researchers is that unified training and coordination offered comparable support across departments, but that interpretation remains provisional. A clearer role difference appeared for liaison nurses: their training and competency support score was 16.6 ± 3.8, compared with 15.7 ± 3.7 among non-liaison nurses, a statistically significant difference with p = 0.032. Perceived professional development support also differed across professional-title groups, with p = 0.012.

Correlation analysis identified close statistical relationships among organisational perceptions, perceived knowledge and learning willingness. Overall system satisfaction was positively correlated with self-assessed diabetes knowledge, with Spearman’s r = 0.683 and p < 0.001. Training and competency support was positively correlated with willingness to learn, with r = 0.641 and p < 0.001, while organisational culture and professional development support had a similar association, with r = 0.622 and p < 0.001. These coefficients show that nurses reporting greater support also tended to report greater perceived knowledge or willingness to train; they do not establish the direction of those relationships.

Multivariable ordinal logistic regression tested whether the organisational associations remained after accounting for professional characteristics. For each one-point increase in the training and competency support score, the odds of reporting greater willingness to engage in further diabetes training were 1.54 times higher, with a 95% confidence interval of 1.36–1.76 and p < 0.001. Each one-point increase in perceived professional development support was associated with 1.40 times the odds, with a 95% confidence interval of 1.22–1.60 and p < 0.001. By comparison, each additional year of clinical practice had an odds ratio of 1.01, with a 95% confidence interval of 0.95–1.06 and p = 0.844. Professional title was not independently associated with the outcome, and neither was diabetes liaison nurse status, for which the odds ratio was 0.64, with a 95% confidence interval of 0.33–1.24 and p = 0.183.

The assessment tool itself limits how confidently its domain scores can be interpreted. Researchers created it for this organisational context through a literature review, institutional policy review, consultations with senior nursing managers, diabetes specialist nurses and frontline nurses, and three pilot rounds involving 62, 31 and 39 nurses. The final core scale contained 20 items across five conceptually defined domains, with one negatively worded item per domain reverse-scored. Internal consistency was high for the complete scale, with Cronbach’s alpha of 0.917, but only low to questionable for the individual four-item domains, with alpha values from 0.54 to 0.61. Exploratory factor analysis did not reproduce a clear structure matching the five proposed domains; several items overlapped across domains, and reverse-worded items tended to cluster together, suggesting a possible wording effect.

Other study limitations restrict generalisation and causal interpretation. The single-group, online survey captured perceptions at one point in time, and the number of eligible nurses who saw the invitation was not known, so a formal response rate could not be calculated. Voluntary participation may have introduced self-selection, while self-reporting can create social-desirability and common-method effects. The integrated governance and staffing structure of this hospital group may differ from settings with other organisational models, limiting external validity. Most importantly, reverse causation cannot be excluded: nurses who are already motivated to learn may evaluate support more positively, while supportive organisational environments may also encourage learning. The domain-level findings should therefore be regarded as exploratory, and broader use of the instrument would require independent validation, test–retest assessment, confirmatory factor analysis, measurement-invariance testing and cross-cultural evaluation.

Within those bounds, the study’s main contribution is to separate organisational resources from individual role labels when examining continued diabetes learning. The results show that perceived training support and professional development opportunities were associated with nurses’ willingness to undertake further training, whereas the professional characteristics included in the model were not. They also show that the absence of a significant endocrinology–non-endocrinology difference in this hospital group should not be interpreted as proof that specialist influence has been made unnecessary. Instead, the findings provide a testable proposition for longitudinal and implementation research: future studies could examine whether strengthening training pathways, support for professional development and other system resources is followed by measurable changes in objectively assessed nursing competence, care processes and patient outcomes.

Subject of Research: Cross-sectional study of organisational support, self-assessed diabetes knowledge and training willingness among hospital nurses in China

Article Title: Organisational Support for Diabetes Nursing Teams, Self‐Assessed Knowledge, and Training Willingness: A Cross‐Sectional Study

Article References: Si, Y., Liu, J., Zhang, D., Wang, X., Xu, X., & Liu, S. (2026). Organisational Support for Diabetes Nursing Teams, Self‐Assessed Knowledge, and Training Willingness: A Cross‐Sectional Study. Nursing Open, 13(10), Article e70918. https://doi.org/10.1002/nop2.70918

Image Credits: AI Generated

DOI: 10.1002/nop2.70918

Keywords: diabetes nursing, organisational support, continuing education, nursing workforce, professional development, liaison nurses, self-assessed knowledge, cross-sectional study, hospital management, Organisational, Support, Diabetes

The research, led by Jiahui Yu of The First Affiliated Hospital of Guangzhou Medical University and Chao Zhong of Nanfang Hospital, Southern Medical University, evaluated a 480-hour full-time training program delivered to registered clinical nurses selected by their hospitals for advanced organ transplantation specialty training. The trainees came from six Chinese provinces and completed the program in two cohorts between 2022 and 2023. Rather than treating specialty education as an informal apprenticeship, the program was built around a clearly defined sequence of learning stages, each with its own duration, objectives, and assessment structure.

The curriculum unfolded in four phases. The first two weeks, totaling 80 hours, were devoted to advanced nursing practice leadership, giving trainees a grounding in the professional and organizational dimensions of the specialty. This was followed by three weeks — 120 hours — of specialist theoretical coursework covering the scientific and clinical foundations of transplant nursing. The third phase placed trainees in a provincial training-base hospital for four weeks of clinical placement, amounting to 140 hours of hands-on exposure to real transplant care environments. The final four weeks, another 140 hours, consisted of supervised practice in which each trainee worked one-to-one with a mentor, with logbook-guided standardization ensuring that every required competency was systematically documented and verified.

To measure whether this elaborate structure translated into genuine capability, the researchers used the Chinese version of the Nurse Competence Scale, a validated instrument that assesses self-reported nursing competence across seven dimensions, from helping and teaching functions to diagnostic work, case management, and professional development. Trainees completed the scale before the program began and again after its conclusion. The team also collected secondary outcomes, including performance on the program’s completion assessment, satisfaction with teaching measured on an 11-item questionnaire using a five-point Likert scale, and trainees’ self-reported workplace activities six months after finishing the course.

The results were striking. Across the 43 trainees included in the final analysis, mean total Nurse Competence Scale scores rose from 72.74 before training to 80.44 afterward — a mean difference of 7.70 points, with a 95 percent confidence interval of 6.87 to 8.53 and a p-value below 0.0001. The standardized effect size, Cohen’s dz, reached 2.86, an exceptionally large value indicating that virtually every trainee improved substantially. Importantly, the gains were not confined to a single domain: significant improvements appeared across all seven dimensions of the competence scale, suggesting that the program’s integrated design benefited technical, communicative, and professional capacities alike.

Satisfaction with the program was similarly emphatic. The mean overall teaching satisfaction score was 4.88 out of a possible 5, and of the 473 individual item-level responses collected across the questionnaire, 470 — or 99.37 percent — were rated as satisfied. For a program demanding nearly three months of full-time commitment from working nurses, this near-universal approval suggests that the balance of theory, clinical exposure, and mentorship resonated strongly with participants.

Perhaps the most consequential findings emerged at the six-month follow-up, which probed whether newly acquired competence translated into changed behavior back at trainees’ home institutions. Every single trainee — 100 percent — reported organizing complex case discussions after returning to work. Nearly all, 93.0 percent, reported conducting teaching rounds and quality improvement activities, while 60.5 percent reported providing nursing consultations. These figures imply that the program did not merely produce better individual practitioners; it seeded a network of nurses capable of leading education, quality initiatives, and specialist consultation across hospitals in multiple provinces.

The study also uncovered an intriguing pattern in who benefited most. Changes in Nurse Competence Scale scores were inversely correlated with both age and years of clinical experience: younger, less experienced nurses showed larger gains than their senior colleagues. The correlation coefficient was -0.427 for age (p = 0.004) and -0.493 for clinical experience (p < 0.001). The authors interpret this cautiously, but the pattern is consistent with a well-known phenomenon in education research — a ceiling effect, in which highly experienced nurses have less room to improve on a self-reported competence measure, while early-career nurses have more headroom and respond more visibly to intensive training.

The researchers are careful to frame their conclusions appropriately. Because the study used a single-group pre-post design — with no control group of nurses receiving alternative or no training — it cannot definitively attribute the observed improvements to the program itself. Self-reported competence measures also carry inherent limitations, since they reflect trainees’ perceptions rather than directly observed performance. The authors explicitly describe their findings as preliminary evidence intended to inform specialist nurse education, and they call for controlled, multicenter studies incorporating objective outcome measures, such as Objective Structured Clinical Examinations, to confirm and extend the results.

Even with those caveats, the study arrives at a moment when the demand for transplant nursing expertise is rising globally. As transplantation expands to treat more patients with end-stage organ failure, health systems face a persistent shortage of nurses equipped for the specialty’s unique demands — from perioperative management and immunosuppression monitoring to long-term follow-up and patient education. By demonstrating that a structured, theory-practice integrated model with one-to-one mentorship can produce large, multidimensional gains in self-reported competence and measurable changes in workplace behavior, the Chinese team has provided a concrete, replicable template. If future controlled studies validate these findings, the 480-hour model could become a reference point for transplant nursing education far beyond the six provinces where it was first tested.

Subject of Research: Evaluation of a structured training model for organ transplant specialist nurse trainees

Article Title: Evaluation of a structured training model for organ transplant specialist nurse trainees: a single-group pre–post study with six-month follow-up

Article References: Yu, J., Shi, L., You, L., Huang, D., Zhuo, J., Chen, E., Yang, Q., Wu, D., Li, X., & Zhong, C. (2026). Evaluation of a structured training model for organ transplant specialist nurse trainees: a single-group pre–post study with six-month follow-up. BMC Nursing. https://doi.org/10.1186/s12912-026-05285-5

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05285-5

Keywords: transplant nursing, nursing education, clinical competence, Nurse Competence Scale, specialist training, mentorship, workforce development, pre-post study, organ transplantation, nursing competence, China, continuing education

The research, published in BMC Medical Education by a team led by Chiao-Yin Cheng and Liang-Han Wang of Far Eastern Memorial Hospital, evaluated a continuing education program delivered across nine sessions in New Taipei City between April 7 and June 20, 2026. The course brought together a workforce that rarely trains together: police, fire-based emergency medical services personnel, public health staff, nurses, and mental health outreach workers. This mixed frontline group is typically the first point of contact for people experiencing acute mental health crises, yet evidence about shared education for such a diverse audience has been scarce, particularly in Asian emergency-response systems.

The study used a single-group pre-post design, meaning every participant was assessed before and immediately after the training without a separate control group. Researchers measured four self-reported outcome domains: self-efficacy, cognition toward behavioral emergencies, stigma associated with behavioral emergencies, and stigma associated with substance use. The reliance on anonymous questionnaires posed a genuine analytical challenge. Because no direct identifier was collected, the team could not simply match each person’s before-and-after responses. Instead, the primary analysis was restricted to observed pre and post records linked through a strict demographic key that appeared exactly once in both datasets. No imputation and no timestamp-order matching were used, a conservative approach designed to prevent inflated or spurious pairings.

The numbers tell a clear story about reach and attrition. Of 750 attendees, 714 completed the pre-training questionnaire and 635 contributed complete post-training responses, but only 395 records could be paired under the strict uniqueness rule. Among those 395 matched participants, self-efficacy rose from a mean of 3.16 (with a standard deviation of 0.55) to 3.54 (0.58), a mean difference of 0.39 with a 95 percent confidence interval of 0.34 to 0.44 and a p value below 0.001. The standardized effect size, Cohen’s dz, was 0.76, which in behavioral research is considered a large immediate effect. In practical terms, respondents felt substantially more capable of handling psychiatric emergencies after just one short course.

Cognition, the second domain, also improved but more modestly. Mean scores climbed from 3.81 (0.59) to 3.95 (0.55), a difference of 0.14 (95 percent CI 0.09 to 0.19, p less than 0.001) and a dz of 0.29, a small-to-moderate effect. The pattern makes intuitive sense: a four-hour session can quickly reshape how confident people feel, but shifting factual understanding and mental models about mental illness across a heterogeneous audience is a slower process. Notably, the baseline cognition score was already relatively high, leaving less room for improvement, a ceiling effect that any brief educational intervention would struggle to overcome.

The stigma results are the study’s most thought-provoking finding. Behavioral-emergency stigma scores actually increased slightly after training, with a mean difference of 0.03 (95 percent CI 0.01 to 0.05), while substance-use stigma showed no significant change at all (p equal to 0.716). The small magnitude of the stigma shift may seem trivial, but the direction is worth noting. It is possible that exposure to realistic case discussions made participants more aware of their own implicit attitudes, or that certain training content inadvertently reinforced stereotyped perceptions. The authors are appropriately cautious: with study-specific, non-validated measures and an anonymous design, no firm explanation can be pinned down. What is clear is that a brief lecture-based course did not reduce stigma, challenging the common assumption that education automatically improves attitudes.

Satisfaction data, at least, were strongly positive. Among the 635 observed post-training respondents, agreement or strong agreement across satisfaction items ranged from 84.1 percent to 86.3 percent. That level of endorsement from a mixed audience of police officers, firefighters, nurses, and public health officials is itself notable, because interprofessional training often struggles to feel relevant across professional cultures. The New Taipei City Government Department of Health supported the sessions, and the study was funded by an intramural grant from Far Eastern Memorial Hospital, with the funder having no role in design, analysis, or reporting.

The research builds on a well-known international model, the Crisis Intervention Team approach, which originated in Memphis and has spread across many police departments as a way to improve responses to mental health calls. What distinguishes this Taiwanese study is its genuinely interprofessional scope and its city-wide scale. Rather than training one agency in isolation, it placed all the actors in a prehospital behavioral emergency in the same room, learning the same material. That design reflects a growing recognition in emergency care research that outcomes for people in psychiatric crisis depend on coordination among multiple agencies, and that shared training may build the informal networks and mutual understanding that formal protocols cannot.

Methodologically, the study deserves credit for transparency about its limitations, and the authors follow the TREND guidelines for reporting evaluations with nonrandomized designs. The strict linkage approach means the paired sample of 395 is only a fraction of the full 750 attendees, raising the possibility that those with complete, uniquely matchable demographics differ systematically from the rest, perhaps being more diligent or more distinctive in their demographic profiles. The trial was retrospectively registered with ISRCTN on July 9, 2026, and also listed on ClinicalTrials.gov under NCT07697326. The team explicitly frames the findings as immediate pre-post associations rather than causal evidence of training effectiveness, and they call for future evaluations using unique anonymous identifiers, validated measures, delayed follow-up, and observed performance or service-level outcomes such as actual field behavior and downstream use of coercion or emergency detention.

For policymakers, the message is twofold. On one hand, the large immediate gain in self-efficacy among nearly 400 paired respondents suggests that even brief, low-cost interprofessional courses can move a critical psychological lever: responders who feel confident are more likely to attempt verbal de-escalation rather than default to physical restraint or other coercive measures. On the other hand, the stubborn stigma scores indicate that attitude change requires more sustained, targeted, and ideally longitudinal interventions, possibly involving contact-based approaches, reflective supervision, and repeated exposure over months rather than a single afternoon. As cities worldwide grapple with how to handle a rising volume of mental health-related emergency calls, this Taiwanese experiment offers a pragmatic blueprint, and a candid warning, for the next generation of prehospital crisis training.

Subject of Research: Interprofessional continuing education for prehospital behavioral emergency response among police, EMS, and health personnel in Taiwan

Article Title: Interprofessional continuing education for prehospital behavioral emergency response: a city-wide pre-post study in Taiwan

Article References: Cheng, C.-Y., Wang, L.-H., Chen, Y.-L., Fu, Y.-K., Sun, J.-T., & Ho, H. (2026). Interprofessional continuing education for prehospital behavioral emergency response: a city-wide pre-post study in Taiwan. BMC Medical Education. https://doi.org/10.1186/s12909-026-10646-4

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10646-4

Keywords: behavioral emergency, interprofessional education, continuing education, prehospital care, emergency medical services, de-escalation, mental health stigma, self-efficacy, Taiwan, crisis intervention, police training, medical education

The research team, drawing on pharmacists recruited through professional social networks and pharmacy association groups between March and June 2025, designed the investigation in two phases. The first phase was a cross-sectional survey intended to map who was using AI and why. The second was a quasi-experimental test of whether a single hour of targeted education could soften the attitudes that keep capable professionals away from the technology. Together, the two phases offer one of the most detailed portraits yet of how the digital divide plays out inside a specific health profession in a developing but technologically ambitious country.

The numbers from the first phase are striking. Of the 901 pharmacists surveyed, 75.1 percent reported familiarity with AI, yet only 41.7 percent of the entire cohort said they had actively used AI tools within the previous twelve months. Among those who were familiar with the technology, 55.5 percent had used it. And what they used it for matters: the most common application, cited by 42.3 percent of users, was verifying medication information, while a mere 8.3 percent used AI to analyze patient data or recommend dosages. The researchers suggest this pattern reflects the easy availability of large language models alongside persistent privacy concerns about patient data, a trend consistent with surveys of primary care providers elsewhere.

When the team ran the sociodemographic variables through a multivariable logistic regression, three factors emerged as independent predictors of AI use. Pharmacists who graduated after 2020 had nearly twice the odds of using AI compared with earlier graduates, an adjusted odds ratio of 1.943. Those holding a postgraduate degree had more than twice the odds of diploma holders, at 2.402. And the availability of digital infrastructure in the workplace, meaning reliable internet access, scalable storage, and application hosting, roughly doubled the odds of adoption as well, with an adjusted odds ratio of 2.099. Hospital pharmacists, who benefit from institutional information technology systems, were also significantly more likely to use AI than colleagues in privately owned or chain pharmacies.

The most intriguing finding came from an interaction analysis. The researchers hypothesized that the quality of the digital environment might moderate the apparent generational gap in AI adoption, and the statistics bore this out. Among pharmacists who graduated before 2020 and lacked workplace digital infrastructure, only 16.0 percent used AI. Yet post-2020 graduates maintained a 67.3 percent adoption rate even in low-infrastructure settings, likely by relying on personal mobile devices. When proper digital infrastructure was available, the pre-2020 cohort’s adoption rate jumped to 52.8 percent, shrinking the generational gap from 51.3 percentage points to just 7.1. The authors describe this as a technological friction effect: older pharmacists are not resisting the technology so much as being locked out of environments where it can run.

This framing challenges a common narrative that attributes slow AI uptake in developing countries to generational resistance. The Jordanian data suggest that basic connectivity is an essential leveler, echoing calls from the European Association of Hospital Pharmacists to invest in digital infrastructure, electronic prescribing, and interoperability as prerequisites for AI integration. Comparable studies in Eastern Romania, Switzerland, Greece, and Bulgaria have documented similar structural and educational barriers, indicating that the problem is not confined to the Middle East but mirrors the digitalization struggles of European pharmacy itself.

Income and workload also mattered. Pharmacists earning more than 600 Jordanian dinars per month had higher odds of AI use than the lowest earners, although the wide confidence interval on that estimate suggests some statistical uncertainty. Seeing more than fifty patients a day was independently associated with adoption, perhaps because high patient volumes create pressure to find efficiency tools. Gender, by contrast, dropped out of the picture once other variables were controlled: although the unadjusted chi-square analysis showed slightly higher use among men, the regression model found no meaningful difference between male and female pharmacists.

The second phase of the study addressed a different question: can attitudes be changed cheaply and quickly? Of the original 901 participants, 301 volunteered for a 60-minute educational webinar delivered by an external expert in health informatics and computational pharmacology. The session combined a thirty-minute lecture on AI basics and job-displacement concerns, a twenty-minute live demonstration of AI checking drug interactions, and a ten-minute ethics discussion on data privacy and algorithmic bias. Sessions were repeated bimonthly from April to July 2025 to accommodate different shift patterns, and attitudes were measured immediately before and after using paired categorical analysis with McNemar’s test.

The results were dramatic, at least in the short term. The share of pharmacists who believed AI will replace the need for pharmacists plummeted from 70.0 percent to 24.6 percent, a drop of 45.4 percentage points. Belief that AI involves high operational costs fell from 88.4 percent to 41.5 percent. Concerns about patient data confidentiality dropped by nearly 40 points, while agreement that AI helps provide optimal pharmaceutical care more than tripled, rising from 20.9 percent to 75.4 percent, and trust in AI’s reliability for drug-related information nearly quadrupled, from 15.3 percent to 60.9 percent. Notably, one belief barely moved: agreement that AI requires human oversight rose only from 19.6 percent to 22.9 percent, a change the authors interpret not as resistance but as evidence that the training successfully framed AI as a decision-support aid rather than an autonomous authority, a stance aligned with the Pharmaceutical Group of the European Union’s position that AI should assist, never replace, professional expertise.

The authors are careful about the limits of these findings. The cross-sectional design cannot establish causation, the intervention lacked a control group, and the posttest was administered immediately after the webinar, so only short-term attitudinal shifts are documented, not lasting changes in practice. The volunteers for Phase II may also have been more motivated or technologically adept than their peers, and the online recruitment method may underrepresent pharmacists in remote areas with poor internet access, precisely the population the infrastructure findings highlight. Still, the study’s practical prescriptions are clear: pharmacies need minimum standards for digital infrastructure, continuing education should incorporate AI fundamentals, and mentoring schemes that pair recent graduates’ digital fluency with senior pharmacists’ clinical experience could help close the gap from both directions. Whether a one-hour webinar produces pharmacists who actually use AI years later remains an open question, but the Jordanian data make a strong case that the first barrier to remove is not fear. It is the missing wiring.

Subject of Research: Socioeconomic determinants of artificial intelligence adoption among Jordanian pharmacists and the effect of an educational intervention on their attitudes

Article Title: The digital divide in pharmacy: Socioeconomic determinants of AI adoption and the impact of educational interventions in Jordan

Article References: Al-Tarawneh, A., Abu Dayyih, W., & Abdel-Qader, D. H. (2026). The digital divide in pharmacy: Socioeconomic determinants of AI adoption and the impact of educational interventions in Jordan. Pharmacia, 73, Article e204786. https://doi.org/10.3897/pharmacia.73.e204786

Image Credits: AI Generated

DOI: 10.3897/pharmacia.73.e204786

Keywords: artificial intelligence, pharmacy, Jordan, digital divide, pharmacists, educational intervention, digital infrastructure, health informatics, cross-sectional survey, technology adoption, job displacement fears, continuing education

The research team, led by Mohsen Mollahadi of the Nursing Care Research Center at Baqiyatallah University of Medical Sciences in Tehran, distributed a 43-item Wound Care Self-Efficacy Questionnaire, or WCSEQ, to nurses across Iran through internal social messaging applications. Of those who started the survey, 84 percent completed it, yielding 948 full responses with a mean completion time of just 15 minutes. The questionnaire breaks self-efficacy into four domains: Anatomy and Physiology, Care of Chronic and Acute Wounds, Wound Management and Evaluation, and Values and Attitudes. Each domain probes a different facet of the psychological construct of self-efficacy, the belief in one’s own capability to organize and execute the courses of action required to manage a clinical situation.

The overall mean WCSEQ score came in at 209.08 with a standard deviation of 40.60, out of a maximum possible 301 points. That translates to 69.4 percent of the ceiling, which the study’s descriptive benchmarks classify as moderate-to-high self-efficacy. In other words, Iranian nurses generally believe they can handle wound care competently, but there is clear room for improvement, particularly given that chronic wounds, diabetic ulcers, pressure injuries, and surgical site complications are rising across aging populations worldwide.

Breaking the total down by subscale reveals where confidence is strongest and weakest. The Anatomy and Physiology domain averaged 34.89 out of a possible 49, the Care of Chronic and Acute Wounds domain averaged 104.23 out of 147, the Wound Management and Evaluation domain averaged 43.16 out of 63, and the Values and Attitudes domain averaged 26.79 out of 42. The pattern suggests that nurses feel reasonably assured about the technical execution of dressing changes and wound assessment, but the foundational science and the attitudinal components sit slightly lower, hinting that continuing education could target basic physiology and professional attitudes as much as procedural technique.

Before running any multivariable model, the researchers used non-parametric group comparisons with Bonferroni-corrected post-hoc pairwise tests, having first assessed normality with the Shapiro-Wilk statistic. These univariate analyses showed significantly higher total WCSEQ scores among nurses who held a wound or stoma care specialization, who had attended a wound care workshop, who had accumulated longer workshop durations, who performed wound care directly, who carried higher monthly patient caseloads, who worked where a wound clinic was available, who collaborated with wound clinics, and who reported greater familiarity with clinical guidelines. Every one of these comparisons reached statistical significance at p less than 0.05.

The multivariable linear regression then isolated which factors held up independently. The full model explained 29.2 percent of the variance in total WCSEQ scores, with an R-squared of 0.292, an adjusted R-squared of 0.272, and an F statistic of 14.58 on 26 and 920 degrees of freedom, p less than 0.001. Guideline familiarity dominated the model, with standardized beta coefficients ranging from 0.211 to 0.431 relative to nurses reporting very low familiarity, all p values below 0.001. That is a substantial effect size for a survey-based predictor, and it dwarfs the contributions of every other variable in the equation.

Several other factors remained independently significant after adjustment. Direct wound care experience carried a standardized beta of 0.120, p less than 0.001. Cumulative years of experience carried a beta of 0.114, p less than 0.001. Wound and stoma care specialization carried a beta of 0.104, p equal to 0.005. Collaboration with a wound clinic carried a beta of 0.073, p equal to 0.029, and willingness to participate in more workshops carried a beta of 0.059, p equal to 0.039. Interestingly, workshop duration longer than 30 hours was independently associated with higher scores in two specific domains, Anatomy and Physiology and Wound Management and Evaluation, but not with the total score, suggesting that extended training shapes foundational knowledge and evaluative skill more than it moves overall confidence.

The authors are careful about interpretation, and rightly so. Because the design is cross-sectional and the sampling is convenience-based, the findings reflect associations rather than causation. Nurses who feel more confident may seek out guidelines, or guideline exposure may build confidence, or both directions may operate simultaneously. The study also relies on self-reported self-efficacy rather than observed clinical performance, so it measures perceived capability, not necessarily actual wound care quality. Still, the consistency of the guideline familiarity signal across both univariate and multivariable analyses makes it a compelling target for intervention research.

The practical implications are considerable for health systems far beyond Iran. If structured continuing education programs, interprofessional clinic collaboration, and the integration of national wound care guidelines into routine clinical workflows were tested in longitudinal and interventional studies, health systems could determine whether boosting self-efficacy translates into better wound outcomes, fewer complications, and lower costs. Chronic wound management already consumes enormous healthcare resources globally, and nursing confidence sits at the front line of every dressing change, every pressure injury risk assessment, and every patient conversation about healing. The study, approved by the Institutional Review Board of Baqiyatallah University of Medical Sciences under approval number IR.BMSU.BAQ.REC.1404.086 and adhering to the Declaration of Helsinki with electronic written informed consent, offers a rigorous baseline for that next phase of research, and its message is clear: putting evidence-based guidelines directly into nurses’ hands may be the most efficient lever for building the confidence that quality wound care depends on.

Subject of Research: Nursing Research

Article Title: Wound care self-efficacy among nurses in Iran: a cross-sectional analytical study

Article References: Mollahadi, M., Shabani, S. M. H. K. S., Dehi, M., Jamshidi, Z., Jafari-Oori, M., & Raei, M. (2026). Wound care self-efficacy among nurses in Iran: a cross-sectional analytical study. BMC Nursing. https://doi.org/10.1186/s12912-026-05548-1

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05548-1

Keywords: wound care, self-efficacy, nurses, WCSEQ, clinical guidelines, Iran, nursing education, cross-sectional study, BMC Nursing, continuing education, Wound, care

The stakes are considerable. According to the International Agency for Research on Cancer, roughly 20 million new cancer cases and 9.7 million cancer deaths were recorded globally in 2022, and the burden is projected to grow by 77 percent in new cases by 2050, with mortality nearly doubling. Cancer remains a leading cause of death in China, and dying patients and their families endure profound physical, psychological, social, and spiritual distress. In a global expert assessment of end-of-life care quality across 81 countries and regions, China ranked 53rd, a finding that the study team describes as an urgent call to strengthen how terminally ill patients are cared for in their final days.

Nurses, who have the most frequent contact with dying cancer patients, sit at the center of this challenge. Prior research has shown that they often lack knowledge of end-of-life care, and that gaps in knowledge are reflected in their attitudes and behaviors. Previous training efforts have had mixed results: a Swedish randomized trial improved communication skills but focused narrowly on end-of-life communication, while a Turkish course increased nurses’ acceptance of death but also heightened their fear of it. The Chinese team’s earlier CARES-based course improved attitudes and behaviors but lacked grief support and practice guidelines, and its pre-post design could not exclude environmental biases.

To close these gaps, the researchers built their program on two foundations. First, they developed a supportive care strategy list for end-of-life cancer patients, grounded in supportive care theory and clinical guidelines. Second, they used the Delphi method — a structured consensus process among experts — to construct a training curriculum covering dying phase identification, symptom management, psycho-emotional care, family engagement, and bereavement support. The design draws explicitly on the knowledge-attitude-practice (KAP) model, a widely used framework in health education that holds that knowledge provides the foundation for attitudes, attitudes drive behavioral change, and improved practice ultimately achieves better health outcomes.

The intervention itself was substantial: 18 classes of 45 to 60 minutes each, delivered weekly over seven weeks in February and March 2024. Content was organized into six modules, ranging from an overview of end-of-life supportive care and recognition of the terminal phase, through end-of-life communication, patient-centered symptom and comfort care, family-centered care, and finally bereavement support for families after death. Instruction deliberately avoided passive lecturing alone, incorporating case analyses, role-playing, scenario simulations, video-based learning, and hands-on operational demonstrations. Four instructors — clinical oncology nurses with more than a decade of experience and faculty of the Chinese Nursing Association’s Hospice and Palliative Care Nursing Specialist Training Program — delivered the course, and assessment included situational simulations and reflective summaries.

The study enrolled 28 matched pairs of nurses from 28 clinical departments at Peking University Cancer Hospital, with one nurse per department volunteering for training and a demographically matched colleague serving as a wait-list control. Matching covered age, gender, education level, nursing rank, and years of oncology nursing experience, with experience differences capped at three years. One control participant withdrew after resigning, leaving 27 complete pairs. Baseline questionnaires were collected in late February 2024, and follow-up assessments occurred roughly eight months after training, from late November to early December 2024. The team measured knowledge with a purpose-built 50-item End-of-Life Care Knowledge Questionnaire spanning seven domains, attitudes with the Chinese-validated Frommelt Attitude Toward Care of the Dying Scale, and behaviors with a 31-item practice questionnaire developed by the same group.

The results on knowledge were striking. The training group’s total knowledge score rose from 103.19 before the intervention to 131.41 at follow-up, a statistically significant gain, while the non-training group’s score moved only from 106.22 to 111.48, a change that did not reach significance. In inter-group comparisons after the intervention, the trained nurses outperformed their matched colleagues in the total score and in six of the seven knowledge domains — everything except emotional and spiritual support. Within the training group, every domain improved, including overview of the dying, pain management, comfort management, airway management, restlessness and delirium management, emotional and spiritual support, and nurses’ self-care. The control group showed no significant change in any domain except pain management.

Attitudes shifted as well. Both groups began with relatively high attitude scores — 120.89 for the training group and 117.44 for the controls on the Frommelt scale — but the trained nurses rose significantly to 128.11 at follow-up, while the control group’s change was not statistically significant. The researchers attribute this to the curriculum’s emphasis on the importance and urgency of terminal-phase care, its use of real clinical cases and authentic feedback from patients and families, and its ability to alleviate nurses’ apprehensions while fostering professional engagement. Notably, roughly half of the participating nurses had received either no prior end-of-life care training or only brief sessions under 60 minutes, underscoring how much structured education was needed.

Behaviors told a more nuanced story. Within the training group, all five behavioral domains — pain and comfort management, airway management, restlessness and delirium management, emotional and spiritual support, and self-care — improved significantly, with the total behavior score climbing from 69.48 to 82.91. Yet the inter-group comparison after the intervention showed no statistically significant difference between the two groups. The researchers offer two explanations. First, raw scores did shift, with the control group starting slightly higher and the training group ending slightly higher, and the data imputation strategy used for nurses without dying-patient care experience may have underestimated the intervention’s effect. Second, and more intriguingly, the two groups worked in the same departments: the trained nurses served as role models, and their clinical practices provided observational learning opportunities and encouragement for their untrained colleagues, consistent with Bandura’s social learning theory. This spillover effect, while scientifically complicating the comparison, is arguably a practical benefit — the training’s influence radiated beyond the classroom.

The authors are candid about the study’s limitations. It was a single-center, quasi-experimental trial with a small sample, not a randomized controlled trial; the shared-department design introduced confounding through information sharing; convenience sampling may limit generalizability; the curriculum was tested only at a specialized oncology hospital; the eight-month follow-up differs from the six-month benchmarks common in educational intervention studies; and all outcome measures were self-reported, exposing the results to self-report, social desirability, recall, and observation biases. The analysis also did not correct for multiple testing across subscales, and the female-predominant sample precluded sex or gender subgroup analysis. Even so, the consistency of knowledge and attitude gains, sustained at eight months, offers a compelling case. The team recommends that the program be incorporated into continuing education for oncology nurses and paired with sustained quality improvement initiatives, so that evidence-based supportive care strategies become embedded in routine clinical practice — and so that dying cancer patients, and the families who love them, receive care that is competent, compassionate, and dignified.

Subject of Research: Effect of a structured end-of-life care education program on oncology nurses' knowledge, attitudes, and care behaviors

Article Title: Effect of the end-of-life care education program on improving oncology nurses’ knowledge, attitudes, and behaviors: A quasi-experimental study

Article References: Yu, W., Hou, X., Guo, R., Wang, Y., Ma, X., Pang, D., & Lu, Y. (2026). Effect of the end-of-life care education program on improving oncology nurses’ knowledge, attitudes, and behaviors: A quasi-experimental study. iScience, 29(11), Article 117836. https://doi.org/10.1016/j.isci.2026.117836

Image Credits: AI Generated

DOI: 10.1016/j.isci.2026.117836

Keywords: end-of-life care, palliative care, oncology nursing, nursing education, quasi-experimental study, knowledge-attitude-practice model, bereavement support, symptom management, cancer care, China, iScience, continuing education

The first of the two resources, the Lifestyle Medicine Medical School Curriculum, is a turnkey program intended to weave evidence-based nutrition and broader lifestyle medicine content through all four years of undergraduate medical training. It arrives as medical schools face encouragement to provide at least 40 hours of nutrition instruction, with the federal expectation beginning in Fall 2026. Rather than leaving schools to build their own courses from scratch, the curriculum functions as a ready-made scaffold that institutions can adapt. It includes 10 learning modules covering all aspects of lifestyle medicine education, including the required nutrition content, delivered through virtual learning units, clinical application opportunities, and assessment tools designed to support competency development.

Importantly, the curriculum does not treat nutrition as an isolated topic. It situates dietary science within the six pillars of lifestyle medicine: nutrition, physical activity, restorative sleep, stress management, social connectedness, and avoidance of risky substances. Students encounter clinical cases, nutrition assessment exercises, behavior change strategies, and patient communication approaches that emphasize real-world application. The goal, according to the college, is to help future physicians understand the interconnected role of these factors in treating, reversing, and preventing chronic disease, and to translate that understanding into clinical practice rather than memorizing isolated nutrition facts for examinations.

Brenda Rea, ACLM’s medical director of education, a physician and registered dietitian nutritionist who also holds credentials as a lifestyle medicine intensivist, framed the need for a longitudinal approach. Medical students, she said, need much more than isolated nutrition lectures; they need an educational experience spread across their training that helps them understand how nutrition and other lifestyle factors influence chronic disease and how to apply that knowledge with patients. She described the college’s goal as making high-quality nutrition and lifestyle medicine education easier for medical schools to implement and more meaningful for the physicians those schools produce.

To lower the barrier to adoption further, the medical school curriculum comes with complimentary access to the ACLM Culinary Medicine Curriculum and the Culinary Medicine Program. These open-source resources provide nearly 15 hours of self-paced video instruction along with a comprehensive teaching toolkit. The culinary medicine materials are designed to prepare clinicians, clinicians in training, and members of the public to incorporate optimal nutrition into daily eating patterns, adding a practical, kitchen-adjacent dimension to what can otherwise remain an abstract classroom subject. The combination of didactic modules, clinical application, and culinary training reflects a growing recognition that teaching patients to change what they eat requires skills that go beyond reciting dietary guidelines.

The second resource targets clinicians who are already in practice. ACLM has launched the third edition of its online course, Food as Medicine: Nutrition for Treatment and Risk Reduction, a 2.75-hour program intended to help health professionals translate nutrition science into concrete strategies for treating and reducing the risk of common chronic diseases. The course examines evidence-based dietary patterns, food groups, and nutrition strategies related to cardiovascular disease, insulin resistance and type 2 diabetes, obesity, and certain cancers. It also explores the roles of carbohydrate, fat, and protein sources in health outcomes and provides practical approaches to patient-centered nutrition counseling and behavior change.

The learning objectives are explicitly practical. Upon completing the course, participants should be able to describe dietary patterns shown to be effective in treating and reducing the risk of common lifestyle-related chronic diseases, discuss how dietary behaviors affect the development and progression of chronic disease, identify how different macronutrient sources may contribute to disease progression or improvement, and apply foundational strategies to support dietary behavior change. Those objectives mirror the technical core of lifestyle medicine itself: identifying which dietary patterns carry the strongest evidence, understanding the physiological mechanisms linking diet to cardiometabolic disease, and mastering the behavioral techniques that make counseling effective in the exam room.

Michelle McMacken, executive director of nutrition and lifestyle medicine at NYC Health + Hospitals, a board-certified lifestyle medicine physician, emphasized the clinical context in which such training matters. Patients, she noted, hear a constant stream of confusing and often contradictory nutrition messages, which presents health professionals with an important opportunity to provide clear, evidence-based guidance. She described the course as giving members of the interprofessional care team a working command of the evidence and practical strategies for delivering meaningful dietary counseling within the realities of clinical care, where time is short and patients arrive with entrenched habits and conflicting information from social media and marketing.

The intended audience for the course is deliberately broad. Although it may support physicians seeking education relevant to state-level nutrition education requirements, ACLM stresses that requirements vary by state and medical board, and physicians should confirm eligibility with their licensing authority before counting the course toward any mandate. The course is also designed for registered nurses, nurse practitioners, physician associates, registered dietitians, pharmacists, physical and occupational therapists, certified health coaches, and other health professionals working in chronic disease treatment and prevention, as well as clinicians still in training. That breadth reflects the reality that nutrition counseling increasingly happens across an interprofessional team rather than solely through the physician. Participants can earn 2.75 continuing education credits, and the course will remain available through September 14, 2029, giving clinicians a multi-year window to complete it.

The launch arrives at a moment when the American College of Lifestyle Medicine has been steadily building infrastructure to scale lifestyle medicine as a standard of care. Since 2004, the organization has trained more than 100,000 health professionals and made more than 1.75 million hours of accredited continuing education available through courses and conferences for physicians and health professionals. With hundreds of institutional partners worldwide, ACLM describes its mission as helping healthcare move from a system designed to manage disease to one capable of restoring health. The new medical school curriculum and the updated food as medicine course represent that strategy applied at two critical points in the professional pipeline: the training of future physicians who will soon be required to learn nutrition at a defined minimum level, and the continuing education of the existing clinical workforce that must counsel patients today. If medical schools adopt the turnkey model at scale, the initiative could accelerate the integration of evidence-based nutrition and whole-person care into mainstream medical training, bringing the treatment of root causes of chronic disease closer to the center of American clinical practice.

Subject of Research: Lifestyle medicine and nutrition education resources for medical schools and practicing clinicians

Article Title: ACLM launches two solutions to advance nutrition and lifestyle medicine education, helping meet federal and state requirements

Article References: ACLM launches two solutions to advance nutrition and lifestyle medicine education, helping meet federal and state requirements. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: American College of Lifestyle Medicine, medical education, nutrition education, lifestyle medicine, food as medicine, continuing education, chronic disease, culinary medicine, medical school curriculum, dietary counseling, health professionals, federal requirements

The study, published in BMC Medical Education, enrolled 106 primary healthcare nurses working across 16 primary healthcare units in Indonesia. The units, rather than individual nurses, were randomized to one of two arms of the trial, a design choice that guards against the contamination that would inevitably occur if colleagues within the same clinic experienced different training formats and shared what they learned. Eight units received the board game-based education, while the other eight received a traditional lecture covering the same dengue-related content. Fifty nurses were trained with the game and fifty-six with the lecture, and all participants completed assessments at three time points: before the intervention, immediately afterward, and one month later.

The theoretical architecture behind the game is what distinguishes it from a casual quiz night. The developers grounded the intervention in Kolb’s Experiential Learning Theory, a framework that describes learning as a cycle moving through concrete experience, reflective observation, abstract conceptualization, and active experimentation. Rather than passively receiving information, players encounter realistic dengue scenarios on the board, reflect on the decisions they make, connect those decisions to underlying clinical principles, and then apply revised understanding in subsequent rounds of play. The design was further shaped by the ARCS motivational model, which structures instruction around Attention, Relevance, Confidence, and Satisfaction, four conditions that educational psychologists consider essential for sustaining learner engagement.

The rationale for the work rests on the specific role primary healthcare nurses play in dengue-endemic settings. In Indonesia, where dengue remains a major public health burden, these nurses are responsible for early case detection, initial management, referral decisions, and community-level prevention. Their knowledge and confidence directly shape how quickly a febrile patient is recognized as a potential dengue case and how effectively households in their catchment areas are advised to eliminate mosquito breeding sites. Yet workplace-based dengue education in such settings is still commonly delivered through lectures, a format the researchers note may not fully support active engagement among busy frontline staff who learn best when instruction fits the rhythms of clinical practice.

When the results were analyzed using linear mixed-effects models, a statistical approach that accounts for both the clustering of nurses within units and the repeated measurements taken from the same individuals over time, a clear pattern emerged for knowledge. Dengue-related knowledge showed a statistically significant group-by-time interaction, with F equal to 4.48 and a p-value of .01. In practical terms, the two groups started at similar levels, with the intervention group averaging 4.04 on the knowledge measure at baseline and the control group averaging 4.54, but the game-trained nurses climbed to 5.72 immediately after the intervention while the lecture group reached only 5.43. The board game, in other words, produced a steeper and statistically distinguishable jump in what nurses knew about dengue right after training.

The picture was more nuanced for the other two outcomes. Attitudes toward dengue prevention, measured with a validated Indonesian-language instrument, improved in both groups but did so at statistically similar rates, with the group-by-time interaction falling just short of significance at F equal to 2.57 and p equal to .08. Confidence, assessed with the Indonesian version of the Confidence Scale, rose comparably in both arms as well, with an interaction statistic of F equal to 0.28 and p equal to .76. The authors interpret this convergence carefully: both educational approaches succeeded in improving knowledge, attitudes, and confidence, and the game’s advantage was confined to the immediate knowledge gain rather than extending to how nurses felt about prevention or how assured they were in their own abilities.

One important caveat tempers the headline finding. The board game session was longer than the lecture session, which means the intervention group effectively received more instructional time. The authors explicitly caution that the greater immediate knowledge improvement should be interpreted with this imbalance in mind, since additional exposure to the material, regardless of format, could plausibly account for part of the difference. Disentangling the motivational power of play from the simple effect of longer contact time would require a trial in which the two formats are matched for duration, a refinement that future studies in this line of research will need to address.

What the trial does establish is that a game-based approach is feasible, acceptable, and at least as effective as the status quo. Learning satisfaction was high in both groups, suggesting that neither format alienated participants, but the experiential design of the game aligns with a substantial body of educational theory indicating that active, scenario-driven learning promotes deeper processing than passive listening. For overstretched primary care clinics, the appeal of a board game also lies in its practicality: it requires no digital infrastructure, no internet connectivity, and no specialized equipment, making it a low-cost tool that can be deployed in resource-limited settings where high-tech training platforms are impractical.

The trial was rigorously conducted by the standards of educational research. It was registered with ClinicalTrials.gov under identifier NCT07028411 on 19 June 2025, with the first participant enrolled on 8 August 2025. Ethical approval came from the Institutional Review Board of Universitas Gadjah Mada in Indonesia, and the study was carried out in accordance with the Declaration of Helsinki, with written informed consent obtained from all participants. The reporting followed CONSORT guidelines for randomized trials, and the analysis employed restricted maximum likelihood estimation within the mixed-model framework, with model fit considerations informed by Akaike and Bayesian Information Criteria. The work received no specific grant from any funding agency, and the authors declare no competing interests.

The broader significance of the study extends beyond dengue. Gamified and experiential learning interventions are attracting growing attention in health professional education, but rigorous cluster randomized evidence comparing them head-to-head with conventional instruction remains scarce, particularly in low- and middle-income countries where the educational burden is heaviest. By demonstrating a measurable knowledge advantage, even one tempered by session-length differences, this trial offers a template for how serious games can be evaluated with the same methodological rigor applied to drugs and devices. As the authors conclude, the board game may serve as a promising supplementary approach for dengue education among frontline primary healthcare nurses in endemic settings, a modest cardboard intervention with the potential to reinforce the knowledge that early detection and community prevention depend upon.

Subject of Research: Effects of a board game versus lecture-based education on dengue-related knowledge, attitudes, and confidence among primary healthcare nurses in Indonesia

Article Title: Effects of a board game on dengue-related knowledge, attitudes, and confidence among primary healthcare nurses: a cluster randomized controlled trial

Article References: Hertanti, N. S., Kuo, S.-Y., Kuo, C.-L., Ko, N.-Y., Chung, M.-H., & Chuang, Y.-H. (2026). Effects of a board game on dengue-related knowledge, attitudes, and confidence among primary healthcare nurses: a cluster randomized controlled trial. BMC Medical Education. https://doi.org/10.1186/s12909-026-10561-8

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10561-8

Keywords: dengue, board game, nursing education, cluster randomized controlled trial, primary healthcare, Indonesia, experiential learning, ARCS motivational model, workplace education, knowledge gain, continuing education, public health

The study, led by Larissa Couto-Rosa and colleagues at the Federal University of Espírito Santo, set out to fill a conspicuous gap. International research had repeatedly suggested that pharmacists in many countries hold unsatisfactory knowledge about ASD, which can interfere with the quality of care they deliver. Yet until now, no nationwide study had ever assessed the knowledge of Brazilian pharmacists about the disorder. Given that Brazil has one of the largest pharmacy workforces in the world and a universal health system that relies heavily on pharmaceutical services, the absence of such data was a genuine blind spot in health services research.

To close that gap, the team conducted a cross-sectional survey running from June 2021 to August 2022. Pharmacists from all five regions of Brazil were selected by convenience sampling and answered an online questionnaire, open from June 2021 to February 2022, that collected sociodemographic information and measured both knowledge and stigma related to ASD. The instrument at the heart of the study was the Brazilian version of the Autism Stigma and Knowledge Questionnaire, known as the ASK-Q, a validated tool that breaks understanding of autism into distinct domains: diagnosis, etiology, and treatment, alongside items probing stigmatizing attitudes.

The technical thresholds of the ASK-Q are worth understanding, because they set a demanding bar. To be classified as having adequate knowledge, respondents needed to score at least 92.3 percent on the diagnosis domain, 88.7 percent on etiology, and 92.9 percent on treatment. On the stigma scale, the expectation is even stricter: respondents should not endorse stigma at all, with the cut-off set at 99.01 percent. These are not lenient benchmarks. They require near-complete mastery of facts about how autism is identified, what causes it, and how it is treated, as well as the complete absence of misconceptions that have historically surrounded the condition.

Against those demanding standards, the 413 participating pharmacists performed remarkably well. Almost all respondents demonstrated adequate knowledge in every clinical domain: 99.0 percent reached the threshold for etiology, 99.0 percent for diagnosis, and 98.8 percent for treatment. Perhaps most striking of all, every single participant, 100.0 percent, declined to endorse stigma toward people with autism. In a field where international studies have often painted a more troubling picture of gaps and misconceptions among frontline health workers, the Brazilian results stand out as an unusually strong foundational understanding of the disorder.

The survey also revealed a clear pattern in where that knowledge came from. Pharmacists who had a family member with ASD achieved the highest rates of correct answers in the diagnosis domain, a difference that was statistically significant with a p-value below 0.001. Similarly, pharmacists who had direct contact with a person with autism scored highest on the etiology and diagnosis domains, with p-values of 0.004 and 0.002 respectively. In other words, personal exposure to autism, whether through family ties or professional and social contact, was the strongest predictor of deeper understanding. Knowledge, it seems, travels through lived experience more powerfully than through formal training alone.

The demographic profile of the sample adds important context. The majority of participants, 81.1 percent, were women, which mirrors the composition of the pharmacy profession in Brazil and much of the world. The researchers emphasize that the sample was comprehensive, spanning different age groups and socioeconomic backgrounds across the country’s five regions, which strengthens the generalizability of the findings. At the same time, they are candid about a key limitation: because convenience sampling was used, individuals with greater awareness of or interest in autism may have been more likely to agree to participate. That means the true national average could plausibly be lower than the near-perfect scores reported, a caveat that any interpretation of the results must carry.

The study was conducted with rigorous ethical oversight. It was approved by the Human Research Ethics Committee under registration CAAE 39222520.6.0000.8151, carried out in accordance with the Declaration of Helsinki, and all participants provided informed consent and agreed to confidentiality and privacy statements. The statistical analysis was appropriately matched to the data: descriptive statistics summarized the sample, the Mann-Whitney test compared unpaired samples, and the chi-square test assessed associations with categorical variables. The research received no external financial support and was conducted by a team affiliated with the Federal University of Espírito Santo and the Federal University of Catalão.

Why does pharmacist knowledge about autism matter so much in practice? Pharmacists occupy a unique position in the medication-use system. They counsel families starting new therapies, monitor for adverse effects and drug interactions, and increasingly participate in pharmaceutical care programs within Brazil’s unified health system, the SUS. For autistic patients, who may take psychotropic medications or manage co-occurring conditions, a pharmacist who understands the disorder can communicate more effectively, adapt counseling to sensory and communication needs, and flag inappropriate prescriptions. Conversely, a pharmacist who misunderstands autism may reinforce myths, dismiss family concerns, or fail to recognize when a referral is needed. The near-universal absence of stigmatizing attitudes found in this survey is particularly encouraging, because stigma is often the hardest barrier to dismantle.

The authors argue that their findings should feed directly into policy and education. The results, they write, may contribute to strategies to improve knowledge about ASD, such as continuing education programs, integrating autism training into pharmacy curricula, and public health campaigns. They may also influence public policies, clinical practices, and future research in pharmacy and autism care. Given the strong baseline documented here, the priority shifts from remediation to refinement: embedding structured ASD content into professional education so that understanding does not depend on personal contact with an autistic person. For a profession that sees millions of Brazilians every day, even incremental gains in knowledge could translate into earlier recognition of developmental concerns and better support for autistic individuals and their families, long before they reach a specialist’s office.

Subject of Research: Pharmacists' knowledge and stigma regarding autism spectrum disorder in Brazil

Article Title: Pharmacists’ knowledge about Autism Spectrum Disorder – a national survey

Article References: Couto-Rosa, L., Schultz, P. V., Brambila-Manso, B., Rocha, K. S., Ayres, L., Araújo, D. C., & Santos-Júnior, G. A. D. (2026). Pharmacists’ knowledge about Autism Spectrum Disorder – a national survey. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15564-1

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15564-1

Keywords: autism spectrum disorder, pharmacists, Brazil, national survey, health services research, ASK-Q questionnaire, stigma, pharmaceutical care, continuing education, cross-sectional study, public health, diagnosis knowledge

Psychiatric nursing presents a distinctive set of challenges. Patients frequently experience impaired communication, emotional dysregulation, social isolation, and stigma, and establishing a trusting therapeutic relationship can be slow and difficult. Nurses in these settings rely heavily on empathy, therapeutic communication, and emotional presence, yet the demanding nature of the work exposes them to burnout, emotional exhaustion, and reduced job satisfaction when those emotional resources run dry. Previous research has hinted that aesthetics-based care, which draws on sensory experience, creativity, and reflective practice, correlates with higher levels of compassion, but rigorous educational trials in psychiatric settings have been scarce.

To address that gap, the research team recruited 90 registered nurses from a hospital workforce of roughly 170, all of whom held a bachelor’s degree or higher, had at least six months of psychiatric experience, and consented to participate. Participants were assigned to intervention or control groups of 45 each using a lottery-based allocation. Because blinding was impossible in an educational trial, the study was designed and reported as a quasi-experiment under the TREND reporting guidelines. Data were collected between June 2024 and March 2025, and remarkably, every participant completed the full study, giving a 100 percent response rate with no missing outcome data.

The intervention itself was deliberately experiential. Two nursing faculty members specializing in psychiatric nursing and aesthetics delivered four structured weekly sessions. The first introduced the concepts and theoretical foundations of aesthetics-based nursing care, tracing its history as the art of nursing. The second explored the psychological and spiritual dimensions of care, asking nurses to consider how touch, tone of voice, gestures, and deliberate word choice shape the patient experience. The third focused on empathy, therapeutic companionship, and creativity in solving clinical problems. The fourth summarized the links between aesthetics, job satisfaction, communication, and professional motivation. Between sessions, nurses in small groups of five completed reflective assignments and shared their own lived experiences of aesthetic care.

The researchers measured outcomes using two validated instruments. The Aesthetics of Nursing Care Scale, recently validated in Iran, spans 20 items across five dimensions: compassionate commitment and competence, stress-free care, humanistic attention to the patient, patient satisfaction and comfort, and admirable commitment and competence. The Compassion Competence Scale, developed by Lee and Seomun, assesses 17 items across communication, sensitivity, and insight. Both tools showed strong internal consistency in this sample. Questionnaires were completed before the intervention and again one month after the program ended, an interval chosen specifically to test short-term retention and real-world application rather than immediate post-training enthusiasm.

The results were dramatic. The overall aesthetic care score in the intervention group rose from a baseline of 43.26 to 81.02, while the control group remained essentially flat, moving only from 43.80 to 46.24 over the same period. Every one of the five aesthetic care dimensions improved significantly in the trained group, with between-group effect sizes ranging from roughly 2.0 to 4.1 on Cohen’s d, far beyond the conventional threshold of 0.8 for a large effect. The control group showed no statistically significant change on any measure. To ensure ethical fairness, the control nurses were offered an abbreviated version of the workshop after data collection concluded.

Compassion competence followed the same pattern. Total scores climbed from 40.80 to 60.73 in the intervention group while the control group rose only from 39.35 to 40.71. Communication subscale scores increased to 25.91 versus 18.17 in controls, sensitivity scores to 19.46 versus 12.28, and insight scores to 15.35 versus 10.24. The between-group effect sizes for compassion outcomes ranged from 1.26 to 1.68, again indicating substantial educational impact. No adverse events related to the training were reported during the study period.

The authors attribute these gains to the reflective and participatory character of the program. Group discussion, scenario-based learning, and the sharing of lived clinical experiences appear to encourage nurses to examine the emotional and interpersonal texture of their work, heightening self-awareness and sensitivity to patients’ needs. This aligns with prior qualitative work showing that aesthetic experience fosters more humane, empathetic connections with patients and helps convert intuitive understanding into artistic, attentive behavior. Importantly, the study suggests that compassion competence, often treated as a fixed personal quality, can be cultivated through structured education, potentially protecting nurses against the emotional labor and burnout that accumulate in psychiatric environments.

The implications extend to nursing curricula, orientation programs, and continuing professional development. Healthcare managers and educators may find that embedding aesthetics-based education into routine staff development strengthens therapeutic relationships, improves patient experiences, and nurtures a more humanistic care culture, particularly in mental health settings where trust and communication are central to recovery.

The researchers caution that the evidence has limits. The study took place at a single hospital, follow-up lasted only one month, and all outcomes were self-reported, leaving room for social desirability bias and expectancy effects, while the absence of blinding and the possibility of a Hawthorne effect cannot be excluded. Patient-centered outcomes such as satisfaction, therapeutic alliance, and clinical recovery were not measured. Larger multicenter trials with longer follow-up, objective measures, and patient-reported endpoints are needed. Even so, the scale of improvement in this trial makes a compelling case that the art of nursing, long celebrated in theory, can be systematically taught and meaningfully improved in the clinic.

Subject of Research: Aesthetics-based educational intervention to improve compassion competence and aesthetic care quality among psychiatric nurses.

Article Title: Effects of an Aesthetics‐Based Educational Intervention on Compassion Competence and Aesthetic Care Quality Among Psychiatric Nurses: A Quasi‐Experimental Study

Article References: Balideh, D., Farokhzadian, J., Miri, S., Shahraki, S. K., & Motamed‐Jahromi, M. (2026). Effects of an Aesthetics‐Based Educational Intervention on Compassion Competence and Aesthetic Care Quality Among Psychiatric Nurses: A Quasi‐Experimental Study. Nursing Open, 13(9), Article e70854. https://doi.org/10.1002/nop2.70854

Image Credits: AI Generated

DOI: 10.1002/nop2.70854

Keywords: psychiatric nursing, compassion competence, aesthetic care, nursing education, quasi-experimental study, therapeutic communication, nurse burnout, reflective learning, mental health care, Iran, humanistic care, continuing education